Navigating specialized clinical care can be complex, especially when one has a chronic condition or disability or is homebound. This type of care is often situated in specialized facilities and requires travel, which can become arduous, time-consuming, and expensive. As an example, in 2021, a person in the US without insurance will pay an average of $84 to visit a primary care doctor, $157 to see a specialist, and $737 for an emergency room visit. Expanded access to specialized care presented in people’s homes can potentially transform the way we deliver clinical care into the homes of those whose daily routines make travel inadvisable.
Understanding the Need for Specialized Clinical Care
What is Specialized Clinical Care?
Specialized clinical care means having access to physicians who are trained to provide healthcare services for patients with specific health problems through their specialty training in various areas of medicine, like cardiology, neurology, oncology, rheumatology, and so on. This type of care is essential for people dealing with complex or chronic conditions.
Challenges in Accessing Specialized Clinical Care
- Geographic barriers or distance: Many people live in rural or underserved areas where they do not have access to specialized care.
- Mobility: Patients may have limited mobility and hence be unable to travel to a specialist facility.
- Cost: The expense of traveling, accommodation, and treatment can be prohibitive for many families.
- Time Constraints: Scheduling and attending appointments can be time-consuming and disruptive to daily life.
The Rise of Home-Based Specialized Clinical Care
Telehealth and Virtual Consultations
Telehealth leverages digital technology to provide healthcare services remotely. This includes:
- Video Consultations: Live two-way video conversations between the patient and the clinician, allowing for pre-appointment, during-visit, and post-visit check-ins. This enables diagnosis, treatment planning, and follow-up all without the patient going to a clinic.
- Remote Monitoring: The use of devices to measure vital signs and other health metrics in-home that are then transmitted to care providers for remote review and intervention.
- Mobile Health Apps: Symptom trackers, medication reminders, and access to educational resources.
Home-Based Specialty Services
Beyond telehealth, home-based specialty services include:
- Home Infusion Therapy: Giving drugs or other treatments by IV at home, often managed by nurses who come to the house.
- Home-Based Diagnostic Testing: Conducting blood work, imaging, and other diagnostic tests at home instead of in facility settings.
- On-Demand Specialist Visits: Some specialists may be able to offer house calls for physical exams and consultations, though this is less common and might also depend on the specific specialist, location, and availability.
Benefits of Accessing Specialized Clinical Care at Home
1. Enhanced Convenience
- Less travel: You don’t need to travel across town and back just to see a specialist (a boon for people who are housebound or who live in small towns).
- Flexibility Of Scheduled Appointments: Telehealth service appointments are more flexible to the schedule of the patients, facilitating the convenience and appointment availability of the patients.
2. Improved Patient Comfort
- Home Environment: Patients and physicians interact in the world of the patient and that can help reduce stress and anxiety associated with a medical visit.
- Individualized care: needs-based care plans and consultations that consider a patient’s home context and lifestyle.
3. Cost Savings
- Reduced Travel Expenses: Savings on transportation, lodging, and other associated costs.
- Lower Medical Costs: Services and procedures might be less expensive when offered at home or via telehealth.
4. Continuous Monitoring and Care
- Continuous Remote Surveillance: Long-term health metrics can be continually tracked, allowing for early intervention and improved management of chronic diseases.
- Proactive management: Let the hospital preempt problems and hopefully help people do better.
Implementing Home-Based Specialized Care
1. Choosing the Right Services
- Assess Needs: Given the person’s clinical, physical, mental health, financial, and real estate needs, what are his or her specific needs in terms of household, assistance with medication, specialized care, personal care, personal satisfaction, social contact, spiritual needs, emotional connection, engagement, and communication?
- Research Providers: Seek telehealth platforms or home-based service providers able to provide key specialty care.
2. Setting Up Technology
- Telehealth platforms: make sure that there are computers or smartphones with internet access, and make sure users know how to use the telehealth platform.
- Remote Monitor (Devices needed; Swipe Left for more): Obtain and install the necessary monitoring equipment, then connect and test the setup.
3. Coordinating Care
- Home-based care should be integrated: It should fit well into the rest of the care and treatment the patient receives, such as from primary care and other specialists.
- Communication: To foster collaborative and transparent care, provide a means of communication between the patient and caregivers, and share this information with healthcare providers.
4. Training and Support
- Patient Education: Help patients and caregivers learn how to use telehealth services and equipment.
- Technical Assistance: Offer technical support to address any issues with digital platforms or devices.
Addressing Challenges and Limitations
1. Technology Access and Literacy
- Digital Divide: Ensure that all students have access to technology and know how to use it. We offer device assistance and training in digital literacy.
- Support Services: Utilise medical, community support, or technical support to assist individuals with access and use of telehealth platforms and remote monitoring tools.
2. Privacy and Security
- Data protection: Telehealth platforms and remote monitoring systems should be in accord with existing data protection regulations and hold patient data securely.
- Secure Communication: Use encrypted communication channels to safeguard sensitive health information.
3. Regulatory and Reimbursement Issues
- Check insurance coverage: Confirm insurance coverage for telehealth services and home-based specialty care to ensure we and home-based specialty care are covered.
- Regulations vary by state. Please note that telehealth and home-based care regulations may vary from state to state.
Being able to access specialist clinical care from home has the potential for convenience, comfort, and cost savings Benefiting from specialist clinical care at home is part of a regular day with a teleCNA visit and is also part of an annual check-up, made possible by removing the barriers of access to healthcare from individuals with needs beyond the scope of primary care.
