damental shift in the way we think of provider continuity, arguing the need to expand the meaning to include the patient and informal caregivers. Currently, provider continuity is defined by visits over time to the same clinician. Buetow points out that many patients and informal caregivers are co-providers of health care and need to be included in the definition. He argues that provider continuity will not happen if different caregivers attend during successive office visits, fragmenting clinician interaction with the patient or those who care, speak or decide for the patient, and thereby reducing the consistency of the care. Such fragmentation, he posits, may weaken knowledge of the patient and information exchange. This reconceptualization of continuity is especially relevant for young children, older persons and other dependent patients who rely on informal caregivers for health care. Buetow points out that the issue of continuity will only become more critical as the population continues to age.
Towards a New Understanding of Provider Continuity
By Stephen A. Buetow, Ph.D.

Family Practice Networks: Possible Surveillance System for Bioterrorism?
In this study, the authors examine the potential of practice-based research networks to rapidly gather data on time-sensitive topics, such as the early detection of a bioterrorism event. Comparing the results of an electronic survey sent to members of a regional practice-based research network with an instrument mailed to a nationwide random sample of family physicians, researchers found that 1) response rates from electronic practice-based research network surveys are as good as those from traditional surveys using mailed survey instruments to a larger population, 2) the timeliness of response is greatly enhanced using electronic communication within practice-based research networks, and 3) the validity of results emerging from the network is consistent with that obtained by
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Contact: Angela Lower
alower@aafp.org
913-906-6253
American Academy of Family Physicians
5-Oct-2004

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