Name of the Procedure:

Telephone calls by a registered nurse to a disease management program member for monitoring purposes (HCPCS Code S0320)

Summary

This procedure involves registered nurses making scheduled telephone calls to patients enrolled in a disease management program. The primary goal is to monitor the patient’s health status, provide education, and offer support.

Purpose

The purpose of this procedure is to help manage chronic diseases such as diabetes, heart disease, or asthma. The main goals include ensuring medication adherence, monitoring symptoms, providing dietary and lifestyle advice, and identifying any early signs of complications.

Indications

• Chronic diseases like diabetes, heart disease, asthma, etc.
• Recent hospital discharge requiring follow-up
• Complex medication regimens needing regular checks
• Patients who need continual support to follow treatment plans

Preparation

• Make sure the patient has a working telephone and a quiet place to take the call.
• Patients may need to keep a log of symptoms, blood sugar levels, blood pressure readings, or other relevant health data.
• No specific diagnostic tests are needed beforehand, but patients should have their health records accessible.

Procedure Description

1. A registered nurse will schedule regular monthly phone calls with the patient.
2. During these calls, the nurse will:
   • Review the patient’s current health status and symptoms
   • Check adherence to medication and treatment plans
   • Offer guidance on lifestyle modifications, dietary changes, and exercise
   • Provide education about managing the chronic condition
   • Answer any questions the patient may have.

Duration

Each telephone call typically lasts between 15 to 30 minutes.

Setting

These calls are conducted over the phone, allowing patients to be in the comfort of their own homes.

Personnel

The procedure is carried out by a registered nurse who specializes in disease management.

Risks and Complications

• Miscommunication due to poor phone connection
• Limited ability to perform physical assessments
• Potential difficulty in managing acute symptoms remotely

Benefits

• Improved management of chronic diseases
• Early detection and prevention of complications
• Enhanced patient education and empowerment
• Increased adherence to treatment plans
• Continuous support and guidance

Recovery

No recovery time is needed as this procedure is non-invasive. Patients are advised to follow any new instructions or advice given during the call.

Alternatives

• In-person follow-up visits with a healthcare provider
• Remote monitoring devices that track health data in real-time
• Telemedicine consultations using video calls

Pros and cons of alternatives:

• In-person visits provide direct physical assessment but may be more time-consuming.
• Remote monitoring devices can offer real-time data but require technology and connectivity.
• Telemedicine via video offers visual interaction but may not be accessible to all patients.

Patient Experience

Patients might feel reassured and more informed about their condition. There is no physical discomfort involved, and the procedure can be highly convenient and supportive. Pain management and comfort are not typically issues with this procedure since it is entirely non-invasive.