Engaging patients’ families and other support systems in the home are one benefit of home visits, explains Jessica Simo, program manager with Durham Community Health Network for the Duke Division of Community Health, enabling healthcare providers to see the patient in their natural environment.
Why are home visits so important? Number one, it is very challenging to observe problems that individual patients may have with adhering to their medication regimens if you can’t see the medicines in the bottle in the patient’s home. You need to be available to count the medicines and ascertain definitively that they are not missing. Trying to do medication reconciliation over the phone is nowhere near as effective as being in a patient’s home.
Another reason home visits are more effective is that you can physically see what activities of daily living (ADL) or instrumental activities of daily living (IADL) deficits the patient may be experiencing in their natural environment. This is something you can’t directly observe within the confines of an exam room.
The engagement of family or their other support persons is also important. Home visits are an excellent way to see somebody in their natural environment, find out who the support people are for the patient, have a comfortable discussion in their home about an individual plan of care and get the people who can assist with that on board.
Home visits are especially important in a medically complex patient population where there are frequent transitions, whether they be from the acute care setting, from any ED visit or back into the home from an assisted living facility.
Home Visit Handbook: Structure, Assessments and Protocols for Medically Complex Patients outlines an innovative home visit pilot for Medicaid and dually eligible patients that reduced unplanned hospital admission days by 71 percent in three months and provides key performance benchmarks on home visit activity in the healthcare industry.