Visits with doctors, nurse practitioners and physician's assistants are changing, thanks to emerging technology advances. When tagging along for a house call recently with one of our geriatricians, I was really impressed by all the types of tests and care that they can deliver from the comfort of a patient's living room.
Penn Geriatric's overarching House Calls program keeps watch over 220 home-bound elderly patients at a given time, and partners with Penn Home Care nurses to provide all levels of care, from a routine check in appointment after a hospitalization, to managing serious and complex acute illnesses all at home.
Thanks to innovations that have miniaturized medical devices, care providers on the go - from home care visits to busy outpatient practices - can get more and more real-time feedback at the patient's bedside.
Beyond the pulse oximeters and wifi-enabled glucometers, there are now iPhone attachments that offer a recording of the patient's heart rhythm (an electrocardiogram), and pocket-sized ultrasound devices that give doctors an inside look during a physical exam. Need a rapid lab test to see if a patient's chest pain is due to damage to the heart muscle? There's a way – a handheld device, about the size of a 1990's cordless phone, that analyzes drops of blood in minutes. Need to know if your patient’s low blood pressure is from too much or too little medication to widen blood vessels for their failing heart? There's a hand-held device for that too-- using thoracic impedance-- that before would require a catheter to be placed up into the heart.
For a homebound patient who has a hard time getting out the door, let alone getting to the primary care doctor, lab, or even the emergency room, this means that they're getting care that they may not be able to receive otherwise. The pocket-sized devices are also helping care providers assess the patient's prognosis proactively, and keep a closer watch on any known issues.
The patient we visited had been treated for a heart arrhythmia recently. The stethoscope, which celebrates its 200th anniversary in 2016, still helped the doctor as he listened for heart issues. But when the patient held a souped-up iphone in his 81-year-old hands, the patient and doctor could both see nature of his irregular heart rhythm.
Innovations that continue to help patients get the right care, at the right time, are now extending to be in the right place, too. Care providers are seamlessly integrating them into medical practice, once the devices have been tested and FDA-approved, in a way that helps provide patient-centered care in the patient's own home.
I can't wait to see what they come up with next!