Item 4 - Report on Mobile Healthcare Services Option

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Case Study #3 An 89 year old woman lives in her home alone. Her only relative is her son who lives about 50 miles away. She is experiencing nausea, vomiting and severe dizziness with her new medications. It’s Saturday evening and her doctor’s office will not open until Monday morning. She was told to take all her pills and not skip any. She wants to take her pills but feels she will faint and become unconscious. She calls her son. He tells her to call 9-1-1 and says he will drive down to see what he can do. He has his cell phone on during the trip. Following computer protocols, the 9-1-1 call-taker connects the woman with the Nurse Triage (priority sorting) Supervisor in the MediHelp call center. The nurse tells her that it is not uncommon for her new medication to cause some people to feel sick and dizzy. She assures her that it is safe to stop taking the medication so she will feel better until she talks to her doctor on Monday. The nurse asks for the doctor’s name and tells her that she is able to make an appointment for the woman on Monday morning. Before she hangs up, the nurse tells the woman that she will call her son to tell him that things are under control and then call her back in 30 minutes. If the woman is not feeling better, a Mobile Primary Care Unit nurse will be sent to her house to check on her. When the nurse calls back, the woman says she is feeling better now and is no longer dizzy. The Triage Nurse checks with the woman on Monday after her doctor’s visit. The woman has a new prescription and feels fine. Without MHS, the 9-1-1 call would have resulted in the nearest paramedic fire engine being sent, followed by an Advanced Life Support (paramedic) ambulance. It is urgent that EMS personnel provide care and transport decisions quickly and become available to handle the next emergency call. As a result, the patient would have been transported to the local Emergency Department (ED) to sort out the underlying problem. This would have resulted in largely the same patient outcome, except that EMS and ED personnel would have been busy with a non-urgent problem and the patient would have received a bill for the ambulance and ED, at an estimated total of $1,200 to $2,000, depending on local fees and charges. The woman’s son would have made an unnecessary round trip of over 100 miles. 10