Name of the Procedure:

Home Visit for the Evaluation and Management of an Established Patient
Common name(s): House call, Home medical visit
Technical term: Home visit for evaluation and management (E&M) of an established patient

Summary

A healthcare professional visits a patient's home to assess and manage their medical condition. This visit involves taking a focused history, conducting a targeted physical examination, and making straightforward medical decisions regarding the patient's current health status.

Purpose

This procedure addresses ongoing health issues in patients who have difficulty visiting a medical facility due to immobility, chronic illness, or other health constraints. The goal is to provide continuous medical care and management in the comfortable setting of the patient's home.

Indications

• Chronic conditions that require regular monitoring
• Mobility issues preventing clinic visits
• Recent surgery or hospitalization requiring follow-up care
• Acute health concerns that do not necessitate an emergency room visit

Preparation

• Ensure a list of current medications and previous medical history is available.
• The home environment should be prepared with a clean and quiet area for the assessment.

Procedure Description

1. The healthcare provider travels to the patient's home.
2. Upon arrival, the provider reviews the patient's medical history and current medications.
3. A problem-focused interval history is taken, concentrating on specific symptoms or issues.
4. A problem-focused physical examination is conducted.
5. Straightforward medical decision-making occurs, considering the patient's history, examination findings, and current health status.
6. Counseling and coordination with other healthcare providers may be provided as needed.

Duration

Typically, a home visit lasts about 30 minutes to 1 hour.

Setting

The procedure is performed in the patient's home.

Personnel

• Primary Care Physician (PCP) or Nurse Practitioner (NP)
• Sometimes accompanied by a nurse or medical assistant

Risks and Complications

• Minimal risks involved as it's a non-invasive procedure.
• Potential for an incomplete assessment if the home environment is not conducive to an examination.
• Possible delays in emergency intervention if required.

Benefits

• Provides access to care for patients with mobility issues or chronic illnesses.
• Allows for a more comprehensive evaluation by observing the patient's home environment.
• Immediate and personalized medical attention.

Recovery

• No specific recovery needed as this is a non-invasive procedure.
• Patients may need to follow specific care instructions provided by the healthcare professional.
• Follow-up appointments may be scheduled if further evaluation or treatment is necessary.

Alternatives

• Telehealth visits, with limited physical examination capabilities
• Visits to a primary care clinic or urgent care center
• Home visits by community health workers or nurse case managers

Patient Experience

• Patients may feel more relaxed and comfortable being assessed in their own home.
• There may be minimal discomfort during physical examinations.
• Stress is reduced as patients avoid traveling to medical facilities.