At the heart of all of this is a system that, in my estimation, combines elements of Norman Rockwell with elements of Buck Rogers. I got to see it first hand in Saco last year, and it left me deeply impressed.
A tablet device is provided to each patient for home use, and each day the patient is prompted by the device to measure vital signs and answer interview questions customized to their individual condition. The data is then, without any significant effort by the patient, beamed directly into the MaineHealth Care at Home office. It’s simple, it’s inexpensive, and it’s easy for the patient to do.
At the home office, is a large screen, with rows of names on it, receiving data from each patient every day. Each of the names is normally shown in a green box, meaning that the patient is okay. If some reading is questionable, the box turns yellow, which prompts a phone call from a home health nurse. Maybe the patient has not taken her pills that morning. Maybe the patient indulged in too much salt with dinner the night before. Or maybe something more serious is wrong. The nurse on the phone can provide an assessment and it’s often an easy solution – take an extra pill, or maybe just drink some extra water. Or maybe more is required, in which case a consultation takes place with the patient’s physician, and a different course of action is undertaken.
That’s the Buck Rogers part. It’s very cool. The Norman Rockwell part arises from the steady, old-fashioned relationship that develops between the nurse and the patient during regular home clinical visits. I was able to accompany a clinical nurse as she visited the home of a spry retired public school teacher in Old Orchard Beach who had been recently discharged from hospital care. It was great to see the obvious trust and the warmth and the ease of the interaction.
This direct relationship, combined with the confidence she had in knowing that highly trained professionals were always monitoring her post-hospitalization well-being, meant that the patient was able to remain happily at home, comfortable, safe, and healthy. This is exactly how I’d want to be treated were I in a similar situation.
But beyond the clear value of this model to the patient, my support is rooted equally in the fact that providing this type of integrated clinical home health care services to MaineCare patients with chronic health issues, and individuals recovering from an accident, surgery or illness makes good fiscal sense. It’s much more affordable than a stay, or readmission to a hospital, or time in a nursing home or an assisted living facility.
So to the Star Trek and Norman Rockwell images, let me add a final image, of a frugal New England accountant stretching every penny to its limit. This program represents the rare intersection of clinical excellence, a high degree of personal touch, and true cost effectiveness. It’s a triple winner.