Sept. 26, 2019 – While it may be true that most doctors don’t make house calls anymore, HomeCare still does! A Rady Children’s department for more than 25 years, HomeCare encompasses two programs: a home health agency with a clinical care team offering in-home visits and a home infusion pharmacy that delivers intravenous and injectable medications to patients, dispensed and monitored by experienced clinical pharmacists.
Before I began my tour of the HomeCare facility, located in an office park close to the Rady Children’s Health Services (Plaza) building, I got to visit with the team as a group. I learned that their delivery services can extend as far as Orange, San Bernardino and Riverside Counties. They’ve delivered to far-flung locations like Blythe (on the Arizona border) and Apple Valley in San Bernardino County. Clinical services are in three counties: San Diego, Imperial and Riverside.
HomeCare Director Rose Baxter observed that “it takes a village” to operate HomeCare, with team members including intake and customer service specialists, pharmacy techs and pharmacists, supply chain experts, and more. As the tour began, Rose and I both received a baby doll with ports attached as a reminder of the precious little ones who rely on HomeCare.
Our first stop was the intake area. Among other duties, this team works diligently to request and process authorizations from payors such as private insurance companies and Medi-Cal to cover the cost of HomeCare services. HomeCare currently follows more than 1,600 patients, with about 47 percent covered by Medi-Cal or California Children’s Services.
Next, I was introduced to the friendly customer service team, who interacts with families over the phone and face-to-face, such as when they come in to pick up medications. They also carefully review orders with families to ensure the type of medication and quantity is correct.
We then moved to the recently expanded warehouse section of HomeCare. Here you’ll find everything from specialty baby formulas to medical supplies such as gastrostomy tubes. This crew loads supplies and double-checks them for delivery to homes, workplaces or physicians’ offices based on the needs of each patient or family. They also clean and service equipment, such as infusion pumps, for rental or purchase.
From the warehouse, we made our way to the onsite pharmacy, where customized doses of IV and injectable medications are dispensed safely and cost-effectively. Clinical pharmacists work in collaboration with physicians to provide services including immune therapies, IV hydration, pain management, chemotherapy and RSV prevention (using the drug Synagis), which patient families can pick up directly or receive at the Hospital if leaving an inpatient stay. Pharmacists are also available for consultations. As we toured the space, I learned about a machine that automatically makes IV solutions and parenteral nutrition (IV food for patients who cannot be adequately fed by mouth or through a feeding tube) based on the exact combination needed for a specific patient. Pretty cool!
Next, I dropped by the clinical services team as they planned out the day’s visits. This group of registered nurses, physical therapists, occupational therapists and speech therapists travel far and wide to care for patients. A giant white board at the front of the room mapped out where and when their visits were scheduled. One of the most important services this team provides is parent education. They show parents how to use machines and medications in sometimes challenging home environments. They also use telemedicine to communicate remotely with their palliative patients. Other services include comprehensive assessments, skilled procedures and treatments, phototherapy, rehab therapy, ostomy and wound care, IV and infusion therapies, maternal and child services, and social work.
The services this team provides are vital to keeping kids healthy and greatly reducing the need for them to come back to the Hospital. HomeCare is such a great convenience to parents and a comfort to patients to receive their medical treatments at home. When it comes to providing the very best care to kids, this team delivers (literally!)