HIPPE: Carolina Care at Home

Of my three days with the Med Transition Specialists, I spent one day with another subset of the group called Carolina Care at Home (CC@H).  While med histories dealt with people through the admission into the hospital, this group works with the discharge of patients.  Essentially, CC@H extends the Central Outpatient pharmacy into a bedside delivery service before patients leave the hospital.  There are benefits for both parties.  The patient doesn't have to stop at a local pharmacy on the way home to pick up prescriptions, and the hospital generates revenue from the sales.

We started early in the morning by checking the eligibility of the patients about to be discharged from the hospital.  Because there are only four members of this group, they focus on patients with insurance instead of self-pay.  After identifying potential customers, we went through the floors to offer them the service.  After watching the person I was shadowing a few times, I felt comfortable enough to give it a go.  I walked into a patient's room a little nervous, but prepared.  The 26-year-old patient was alone in his room watching TV when we entered.  I asked if he would be interested in bedside delivery, but I didn't get much feedback from him.  I kind of freaked out that I was bad at this and every patient would respond to me in the same way.  After leaving, a nurse let us know that he had the mental capacity of a 5-year-old and probably didn't understand what we were saying.  When we spoke to his guardian later that morning, I noticed that the patient was watching Sesame Street on the TV.  Fortunately, not all of the patient encounters turned out that way.  In fact, pretty much everyone I spoke to was eager to have the meds delivered before leaving the hospital - except one patient that received free medications on the military base.  Of any day on the HIPPE rotation, I spoke to the most patients with the CC@H.

After a patient agreed to CC@H, we would fax their prescriptions down to the Central Outpatient Pharmacy and let them know something was coming.  The popular service could easily overwhelm the staff down there in their little corner of the COP, so it would not be surprising for a 2 hour turn around.  When we went through the floors of her service area, we headed down to the COP to pick up the orders and take them back up to the rooms.  After we left, a pharmacist in the COP would call the patient's room, counsel them on the medications, and collect their payment over credit card.  If the patient paid in cash, we brought up the meds, took their money to the pharmacy, and brought their change back up to the room.  There was a lot of walking done on this day.  Actually, because I have a FitBit I can tell exactly how much walking was done - 14,000 steps for over 5 miles.  For this job, comfortable shoes are a must.

Overall, the Carolina Care at Home initiative is a great program.  The pharmacy can reach out to a hospital full of confined customers.  Patients can receive what they need before leaving and head straight home.  I don't know if other hospitals have a similar program, but if I end up in one that doesn't I will attempt to start it.  Transitions of care is a hot topic in the health care field.  This can earn money from the hospital and help prevent patients from readmission.  Win-Win.