Remote medical support at home
As people live longer with chronic disease and depend more often on complex medication regimens at home, the burden of managing home therapy continues to fall, unassisted, on the patient and family. As I sat listening to my overwhelmed and tearful friend tell me about how her father ended up in the hospital for CHF exacerbation, I couldn’t get this out of my head. He had not been taking the increased dosage of one of his heart medications that the doctor had prescribed because the information had simply gotten lost in the mix. Though my friend typically helped her parents keep track of these things, issues with her own family came up, her brother tried to help but is not well versed in medical lingo… They had each done their best but before they knew it her father’s condition had deteriorated, and here we sat.
Unfortunately, programs and services designed to support patients in the management of their chronic conditions at home have not grown at the same rate as the complexity of the home regimens themselves. Case management in the hospital focuses on medical equipment, and home health nursing services catch those patients without adequate support at home, but where is the support for everyone else? My friend is the most medically literate family member involved in the care of her father and her understanding of the medications that he takes is limited to a general understanding of what it is for (e.g. heart, blood pressure, blood thinner), where to look on the bottle to find how much he should take.
What our healthcare system needs is more robust case management that works in association with the primary care provider and regularly checks in with patients living with chronic disease, to confirm that the patient is taking the right medications, at the right dosages. This service could be staffed by nurses trained in over the phone triage that can discuss with the patient, or primary caretaker, any questions regarding their current condition, and changes to home therapy regimen made at the previous doctor’s appointment. This service would compensate for the ever decreasing amount of time that doctors can spend with their patients, would decrease the number of turn-around admissions to hospitals, and provide support to the patient’s support network… which in the end would improve everyone’s quality of life.
