How the Modern-Day House Call is Evolving Healthcare

family-receiving-care-at-home

If you’re not old enough to remember the days when doctors routinely made house calls, you’ve probably seen them portrayed in movies and old television shows. When someone was sick, a kind and friendly doctor would come to their bedside, armed with his trusty black bag. He would be prepared for all kinds of medical problems like curing an illness, stitching up a wound or delivering a baby. This was a common practice in the US as recently as the 1960’s, and is still common in some parts of the world.

So what changed?

One big change is the way healthcare is paid for. In 1960, almost half of healthcare was paid out of pocket, compared to roughly 11 percent in modern times. This means that in the past, patients had far more control over the way they interacted with their doctors, whereas today the insurance companies often make the rules. Also, healthcare and the tools to practice medicine have changed enormously. Many of the machines used to diagnose and treat patients today were not around in the old days of house call medicine. Many of these machines, even as recently as ten to twenty years ago, were only available in hospitals or large multi-doctor practices. They were simply too large, too costly, and required too much maintenance for any other setting.

Everything Old Is New Again

Despite these hurdles, home healthcare is seeing a resurgence in modern times. Once again, doctors, nurses and other medical staff are visiting patients in their homes to help care for their needs without a trip to the local ER or doctor’s office. We’ve seen the rise of home health aides similar to the services offered in nursing homes and technology-based care models such as telemedicine. But perhaps more interestingly, something akin to the old house call concept is taking hold in communities across the country.

Home Healthcare

Home healthcare encompasses a wide range of in-home care services — from skilled nursing assistance and physical therapy services to telemedicine and the modern-day house call.

By the 1980’s, our emergency medicine system was feeling the strain of ER overuse and Medicare was footing the bill for a growing number of seniors whose ongoing medical care was being handled in a hospital setting. In the 80’s and 90’s, home care companies began to fill the need for care for the elderly that don’t require costly hospital or nursing home stays.

In this model, health aides are sent to the homes of seniors or others with various medical conditions to help them with minor medical care as well as every day needs like bathing, feeding, taking medications or monitoring health markers such as blood pressure or glucose levels.

These tasks are can be performed by nurses, medical assistants, or caregivers with little to no formal medical training. While they cannot address specific medical needs the way a doctor could, the practice has proven invaluable for helping the elderly or disabled to maintain independence. It also has been shown to reduce hospital stays and help post-operative patients recover faster in the comfort of their own homes.

Telemedicine

As technology improves, healthcare changes to go along with it. The advent of the telephone eventually led to our current emergency phone system, allowing people to summon emergency services like ambulances, police and firefighters. Today we’re going a step further, providing direct access to medical professionals from the comfort of home via phone, computer, or other devices.

Telemedicine can’t help with every situation, and for many things a physical examination, ability to perform procedures and obtain diagnostic studies is still necessary. Yet this rapidly growing field is incredibly useful for those seeking medical advice for non-urgent conditions as well as those who need help monitoring ongoing medical concerns.

Access to nurses and doctors via text, phone, or video chat sessions allows patients to ask questions and get answers quickly. First-time mothers can talk to their baby’s doctor without having to expose an infant to a waiting room full of contagious diseases. And in some cases, wearable devices send data directly to a patient’s doctor to monitor vital signs and chronic conditions without the need for repeated office visits.

Woman holding phone

The Modern-Day House Call

There are also a growing number of doctors and other clinical staff who are performing traditional house calls to treat patients in the comfort of their own homes. Frustrated with the lack of personal connection in our current healthcare system, more and more providers are beginning to value the ability to spend time getting to know a patient. Technology has brought about more compact and affordable versions of many typical diagnostic and treatment devices. In fact, in most cases a home visit from a physician or medical team is far less expensive than a trip to the local ER.

DispatchHealth, a company headquartered in Denver but serving a growing number of cities across the country, will send a medical team right to a patient’s home or office. The team includes a nurse practitioner or physician assistant, along with a DispatchHealth medical technician (DHMT). They’re available to treat urgent medical needs that don’t quite require a visit to the ER, like the flu, dehydration, urinary tract infections (UTIs), minor fractures and skin lacerations.

Sounds expensive, right? Actually, DispatchHealth is partnered with most major insurance companies and handles the billing process directly with those companies. This year alone, DispatchHealth is projected to care for 55,000 patients and provide roughly $80.8 million in medical savings from avoidable 911 transports, ER visits and hospitalizations.

By providing comfortable healthcare on the patient’s time and not the physician’s time, patients have an exceptional experience and are able to avoid the hassle of the waiting room and the high costs of treatment at an ER. In fact, DispatchHealth’s Net Promoter Score (NPS) averages 94 which is an indicator of how willing customers are to recommend a company’s products or services to others. To give you a comparison, the healthcare industry typically averages an NPS around 30.

The Bottom Line

The modern-day house call provides a number of benefits including cost savings, convenience, more time with your care provider, less exposure to other sick patients, additional independence for seniors and an effortless medical experience overall. It’s an old idea that’s making new waves across the US and around the world.

So the next time you have a medical question, reach for the phone instead of your keys. The next time you’re recovering from a hospital stay, have the nurses come to your home instead of checking into a nursing home or rehabilitation facility. And the next time you need a quick medical appointment, get urgent care delivered and wait in the comfort of your own home instead of sitting in a waiting room at your local ER.

With nearly 20 years of clinical and management experience in the healthcare industry, Kevin Riddleberger has a tremendous passion for redefining healthcare delivery through technology, process and quality improvement. Kevin is an experienced board-certified physician assistant and has served as a member of hospital quality improvement committees and president of the Colorado Academy of Physician Assistants. He is also an active advisor in Colorado’s local healthcare start-up community, providing both business and clinical expertise. Prior to co-founding DispatchHealth, Kevin was the head of clinical solutions and strategy at iTriage.

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