Leonard Fromer, MD, Discusses the Best Practices for Transitions of Care Programs

Leonard Fromer, MD, executive medical director, group practice forum and assistant clinical professor, Department of Family Medicine, University of California, says that proactivity and community collaboration are the best tools to aid transitions of care programs in new care delivery models. He explains that the people, assets, and resources found within a community setting can ease the patients’ transition in and out of the hospital, as well to and from primary and specialty care physicians.

Dr Fromer adds that expanding the patient’s care team beyond those who work in the office, making proactive care decisions instead of acting on reactions, and maintaining an active, bidirectional flow of data that follows the patient are “predictors of success.”

“When we look at it that way, when we look at the importance especially in chronic disease of the patient in the community not inside the health system and managing all of those transitions becomes a little more of a lets reach out and make something happen in the right way than wait until it just happens to the patient,” Dr Fromer explains.