House calls program helps UAB reach senior citizens

When Michelle Johnson’s mother had a stroke, it became harder for her to make it to her doctor’s appointments at UAB.

It didn’t take long for Johnson to receive a call from Dr. Marianthe Grammas, medical director of UAB’s Geriatrics Clinic and head of the hospital’s house calls program.

“Dr. Grammas’ office called and said, ‘We’re going to come out and visit with your mom,’” Johnson said.

The clinic’s medical team, for the past two years, has come to visit Johnson’s mother, taking the traditional doctor’s visit outside the hospital walls. Johnson said it’s been a blessing to her because now she doesn’t have to take a day off of work, and she can schedule around the visit. In addition to the ease of scheduling, Johnson said she doesn’t have to move the removable ramp attached to the home.

“That really took a load off,” Johnson said.

Doctors are able to keep up with lab work, make sure she has what she needs and provide services normally given in a doctor’s office from the comfort of home.

Grammas said the clinic has been around for more than 20 years, and while doctors have always made house calls on an as-needed basis, the clinic began to “recruit” patients to be part of the formalprogram in 2015.

“We have a lot of older adults who have trouble making clinic visits,” Grammas said.

Severe impairments, exhaustion from making the visit and the cost of using an ambulance to get to the doctor can all contribute to some patients being unable to visit the clinic in person.

As doctors recognized the need, they began to build a referral process, and the program has grown from about 20 to 30 patients in 2015 to about 250 patients today, Grammas said.

The clinic’s team consists of Grammas, two nurse practitioners, a case manager, a medical assistant and a social worker. They’ll travel to patients 30 miles away from UAB in any direction, Grammas said.

“It’s a program that has benefits in lots of different areas,” Grammas said. “They appreciate the fact that we’re able to come to them.”

Doctors are able not only to check up on the patient’s health, but also to examine their environment to better discover what needs they might have. Doctors who visit the home can learn about the patient’s living conditions, their neighborhood, their caregiver, safety hazards and other aspects of care not seen in the usual clinic visit.

“From the minute you start to drive into their neighborhood, you start to recognize things,” Grammas said.

Because patients don’t have to go through the hassle of arranging a clinic visit, doctors are able to see them more regularly.

“By being able to see them on a regular basis, we’re able to improve their overall quality of health,” Grammas said.

The hospital has seen a “significant” reduction in ER and regular hospital visits, Grammas said.

The program works just like a normal visit for insurance purposes, and house visits are provided to patients of all socioeconomic conditions, Grammas said.