West Texas VA Health Care System
Meeting Needs for Veterans who Live in Rural Areas
Meeting the Needs of Veterans who live in Rural Areas
In an article published by The New York Times on October 14, 2015, entitled “Bring Back House Calls”, Dr. Sandeep Jauhar wrote, “Before World War II about 40% of all doctor-patient encounters were house calls. Today, the proportion has dwindled to less than 1 percent. “He further wrote “I have made an occasional house call, and what I have learned about my patients has been invaluable. One patient of mine had severe heart failure that rendered him too weak to come see me, unless he was brought in to the E.R. by ambulance. He lived only a mile from the hospital, so I went to go visit him. In his kitchen sink was a mess of dirty dishes. I looked in the fridge; it was nearly empty. There were canned soups on the counter, all loaded with sodium, precisely what he should not have been consuming. His wife was sitting silently at the dining table appearing exhausted. It was then I learned that she had stopped driving. It didn’t matter which medications I had ordered at the pharmacy; he had no way to get them.”
Situation’s like the one above lead to emergency room visits and hospital readmissions, as cited in the above listed article. “The price tag of unplanned readmissions is $17 billion a year for Medicare alone.” The VA has brought back house calls in the form of Home Based Primary Care (HBPC). HBPC is a program designed to accommodate Veterans needing comprehensive home care services to maximize institutionalization, and maintain the quality of life, targeting those Veterans for whom routine clinic-based care is not effective. This allows the VA to provide health care in patients home and eliminates the need for those Veterans to travel to clinics or hospitals for routine care. The HBPC program has shown to reduce urgent care visits, reduce hospitalization frequency and duration, delay nursing home placement, and help maximize function and independence of our Veterans.
HBPC does more than provide in-home health care; it brings out the best in our medical professionals. While in the home, our staff is blessed with a real life perspective of their Veteran’s lives and how that affects their health conditions. It teaches staff members to tailor communication and education to a specific Veteran. It helps sharpen their skills which lead to better physical exams, more personal care plans, appropriate use of medical terminology, and engages in true shared decision-making with our Veterans. Another beautiful side effect of HBPC is the stronger bond between the Veteran and the providers as well as the strengthening of community relationships with the VA in pursuit of excellence in healthcare.
The question asked was should be bring back house calls? The VA said yes and HBPC was the answer.