Access to high-quality primary care |
Universal access without significant geographic, financial barriers |
Limited access due to lack of money, remoteness, illiteracy, travel constraints or limited number of healthcare facilities |
Availability of healthcare professionals |
Sufficient range and number of healthcare professionals who contribute to the primary care team |
Lack of sufficient healthcare professionals perhaps due to lack of training, outward migration or poor employment situation |
Access to specialists |
Specialists immediately available in person (or remotely through telemedicine) for expert assessment |
Specialty expertise may not exist, or may be limited in number or quality |
Diagnostic tests |
Full range of appropriate diagnostic modalities (eg, imaging, laboratory tests) available when needed/appropriate |
Diagnostic tests limited in scope, availability or quality as well as failure to interpret tests correctly |
Communication |
Patients and providers communicate efficiently; consultation and test results exchanged reliably and in timely fashion |
Little or no sharing of medical information |
Care coordination |
Coordinated care facilitates available; accurate and efficient evaluation |
Consultations are delayed; test results are lost, lack of health records to document care |
Follow-up |
Diagnosis enhanced by being able to follow symptom evolution; diagnostic errors are detected and errors ameliorated |
Limited follow-up and discontinuities degrade the ability for diagnostic impressions to evolve |
Affordability of care |
All needed care is affordable and/or covered by insurance |
Care unaffordable, or compromises other basic needs such as food or housing |
Training of healthcare professionals |
Physicians, nurses and all professional staff are well trained. Certification and licensure requirements ensure competency |
Training is sub-optimal. Certification and licensure requirements are deficient |
Availability of health informatics resources |
Mature health informatics resources exist to support clinical care and decision-making |
Health informatics resources including internet access not available especially in remote areas. Unaffordable subscription or download fees for medical information |
Culture |
Culture of safety exists; climate where clinicians not afraid to share and learn from mistakes. Patient-empowerment promoted, patients are partners in care |
Traditional cultures often punitive, which discourages sharing and inhibits learning. Patients more passive care recipients |