Chronic Disease
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CHRONIC CARE MANAGEMENT (CCM)
ETHC supports and offers comprehensive checks for patients with chronic disease with the help of decision support. The quarterly CCM checks are free to all eligible patients.
The programme is based on the Chronic Care model which is designed to support and treat patients with chronic conditions in the community where the follow up are done regularly throughout each year. The patients with a chronic condition get an opportunity to work with their general practice team to help improve the management of their condition. The CCM programme delivers a continuity of care by integrating various services. It helps to facilitate the patient care from acute episodic care to structured case management.
CCM Programme also facilitates the education of the family around the healthcare conditions and needs of the individual so that the family can support the care management through better and healthy practices at home.
The CCM programme currently includes five modules: Diabetes, Congestive heart failure (CHF), Respiratory Disease (COPD), Cardio-vascular Disease (CVD), Frequent Adult Medical Admissions (FAMA) and Depression.
CCM at ETHC
Using an interdisciplinary approach to care, the ETHC team delivers services to those patients requiring medically complex care that includes medical management, continuous services / interventions, skilled nursing care, wound care, and dialysis. The goal of care is to stabilize the medical condition so the patient can maximize and maintain as much independence as possible.
If you present yourself with any chronic condition at ETHC clinic, you may ask for chronic care management and the benefits that you are eligible for.
CCM Programme
The CCM programme currently includes five modules: Diabetes, Congestive heart failure (CHF), Respiratory Disease (COPD), Cardio-vascular Disease (CVD), Frequent Adult Medical Admissions (FAMA) and the pilot module of Depression.
