This is the Healthcare Delivery Providers, part of the Healthcare Marketplace Specialization. This is module 1.1.3 Case Study Review. The learning outcomes for this lecture are that we will understand the key points in the case study for this course. We will understand the settings of care within the case study, and finally we will explore how we are going to use the case study during this course. An acronym I want you to remember is congestive heart failure or CHF and transitional care unit or TCU. So we'll start with Harlan Reeves. Now if you've read the case study which I really hope you have, along with the addendum, you know that Harlan Reeves is a retired mechanic. He has two kids, his wife, Margie, and they, he and his wife lived together, and you can see that he was born in 1944, and so at the time of the study he is 69 years old, and they live in their own home in a state called Oregon which is another state in the United States. So again, here's Harlan looking very smart in his bowtie. I'm a big fan of bowties as well, so we will remember Harlan and his family as he flows through the healthcare delivery system and we will learn about the various components throughout this course. So as you will note in the case study, Harlan suffers from Diabetes. He suffers from heart failure, or what we call congestive heart failure. He has unfortunately had a heart attack and got a stent placed, which is a small tube-like thing which is put in the blood vessels in the heart to open up the blood supply. Unfortunately, he is overweight, has history of smoking and drinking, and now has to take multiple medications everyday. Now this is the critical part of the delivery road map that I will really draw your attention to over and over throughout this course. So let's start getting familiar with this delivery roadmap as we go along. So remember Harlan. And about 14 months ago, he was diagnosed with congestive heart failure. So at first he was being seen with his primary care physician. So that's the primary clinic. Then he was referred to a cardiologist. That's a specialty clinic. So again, we're still in the primary care and specialty clinic box. And then, unfortunately, he was diagnosed with congestive heart failure like I said. And then about seven months ago he had a heart attack at home and then he was admitted from a home to the acute care hospital. So again, here we are with Harlan at home and then he has to be admitted from home to the acute care hospital. After that he is discharged from the hospital to a nursing home. And some other times he's discharged from the hospital, home, with home care. Sometimes he has to go back to his home and follows up with the primary care clinic. So again remember how the care continuum for Harlan works. He starts receiving care with the primary and specialty clinic, is living at home, sometimes has to go into the hospital, and sometimes has to go into the post-acute care facilities and also receives care with some community based services, and then back following up with the primary care clinic. So, again this the delivery road map, that we will be looking at, for Harlan. And we will look at all these various settings of care in the health care delivery system. The other thing to note, which is on the vertical axis is the dependency from lower to higher as the patient goes into the hospital, the acuity or how acutely ill the patient is increases, and obviously as a result of that, the cost of care for the patient or Harlan increases as we move up the vertical axis. So at this time, we will take a short quiz. As you will note in the case study, there are a couple of other very key stakeholders. So the payers that pay for the medical care. So, WestPlan Insurance that Harlan has, and also Medicare. Obviously the wife of the patient, the daughter of the patient, and the son of the patient, as a family unit, also are critical stakeholders. And there are many other stakeholders that we read about in the addendum, the community base services, the support systems and other nongovernmental social service organizations. All of those stakeholders together make up the context in which the delivery system needs to be studied. So in summary, again, I want to stress that I want you to read the case study and the addendum carefully. Especially the parts around the health care delivery system and Harlan's journey. So his journey through the healthcare system will be used to dissect the health care provider care continuum and also, note the very dynamic interplay between the various stakeholders and the delivery system and the patients that help shape where we are and where we will go as we continue to innovate in the healthcare delivery system for tomorrow.
