doctor's bagToday on Twitter, Dale Carter ( @daccarte) , mentioned an article Doctors seeing elderly patients at home saves money, improves care in the Kennebec Journal Morning Sentinel by Gillian Johnston, MD discussing his practice of making home medical visits to his elder clients.

He has been providing this service by utilizing a team approach and states that he is able to gain a better understanding of his patients by seeing their surroundings, if they are taking their medications correctly, eating well, etc.  He can also work with their caregivers to help prevent future problems.

Dr. Johston states that seeing his patients helps to avoid ER visits and by “avoiding a single E.R. visit or hospital admission (we) can save more than enough money to cover the cost of home-based care, which not only costs less to provide, but is more appropriate for this population”.

He also states that “The Veterans Affair’s Home-Based Primary Care program has been operating a similar program for more than 30 years in nearly every state and in rural as well as urban areas. It has seen reductions in hospital days by nearly two-thirds, nursing home days by 88 percent and reduced costs associated with these patients by nearly a quarter.”

Not only that, but this Veteran’s program is one of the most popular of the Veteran’s programs that are offered.

My father has been seen in the ER 4 times in the past 2 months and each time has undergone a multitude of tests, been asked the same questions by the triage nurses and waited….and waited….and waited.  (I have waited, as well.)  Each time, he has been sent home without an admission.

After reading the article in the Kennebec Journal Morning Sentinel, I can only hope that our country adopts a program like the one in which Dr. Johnston participates immediately and with widespread availability.

I would also want to add diagnostic testing to the program.  I don’t see a reason why a Home Health Agency couldn’t draw labwork ordered by a physician, have a courier transport it back to a lab and call in the results within hours.  It would be far safer for an elder citizen to remain in their home waiting for the results of the lab tests that are inevitably ordered in the ER as opposed to being transported via ambulance or automobile (with possibility of injury by falling, etc.) or being exposed to the many germs present in any ER or suffering additional confusion from being “out-of-place”.

Having an elder seen by a physician at home and having lab tests done at home would be much less stressful for the caregiver, as well.

Apparently there is now a bill before Congress [ The Independence at Home Act (S. 1131, H.R. 2560) ] which would establish guidelines in order to make this type of service available AND save Medicare dollars.

If you have any interest in this at all, please take the time to write to your congressperson and ask them to support this bill.  I’m certainly going to do just that.


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