Home-Based Primary Care: A Needed Primary-Care Model for Vulnerable Populations

2012 ◽  
Vol 79 (4) ◽  
pp. 425-432 ◽  
Author(s):  
Linda V. DeCherrie ◽  
Theresa Soriano ◽  
Jennifer Hayashi
Keyword(s):  
Primary Care ◽  
Vulnerable Populations ◽  
Care Model ◽  
Home Based Primary Care ◽  
Primary Care Model ◽  
Home Based

scholarly journals A home‐based, primary‐care model for epilepsy care in India: Basis and design

2019 ◽  
Vol 4 (2) ◽  
pp. 264-274 ◽  
Author(s):  
Gagandeep Singh ◽  
Suman Sharma ◽  
Rajnder K. Bansal ◽  
Raj K. Setia ◽  
Sarit Sharma ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Model ◽  
Home Based Primary Care ◽  
Primary Care Model ◽  
Home Based

scholarly journals Emergency Medical Technician-Facilitated Telehealth Visits: A New Model to Expand Home-Based Primary Care for Homebound Seniors

2020 ◽  
Author(s):  
Karen A. Abrashkin ◽  
A. Camille McBride ◽  
Jill C. Slaboda ◽  
Michael Kurliand ◽  
Amparo Abel-Bey ◽  
...  
Keyword(s):  
Primary Care ◽  
Home Visit ◽  
Care Delivery ◽  
Care Physician ◽  
Emergency Medical Technician ◽  
Care Model ◽  
New Model ◽  
Home Based Primary Care ◽  
Home Based ◽  
Medical Technician

Objective: As the number of older adults living in the United States grows, the gap between the capacity of home-based primary care (HBPC) services and the community demand will continue to widen. Older adults, living longer with mobility difficulties and multiple chronic medical conditions, often prefer to age in place, and new models of care are needed to meet this need. This article provides a framework for an innovative emergency medical technician (EMT)-facilitated telehealth program, the mobile telemedicine technician (MTT) program, which aims to increase access to medical care and efficiency within an HBPC program. Design: A descriptive framework outlining the deployment of an innovative telehealth model. Setting: An HBPC program serving homebound seniors in downstate New York. Participants: Homebound individuals enrolled in an HBPC program with advanced age (over half >90 years), 67% with 5–6 activities of daily living (ADL) dependencies, and high rates of dementia, congestive heart failure, chronic obstructive pulmonary disease (COPD), and diabetes requiring evaluation and treatment of acute conditions. Interventions: HBPC program enrollees requiring evaluation and treatment of acute conditions received a home visit from a telehealth-enabled EMT who has received additional training to provide in-home care. Following an evaluation, the EMT facilitated a telehealth visit via a two-way video conference between the patient and the primary care physician. Main outcome measures: Description of a novel telehealth care model, preliminary results from the first 100 MTT visits including the reason for visit, patient/caregiver, physician, and telehealth-enabled EMT satisfaction survey results. Results: The primary care provider was able to evaluate twice as many patients in a given time period using the new model as in the regular home visit care model. The most common visit reasons were related to skin conditions (22%), neurological conditions (19%), cardiovascular conditions (16%), and respiratory conditions (15%). Satisfaction rates were high from patients/caregivers (45% response rate, 60% strongly agreed and 29% agreed that they were satisfied with the care delivery experience), physician (six surveys over time from one physician, 100% strongly agreed on the effectiveness of care delivery model), and telehealth-enabled EMTs (eight surveys from four EMTs, 100% strongly agreed that they were satisfied with the care delivery experience). Conclusions: In this descriptive article, we outline a new model of care using telehealth-enabled EMTs making home visits to connect with a patient’s primary care physician who is centrally located. This model shows promise for expanding primary care services within the home.

“A More Rounded Full Care Model”: Interprofessional Team Members’ Perceptions of Home-Based Primary Care in Ontario, Canada

2015 ◽  
Vol 34 (3-4) ◽  
pp. 232-251 ◽  
Author(s):  
Tracy Smith-Carrier ◽  
Thuy-Nga Pham ◽  
Sabrina Akhtar ◽  
Mark Nowaczynski ◽  
Gayle Seddon ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Model ◽  
Team Members ◽  
Interprofessional Team ◽  
Home Based Primary Care ◽  
Home Based

Addressing COVID-19 Worry and Social Isolation in Home-Based Primary Care

2020 ◽  
Author(s):  
Rachel Elizabeth Weiskittle ◽  
Michelle Mlinac ◽  
LICSW Nicole Downing
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Primary Care ◽  
Social Workers ◽  
Social Isolation ◽  
Mental Health Providers ◽  
Health Providers ◽  
Home Based Primary Care ◽  
Home Based ◽  
Socially Isolated

Social distancing measures following the outbreak of COVID-19 have led to a rapid shift to virtual and telephone care. Social workers and mental health providers in VA home-based primary care (HBPC) teams face challenges providing psychosocial support to their homebound, medically complex, socially isolated patient population who are high risk for poor health outcomes related to COVID-19. We developed and disseminated an 8-week telephone or virtual group intervention for front-line HBPC social workers and mental health providers to use with socially isolated, medically complex older adults. The intervention draws on skills from evidence-based psychotherapies for older adults including Acceptance and Commitment Therapy, Cognitive-Behavioral Therapy, and Problem-Solving Therapy. The manual was disseminated to VA HBPC clinicians and geriatrics providers across the United States in March 2020 for expeditious implementation. Eighteen HBPC teams and three VA Primary Care teams reported immediate delivery of a local virtual or telephone group using the manual. In this paper we describe the manual’s development and clinical recommendations for its application across geriatric care settings. Future evaluation will identify ways to meet longer-term social isolation and evolving mental health needs for this patient population as the pandemic continues.

Developing a model of home-based primary care in South Korea: A 1.5-year case study

2020 ◽  
Vol 40 (6) ◽  
pp. 1403-1428
Author(s):  
Chang-O Kim ◽  
Jongwon Hong ◽  
Mihee Cho ◽  
Eunhee Choi ◽  
Soong-nang Jang
Keyword(s):  
Primary Care ◽  
South Korea ◽  
Home Based Primary Care ◽  
Home Based

scholarly journals Preparedness and Response Activities of the VA Home-Based Primary Care Program Around the Fall 2017 Hurricane Season

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 591-591
Author(s):  
Tamar Wyte-Lake ◽  
Claudia Der-Martirosian ◽  
Aram Dobalian
Keyword(s):  
Primary Care ◽  
Large Scale ◽  
Care Program ◽  
Department Of Veterans Affairs ◽  
Home Based Primary Care ◽  
Home Based ◽  
Early Implementation ◽  
Hurricane Season ◽  
Patient Health ◽  
At Risk Populations

Abstract Individuals aged seventy-five or older, who often present with multiple comorbidities and decreased functional status, typically prefer to age in their homes. Additionally, as in-home medical equipment evolves, more medically vulnerable individuals can receive care at home. Concomitantly, large-scale natural disasters disproportionally affect both the medically complex and the older old, two patient groups responsible for most medical surge after a disaster. To understand how to ameliorate this surge, we examined the activities of the nine US Department of Veterans Affairs Home-Based Primary Care programs during the 2017 Atlantic Hurricane Season. These and similar programs under Medicare connect the homebound to the healthcare community. Study findings support early implementation of preparedness procedures and intense post-Hurricane patient tracking as a means of limiting reductions in care and preventing significant disruptions to patient health. Engaging with home-based primary care programs during disasters is central to bolstering community resilience for these at-risk populations.

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