Back to the Future for Physician House Calls

Larry Schwartz, CEO, GigFlex LLC
Larry Schwartz, CEO, <a href='' rel='nofollow' target='_blank' style='color:blue !important'>GigFlex LLC</a>

Larry Schwartz, CEO, GigFlex LLC

How Geo-Intelligent Scheduling & Communications Technology Can Bring Back Home-Centric Patient Care

In the 1940s, the majority of physicians in the United States saw their patients in the home, but by 1980 the National Center for Health Statistics showed that house calls were almost extinct with only 0.6% of visits happening in the home (JM, 2000). The most common cited reasons for practitioners being unable to do house calls were lack of efficiency, the time required and poor reimbursement (L, 2000).In 1998, Medicare increased reimbursement for home-healthcare visits by over 50% and between 1998 and 2003 the number of house calls grew at over twice the rate of traditional office visits (K, 2009).  The Covid19 pandemic stimulated strong interest in telemedicine with a 154% increase in telehealth home visits during the last week of March 2020, compared with the same period in 2019 (Jolly, 2020).

There are, however, significant issues with using telemedicine as a general alternative to a doctor’s office visit:

- How do you properly prescreen the patient –for example, taking the patient’s temperature, blood pressure

- How can the doctor’s post appointment orders be accomplished- for example, administering a patient throat swab or drawing patient blood for lab testing

The inability to do full prescreening can negatively impact the quality of a telemedicine doctor’s appointment, and the requirement of a patient to go to a clinic for lab testing defeats the value of a telemedicine visit with regard to allowing the patient to stay at home.

Fortunately, geo-intelligent scheduling and communications technologies are emerging that will enable the seamless integration of telemedicine, medical offices and home healthcare in a way that will enable patients in the future to receive the same quality of care as a doctor’s office visit without the patient ever having to leave their home!

Here is a glimpse athowgeo-intelligent enabled home-centric healthcare could look:

- A patient calls a telemedicine office at 10:00am to schedule an appointment because the patient is  experiencing severe flu-like symptoms

- The telemedicine office schedules an appointment for 1:00pm that afternoon

- The telemedicine office automatically contacts/dispatches an available home-healthcare clinician who is in the vicinity of the patient to the patient’s home at 11:00am to do a full prescreening.

- The prescreening clinician notices a large rash on the patient and initiates an instant video conference with a specialist via a secure HIPAA-Compliant mobile app that includes a virtual ruler that provides the specialist with specifics on the size of the rash

- The specialist informs the clinician that this is just a bedsore and sends a secure test message to the clinician on how to treat the rash. The clinician shares this information with the patient.

- At the telemedicine appointment, the doctor becomes concerned that the patient may could be anemic and/or have COVID19, and orders a blood test

- The telemedicine office automatically contacts/dispatches an available phlebotomist who is in the vicinity of the patient to the patient’s home at 3:00pm. The phlebotomist takes patient blood samples and delivers them to the testing lab at 4:00pm.

- The testing lab reviews the tests results and sends an electronic report to the telemedicine office at 9:00am the following day.

- The telemedicine doctor sees from the report that the patient is negative for COVID19 but does have iron-deficiency anemia and orders prescription iron supplements for the patient.

- The telemedicine office automatically sends the prescription order into the patient’s preferred pharmacy that provides home delivery

- The telemedicine office calls the patient at 10:00am to convey test results and the prescription, just as the doorbell rings with the prescription delivery.

By seamlessly integrating today’s largely siloed healthcare world, geo-intelligent scheduling and communications will dramatically increase the timeliness, efficiency and effectiveness of delivering high quality patient care while dramatically improving the patient experience. 

In 2021, GigFlex LLC will be introducing a powerful consulting & texting freeware mobile app for home healthcare workers that will empower them with the ability to instantly connect with peers while onsite to consult on patient issues.  Key features of this freeware app will include HIPAA-compliant video streaming to enable peers to view the patient and/or patient environment, secure texting for private information sharing, an augmented reality ruler to enable peers to accurately confirm wound dimensions, and secure EMR screen sharing of information accessible through the clinician’s mobile device. No EMR integration is required, and clinicians will be able to download the freeware app from the Apple Store or Google Play store.