A system that facilitates follow up care for patients is a good idea.
It's clearly in the patients best interest. It's in the hospitals best interest as well.
A number of hospitals are doing this already though, using their social workers to arrange follow up care and making sure the patients go. There are also "bundlers" who are doing this, but I suppose they could outsource some of their work to a company like boardrounds. Sometimes a more hands on approach is required, especially when dealing with the elderly.
It's possible, over time, for a pure tech solution to this problem. Ideally it would be integrated within the hospitals EMR (really tough, given the reluctance of EMR's to work with outside solution providers, but I think that will change over time), set up the appointment, and maybe go as far as setting up transportation as well - like integrating with Stat (http://signup.stat.com/ - i have no connection with this company, just a thought). Over the next 10-20 years you will also have a relatively more mobile savvy elderly patient population, which will help this, and other solutions, grow.
> Sometimes a more hands on approach is required, especially when dealing with the elderly.
I'd say that extends to far beyond the elderly. I did the majority of my clinical training in hospitals all throughout Brooklyn, and poor compliance/follow-up was evident across the board for a number of patient populations. Persistent hounding by social workers only proved successful half the time. There are cultural and educational factors at play, in addition to blatant laziness, that I think if addressed would yield improvement.
Like you said, many of the patients just aren't tech savvy, but I'd say more are just not well-informed, educated properly on the importance of continued adherence, and actively engaged in their care. Patients are usually given a card with appointment details scribbled on for when to next see their cardiologist for their CHF, or whatever that is. The period between them walking out of their cardiologist's office to their next appointment is, I guarantee, almost never spent reflecting on their condition or actively taking steps to mitigate the complications, save for taking pills. A patient's conditions are only serious problems to them within the walls of their doctor's office. Once they leave, they're forgotten, understandably, out of fear and comfort and the chaos of life. That's why I think it's critical that a patient receive continuous education and encouragement in the interim between check-ups, to close the gaps and help maintain continuous patient self-conern.
Its in fact a much larger issue than one might think at first and I think Athena Health is trying to do some of that.
For instance I had an early stage melanoma removed and because of various circumstances I had to deal with 5 different doctors and hospitals.
The US is system simply isn't made for this and so I spent a lot of time just understanding what I should follow up on who had what, how to get slides from A - B and so on.
If I ever want to solve something in healthcare this is the issue I wanna solve the most.
* Ideally it would be integrated within the hospitals EMR (really tough, given the reluctance of EMR's to work with outside solution providers.."*
Hospitals and clinics know that they need to open up and share data, but they're frozen in place by outdated technology and a (mostly valid) fear of accidentally violating HIPAA.
