Return of the Housecall?

CLOSE YOUR EYES and envision a physician carrying his or her black bag to make a house call on a frail elderly person, someone with a disability, or even an aging baby boomer. Does this image seem as outdated as multi-week hospital stays? Actually, house calls, with their potential to lower costs while improving healthcare quality, are more relevant than ever.

Today, a disproportionate percentage of rising healthcare costs are tied to the expense of caring for those with complex chronic illnesses and serious disabilities. This population cannot easily get to the doctor’s office or have their needs met in a 20-minute visit. In our approach to caring for these patients, there are many missed opportunities to prevent complications requiring costly hospitalizations and nursing home placements

In greater Boston, house calls are coming back, but with a 21st century twist. Each month, 500 elderly, disabled, and chronically ill persons who are enrolled in a special primary care program receive visits from clinicians committed to helping them retain their independence and health. The person making the house call, however, is more likely to be a nurse practitioner than a doctor. In addition to a stethoscope, the bag is likely to contain a laptop computer that connects the clinician to physicians, hospitals, and an entire array of support services.

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