Health Complexity
Health complexity (see Figure below) is defined as interference
with standard care by biological, psychological, social, and health
system factors, which require a shift from standard care to individualized
care in order for patient outcomes to improve. "Individualized
care" in the context of Cartesian Solutions, Inc.™ consultations enlists the assistance of integrated care managers. These case
managers, disease managers, or care coordinators help patients
bring their illnesses under control using relationship-based educational, health system
navigation, and advocacy techniques. Employment of a complexity approach to targeting those for individualized care, maximizes the cost savings opportunity associated with integrated physical and mental condition care.
| Health Complexity Requiring Individualized Physical
and Mental Condition Care Integration |
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In the current health care system, there is a tendency to equate
complexity with the acuity, severity, and complications related to
physical or mental illnesses (see Figure below). The concept of complexity used
by Cartesian Solutions, Inc.™ and incorporated into INTERMED-Complexity
Assessment Grid (IM-CAG) methodology, expands complexity to include
the psychological, social, and health system domains, which can also
create barriers to improvement. For instance, essential hypertension
in most patients can be controlled by antihypertensive medications (low acuity/severity).
However, if a hypertensive patient has co-existing memory impairment, lives with an influential
family member that believes that medications "poison" a
person’s body, or speaks little English but must order their
prescriptions by mail, then easily treatable hypertension can become
treatment refractory. These contextually complex situations lead to unnecessary medication additions/alterations
and/or hypertensive complications. Psychological, social, and/or
health system factors in such patients trump the low "acuity/severity" of
physical illness in making the patient "treatment non-responsive."
| Health Complexity |
Health Complexity is the interaction of biopsychosocial and health system factors that
create barriers to clinical and financial improvement. It requires
individualized care for outcome improvement.
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| Illness Acuity/Severity |
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Illness Acuity/Severity is the intensity of general medical or mental condition symptoms and/or
direct clinical service needs. It is a component of health complexity.
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Cartesian Solutions, Inc.™
3004 Foxpoint Rd. - Burnsville, MN 55337
Phone: 952-426-1626 - Fax: 952-426-1200
E-mail: integration@cartesiansolutions.com
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