How to perform a house call

This chapter addresses the general approach to conducting a home-based medical encounter, clinical factors that are especially important to focus on in providing care for patients who cannot routinely leave their homes for office visits, and the basic equipment needed for home-based medical care. The medical equipment used in home-based medical care is essentially the same as that used in a typical office visit, and many ancillary services ordered in an office visit can also be performed in a patient’s home. Home-based medical care provides unique opportunities for the clinician to perform a comprehensive assessment of the patient, understand social determinants of health that impact the patient’s care, and integrate these factors into highly patient-centered care plans. This approach balances evidence-based medicine with patient prognosis, preferences, and ability to travel to a medical center for specialized testing or treatment. Similarly, preventive screening and health maintenance in the homebound population require an individualized approach that includes an understanding of prognosis, as well as disease and screening-test characteristics.