Caring for Patients With Comorbidities

A comorbidity can be referred to as the presence of one or more additional diseases or disorders co-occurring in concurrence with a primary disease or disorder. Basically, a comorbidity is any additional disorder or disease and it could be more than one. A comorbidity can indicate either a condition existing simultaneously but independently with another condition or a related medical condition. Comorbidities can sometimes be mistaken for complications but they are two different terms.

Due to the advancements in population health management, quality improvement, and improved efficiency of patient care teams, Patients with comorbidities have been able to receive better care.

Quality Improvement in Comorbidities

When seeking to reduce comorbidities using quality improvement, there are three steps to take/areas to focus on. These areas are the disease itself, the workflow, and the patient safety and adverse areas. When it comes to patient safety, electronic data warehouses can affect issues relating to comorbidities. In looking at the data for populations that developed a particular condition, patterns begin to emerge. For example, patients who have had a stroke, no matter the cause, may be unable to reposition or turn themselves. If the care team isn’t made aware of this condition, they may not realize the need to turn the patient periodically – or use a bed that shifts the patient’s position. Even if the stroke wasn’t severe, very heavy or very thin patients may not move much during their hospital stay. A heavy patient may find it easier to remain stationary than expend the effort to turn. A very thin patient with little padding between the skin and bones may be reluctant to turn to different positions as well. You have to look beyond the core condition to see what other factors may play into it. When it comes to quality improvement in comorbidities cases, there are all sorts of correlations like these between seemingly unrelated conditions that can have a profound effect on the quality of care. By integrating data from a variety of sources, an enterprise data warehouse can help you uncover the relationships to provide a more robust picture of the individual – and various populations.

Preventing the Worsening of Chronic DIseases:

 Comorbidities are most frequently associated with chronic diseases and illness. Perhaps because the patient has spent a lot of time in the hospital or because the immune system is already weakened from the numero uno chronic disease. In the United States, there has been an overall increase in chronic diseases in the last few years. The top 10 diseases and health problems are Heart disease, Cancer, Stroke, Respiratory disease, Injuries, Diabetes, Alzheimer’s disease, Influenza and pneumonia, Kidney disease, and Septicemia. A lot of these conditions in the top 10 are chronic diseases that can be prevented or controlled by reason. A lot of them are also interrelated which is a high indicator that a patient is susceptible to developing a comorbidity. For example, two of the recommendations to reduce the chance of heart disease, certain types of cancer, stroke, diabetes, and kidney disease are to eat a healthy diet and get more exercise. This same interrelationship, however, also means: more effort needs to be made to understand how to deal with comorbidities rather than treating each chronic disease in isolation. But treating all conditions simultaneously requires a way of coordinating and analyzing data from multiple sources. All signs point towards a need for coordination of treatment and patient care to prevent redundancy and reduce incidents of patients with comorbidities.

Need for Coordination

What it all points to, especially when working with older adults, is a greater need for care coordination to achieve a clarity of care that isn’t present when looking solely at one chronic condition. Take a patient with diabetes, hypertension, and is extremely overweight. He or she will likely have a primary care physician who may refer them to an endocrinologist to deal with diabetes, an orthopedist to help with joint pain, and a gastroenterologist to help with the GI absorption after the weight-control surgery. All of these highly specialized professionals are looking at the primary condition the patient is coming to them for, but each treatment needs to be balanced with the other treatments and health concerns. All of these comorbidities add layers of complexity. What might have been a simple, clear-cut treatment plan now needs more coordination, more integration, and the ability to track additional levels of patient complications. These complications can include potential interactions from adding new drugs to a treatment regimen. The impact can often be severe – and even life-threatening.