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A New Perspective Into Affordable, Quality Healthcare: The Case of Pronto Care
Published in Frederick J. DeMicco, Ali A. Poorani, Medical Travel Brand Management, 2023
Adel Eldin, Frederick J. DeMicco
Because somebody did their homework of healthcare market analysis, the results showed as technology is getting better and better every day, you can have up to 40% of house calls done via telemedicine. Similarly, on-demand services with delivery of Flu-Shots successfully, for example in 35 cities by Uber health was tried in a pilot phase of 2000 people who received Flu-shot at home rather than going to doctor office or clinic, which used to be a frequent reason to make the trip to the clinic.
Introduction
Published in Edward M. Rafalski, Ross M. Mullner, Healthcare Analytics, 2022
We begin by discussing the difference between epidemics and pandemics and provide some context for the current pandemic when observed in the context of the history. We then shift to an overview on the healthcare continuum, its structure and general level of preparedness and evolution during the pandemic. There is a distinction between the public health and healthcare systems in the United States. However, there is an even broader level of distinction in the latter beginning with screening and testing through, primary care, urgent care, emergency care, hospital acute care, field hospitals, transition hotel to home, post-acute care, hospital at home, home health, the physician house call, palliative care and hospice care. Some portions of the continuum existed prior to the pandemic (i.e. emergency room (ER)/emergency department (ED), others had been out of use and re-instituted anew (i.e. field hospital) and yet others were created (i.e. triage chat bots). The pandemic created new levels of analytics across the continuum and created a deeper understanding of the interconnectedness of the care of health ecosystem.
Planning for Service Developments
Published in Peter Edwards, Stephen Jones, Stephanie Williams, Business and Health Planning, 2018
Peter Edwards, Stephen Jones, Stephanie Williams
The advantages of this system from the patient’s point of view is that no advance planning is needed. This is particularly useful in cases of minor acute illness, because a patient can see a GP fairly soon after the onset of symptoms. The advantage of this system to the GP may lie elsewhere within the overall activity of the practice. The fact that patients can be seen without any formal barriers may mean a concomitant reduction in the number of house calls requested for patients with minor illness.
“House Calls” by Mobile Integrated Health Paramedics for Patients with Heart Failure: A Feasibility Study
Published in Prehospital Emergency Care, 2022
Bruce A. Feldman, Orlando E. Rivera, Christopher J. Greb, Jeanne L. Jacoby, Jennifer Nesfeder, Paul Secheresiu, Mahek Shah, Deborah W. Sundlof
The “House Calls” program was designed to be a new option in the outpatient management of patients with HF. We demonstrated the feasibility of integrating trained paramedics into the outpatient management of these patients. The paramedics performed scheduled and, when requested by a HF specialist, urgent home encounters for patients with HF. Urgent home encounters performed within 60 minutes of a request, represented a timely response to non-emergency problems. This response-time contrasts with the usual medical response-time of hours to days for non-emergency issues. Signals of effectiveness for reducing early readmissions were observed. For example, in response to patient concerns, HF specialists requested urgent MIHP home assessments in 20% of the enrolled patients. These in-home visits, facilitated by a dedicated Call Center, were performed within 30-60 minutes of a request. Only one of these urgent evaluations resulted in immediate transport to an ED. Urgent MIHP home assessments may provide a cost saving alternative to the usual process of referral to an emergency room and the associated high likelihood of re-hospitalization (32). From the patient’s point of view, assessed by post-enrollment surveys, a timely MIHP in-home evaluation, with a link to their HF specialist, was perceived to be a valuable alternative to an ED visit or urgent office encounter. This process of care may significantly increase a patient’s “home-time”, an important patient-centered variable (33). Surveys of HF specialists and the participating patients revealed a positive perception of the paramedic “House Calls” program.
Evaluating the Relationship between Duty Hours and Quality of Life of Nigerian Early Career Doctors
Published in Hospital Topics, 2020
Oluwaseyi Ogunsuji, Oladimeji Adebayo, Olusegun Olaopa, Abimbola Amoo, Martin Igbokwe, Rereloluwa Babalola, Aliyu Sokomba, Olayinka Atilola, Olayinka Ilesanmi, Kabir Durowade
Patients’ safety appeared to have spurred the first significant ECDs work-hour regulation revolution. The death of Libby Zion, an 18-year old freshman in 1984, at a New York hospital under the care of resident doctors triggered the ECDs duty-hours reform, with questions being asked on how best to organize the work hours of ECDs undergoing training (Temple 2014; Khoong and Linker 2017). The European Working Time Directive (EWTD) was implemented in 1998 with a maximum of 48 working hours per week, which the UK started implementing for doctors in 2004 and over 25% European countries have also implemented this policy (Imrie, Frank, and Parshuram 2014; Temple 2014). In the US, the Accreditation Council for Graduate Medical Education (ACGME) has been enforcing limited working hours for resident doctors since 2003, and they were limited to a maximum of 80 hours per week averaged over four weeks with no more than 30 hours shift at a stretch (Schuh et al. 2011; Hanna, Gutteridge, and Kudithipudi 2014; Imrie, Frank, and Parshuram 2014; Temple 2014; Khoong and Linker 2017). In addition, a 10 hours break after every 24 hours shift and a limit of in-house call once every three days was also introduced (Schuh et al. 2011; Hanna, Gutteridge, and Kudithipudi 2014; Imrie, Frank, and Parshuram 2014; Temple 2014; Khoong and Linker 2017).
Telemedicine beyond the pandemic: challenges in the pediatric immunology clinic
Published in Expert Review of Clinical Immunology, 2023
Aarti Pandya, Sonya Parashar, Morgan Waller, Jay Portnoy
Before COVID-19, Medicare’s telemedicine policy stipulated that only patients who reside in rural areas could receive telemedicine services and they had to be seen in specific medical locations such as hospitals or physicians’ offices [27]. Furthermore, Medicare only covered a restricted number of services, and care was limited to real-time, two-way video communication, with few exceptions. As a result of COVID-19, most of these requirements for geographic and setting locations were eliminated. This has permitted most patients to benefit from telemedicine services, regardless of their location or setting. This change has even permitted providers to offer telemedicine services to patients in their homes, reminiscent of the traditional house call [28]