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Clinic brings medical care to homebound patients
One advantage is a personal connection
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Nurse practitioner Anga-Lee Tipton talks with patient Mary Kendall during a recent home visit. - photo by Tom Reed

Mary Kendall doesn’t have to get dressed up for her monthly medical checkup.

That’s because the primary care nurse practitioner comes to her.

Still, the convenience doesn’t keep the 74-year-old Kendall, who currently relies on a wheelchair to get around, from getting dolled-up anyway.

Kendall is a patient of The Longstreet Clinic in Gainesville who gets her exams at home because of challenges she would face in getting to the doctor’s office.

“This is the most wonderful service,” Kendall said. “It can be difficult sometimes to find a way to get to doctor’s appointments.”

Primary care medicine is going retro with an increase in home visits like the kind Kendall enjoys.

Longstreet, which has been sending a nurse practitioner to patients’ home for a couple of years, recently chose to expand that program.

It’s part of a growing trend of delivering medical care to the home, especially for patients that find it difficult to leave the house.

With a national focus on reducing health care costs, home visits are aimed to keep patients out of the hospital and nursing homes and in their own homes.

The home calls are typically available for homebound patients, for those too sick to get a regularly scheduled appointment and for those who have difficulty using public or private transportation options.

These types of programs are still being studied for efficiency, but the philosophy behind the program is that the home visits preclude some patients from needing to stay in a nursing home or a hospital bed.

It also puts less scheduling pressures on primary care doctors, at a time when many fear there is a shortage in the field.

As for costs, Kendall pays the same amount after a Medicare reimbursement as she would with a visit to the doctor.

Patients who enroll in house call programs are less likely to need hospitalizations, according to a 2010 study published on the American Academy of Home Care Physicians website.

While home visits are an old-fashioned concept, it’s actually new technology that’s making the trend possible.

“Anything we can do in the office, I can pretty much do in a home,” said Anga-Lee Tipton, Longstreet’s home visits nurse.

Tipton, who comes to homes with a paramedic to assist with the checkup, brings an EKG machine, medication and instruments to take blood samples that can be taken back to the lab.

Tipton also carries a mobile tablet device that can access patient records and communicate with doctors. Tipton has been doing home visits for about a year and a half, but it’s only been in recent weeks that the program was expanded full time.

One of the advantages to visiting a patient’s home, the nurse said, is the personal connection she can build with the patients.

Tipton said visiting a patient’s home allows her to see the environment a homebound patient lives in.

A big part of that is eating habits. Many patients rely on store-bought frozen dinners, which tend to have a lot of sodium, said Tipton. That’s problematic for high-blood pressure patients.

At home, the nurse can see what’s in a patient’s freezer and make suggestions on better options.

For Kendall, she’s found she gets just as good of care at home as she would at a doctor’s office.

After undergoing surgery for a dialysis graft early this year, it was during a follow-up home visit that Tifton found Kendall had an infection that needed attention.

Tifton said that had she not found the infection early, while at Kendall’s home, the problem could have become more serious.

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