Do you need to do medical visits at health home?

February 24, 2020

A medical procedure which is currently declining in frequency, the health home visit is now reserved for patients who are unable to move to the doctor's office (ALD, end of life, dependents, etc.). However, it has many interests both in terms of understanding the patient's living environment and strengthening the quality of the therapeutic relationship. We can ask ourselves the question of whether or not to do it when we open our medical office, or simply question them after years of exercise. Let's do a check in.

Medical visits allow health home support

Medical visits to the patient’s health home remain essential for patients who are unable to travel to the doctor’s office, often at 100% ALD (Long-Term Conditions).

They avoid hospital stays of varying length. The medical visits also present the interest for the doctor to discover or know the place of life of the patient, rich of lessons to adapt the treatment and the behavior to be held. But their frequency will decline from a third in 2002 to 12% of medical procedures in 2010 (source: IRDES Institute for research and documentation in health economics, health home medical visits April 2013). An agreement was in fact concluded between the doctors and the Health Insurance Fund in 2002 to reduce the number of unjustified health home medical visits.

For visits to the homes of "classic" patients, the doctor's effort and his presence in their place of life strengthens the bond of trust between them.

A new consultation space for more flexibility

During a health home medical visit, in addition to the physical presence of the doctor, the latter recreates for his patient the conditions of a ritualized medical act, as in an office.Indeed, he redeploys from his bag, medical tools such as the stethoscope, blood pressure monitoring, otoscope, possibly an electrocardiograph to recreate the conditions of a medical procedure close to the medical consultation in the office. The rituals are also present with the interrogation, the clinical examination and the writing of the prescription. The patient is thus completely confident, as he would be in the medical office.

But moving health home, although essential for some patients, takes time and energy for the doctor who is ultimately paid little for this service.

Time-consuming medical visits

The duration of a health home medical visit would be at least half an hour, not including travel time. Indeed, patients, especially in ALD, often suffer from polypathologies and there are many papers and forms to fill out.In addition, regular health home visits to patients who require it should be planned in advance by organizing the "tour" of the visits.

health home medical visits are therefore sometimes essential for the patient, but remain time-consuming for the doctor. The use of teleconsultation can be a good alternative solution. Indeed, medical teleconsultations will avoid the doctor's trips for oral follow-up or a simple prescription refill, for example. The doctor can also listen and make himself available to the elderly and isolated.The medical teleconsultations between a treating doctor and his own patient base respect the course of care and are therefore reimbursed since September 2018 by Social Security.