Home Visiting Medical Care with Emily Keller
I was honored to speak with Emily Keller for the fifth episode of the Moving Healthcare Forward podcast. She is an Advanced Registered Nurse Practitioner and an incredible visiting primary care provider, working with the Parker Advanced Care Visiting Physician Services at VNA Health Group. Today we spoke about the incredible services she delivers as a visiting provider, the challenges she encounters and how in-home care has changed with the pandemic.
The Benefits of In-Home Healthcare
As the population ages, providing high quality in-home primary care becomes more and more critical. Visiting providers can offer a wide range of important services to homebound patients, including lab work, x-rays, ultrasounds, physical therapy, and more.
Emily Keller explains that not only is in-home primary care just as good as an office visit, it can actually give the physician a chance to get a better understanding of a patient’s health. “We get to see the whole picture, the whole patient. It allows us to see other barriers and other needs they might have… We can really tailor their care plan to what their needs are.” The visiting physician is able to assess the patient’s environment, talk to their family members and get a more holistic impression of the patient’s health in a way that they might not be able to at a typical primary care visit.
Keller initially worked in the ICU, but her experience there taught her that she would prefer working in primary care. She wanted time to get to know and treat the patient, rather than treating the illness. Now, as a visiting nurse practitioner, Keller tends to patients who have mobility issues that make it difficult for them to leave home. Shorter visits might be as simple as taking a patient’s blood pressure, while longer visits can allow for deeper, educational conversations with her patients about their health and medications. “I love that I get to see them in person… There’s just nothing like being able to get your hands and eyeballs on a patient to really give them a good exam.”
The Importance of Person-to-Person Care
Keller shares that before she began working as a visiting care provider, she was afraid it would bore her. However, she’s happy to share that it was just the opposite — each patient presents their own challenges, and she reports that she hasn’t been bored one day. She explains that there is a lot of diversity in home healthcare, between the people she works with and the problems she encounters. Furthermore, she finds such problem solving incredibly rewarding. It’s gratifying to prevent the exacerbation of a health issue or avoid a hospital visit, as she can see the tangible resolution of a problem — and the difference she’s making.
However, Keller admits that there are some problems that are more difficult to find a solution to. Loneliness, boredom and feelings of isolation are common among homebound patients, especially with the pandemic in the last few years. This can lead to deeper mental health and nutritional issues. “That’s one thing where I’ll admit I feel a little helpless,” Keller says. “I’ll ask if there’s anything else they need today, and they say, ‘Do you have a pill for boredom?’”
She hopes that in the future, visiting care providers will be able to meet patients’ needs beyond the medical basics, and make sure that they feel that there’s more meaning in their lives. A big part of that is ensuring they’re able to socialize, which visiting physicians play a part in. Technology can make telehealth visits possible and improve treatments, but Keller argues that it’s impossible to replicate the impact of person-to-person care. “That human connection is integral. Can it be replaced? Sure. Is it going to be as good? I don’t think so.”
Listen to our episode with Emily Keller, advanced registered nurse practitioner with the Parker Advanced Care Visiting Physician Services at VNA Health Group on Apple Podcasts here, or on Spotify here.
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