99325 Domiciliary or rest home visit for the evaluation and management of a new patient, which requires these 3 key components: An expanded problem focused history; An expanded problem focused examination; and Medical decision making of low complexity. Counseli

Name of the Procedure:

Domiciliary or Rest Home Visit for Evaluation and Management of a New Patient

• Common names: Home visit, House call, Domiciliary care evaluation

Summary

A domiciliary or rest home visit involves a healthcare professional evaluating and managing the health of new patients in the comfort of their home or rest home. The procedure includes a thorough health history, physical examination, and medical decision-making based on the findings.

Purpose

• Medical condition: This procedure addresses various chronic conditions, acute health issues, or general health assessments that require evaluation and management.
• Goals: The goal is to provide comprehensive healthcare services in a patient's domicile, ensuring an accurate diagnosis, appropriate treatment plan, and necessary follow-up care without the need for the patient to travel.

Indications

• Patients with mobility issues, chronic illnesses, or acute conditions that make travel challenging.
• New patients requiring an initial comprehensive evaluation for a new or existing health issue.
• Elderly individuals in rest homes needing regular health assessments.

Preparation

• Patient Instructions: No special preparation is required from the patient. However, they should have their current medications, medical records, and any recent lab results easily accessible.
• Diagnostic Tests: Ensure any prior diagnostic tests or assessments have been completed and results are available for review.

Procedure Description

1. Initial Assessment: The healthcare professional will review the patient's medical history, including past illnesses, surgeries, allergies, and current medications.
2. Physical Examination: An expanded problem-focused examination will be conducted, concentrating on specific areas of concern identified through the history.
3. Medical Decision Making: Based on the findings, a low-complexity medical decision-making process will be implemented to develop or adjust the treatment plan.
   • Tools: Stethoscope, blood pressure monitor, thermometer, portable diagnostic devices (e.g., portable ECG).
   • Counseling and Coordination: The healthcare professional will discuss the findings with the patient and any caregivers, providing guidance and coordinating further care as necessary.

Duration

The visit typically takes about 30 to 45 minutes.

Setting

The procedure is performed in the patient's home or rest home.

Personnel

• Primary healthcare provider (e.g., physician, nurse practitioner)
• Medical assistant or nurse (if needed for support)

Risks and Complications

• Common Risks: Minimal, primarily related to accurately assessing conditions without advanced diagnostic tools available on-site.
• Rare Risks: Misdiagnosis or delayed treatment due to the limitation of in-home resources. Proper follow-up and referrals to healthcare facilities as needed mitigate these risks.

Benefits

• Convenient and comfortable care for patients.
• Early detection and management of health issues, potentially avoiding hospitalization.
• Personalized care in a familiar environment.

Recovery

• No recovery is needed from the visit itself.
• Patients should follow the healthcare provider's instructions, including any new medications, lifestyle changes, or follow-up appointments.

Alternatives

• Clinic or hospital visits.
  • Pros: Access to comprehensive diagnostic tools and immediate specialist consultations.
  • Cons: Travel may be difficult for some patients, leading to inconvenience and possible health risks.

Patient Experience

• During the Procedure: Patients may feel at ease in their home environment, allowing for open communication with the healthcare provider. The process should be relatively painless and straightforward.
• Pain Management: Any pain or discomfort will be evaluated, and appropriate measures will be taken to manage symptoms.