House calls were prevalent in the 1930s; by the 1980s, they had all but disappeared. Now, in the 21st century, house calls seem to be making a comeback.
A nicely written piece by Ezekiel J. Emanuel that appeared in The New York Times Opinion Pages early this month touts the return of delivering care in patients’ homes. According to a study referenced by Emanuel, roughly 4,000 physicians conducted more than two million house calls in 2010 alone.
Why the resurgence? House calls, as Emanuel notes, are incredibly cost-effective—especially when compared to emergency room visits. Here’s the even better news: when combined with technology, house calls become even more cost-effective—a fact that has not escaped the private sector’s attention.
“Companies like Microsoft and Costco provide…house calls to their employees in the Seattle area,” writes Emanuel. “Carena, a private company under contract for the service, sends out doctors or nurse practitioners to assess the situation with the assistance of computer software.The software uses algorithms to help them differentiate between cases that are safe to handle at home and those that require the emergency room.”
According to Emanuel, treating someone who needs care—but not an emergency room—via a house call (or even a virtual house call via webcam) is a no brainer. But Emanuel also notes that urgent-care situations (like cuts and fevers and stomachaches) only account for about “40 percent of the nearly 130 million annual visits to emergency rooms.”
So what about the other 60 percent? What about those who suffer from heart conditions or diabetes or dementia? Those who struggle to make the transition from hospital to home? Those who are readmitted within days of having been discharged?
Emanuel feels that house calls and in-home care can be effective in these more chronic-care scenarios as well. The federal government agrees with him. “The Affordable Care Act now imposes penalties on hospitals that have high readmission rates for conditions like heart failure and pneumonia,” writes Emanuel. “To avoid the penalties, hospitals are increasingly deploying nurses on these types of house calls.”
As we move—as a nation in the 21st century—towards an increase in in-home care solutions, more and more medical and data-capturing devices will live in patients’ homes. Physicians and nurses, as well as those responsible for remote monitoring, will need access to the data in those devices to make informed care decisions. As the lines between hospitals and homes blur, iSirona will be there—extracting device data and making it available for decision makers—at any point of care.