Blue Promise: Caring for Chronically Ill Kids

What do you do if your child has a critical and chronic sickness? One idea is to look into the use of a complex medical home that can be like a concierge service for the child and the family.  In this episode of Blue Promise, Dr. McCoy discusses the benefits of a complex medical home with Dr. Paul Hain.

Blue Promise is an online video blog that aims to address complicated health issues with candid conversations from subject matter experts.  New editions are published regularly and are hosted by Dr. Dan McCoy, Blue Cross and Blue Shield of Texas' Chief Medical Officer and Divisional Senior Vice President of Texas Market Strategy. 

Show Transcript

DAN: Hello I'm Dr. Dan McCoy, welcome to this episode of Blue Promise. I am here today with Dr Paul Hain, He is the Chief Medical Officer for Blue Cross Blue Shield of Texas in North Texas Paul you had another career, tell me a little bit about that.

PAUL: I was trained as a Pediatric Hospitalist which is a pediatrician who specializes in taking care of children who are sick enough to be in the hospital so I would care of regular things like pneumonia all the way through the really complex children who come in with ventilators and g tubes and really are more of a chronically ill child.

DAN: And that what I want to talk about today so there's this new concept of a complex medical home tell me a little bit about that.

PAUL: So complex medical homes have really recognized that a certain small segment of the population is technology dependent for instance they will have a home ventilator which might be attached to a tracheostomy to help them breath they might have G tube in which is a little tube that goes from outside the body into the stomach for a liquid nutrition because they have trouble swallowing they might have seizure disorders.

DAN: So they are sick.

PAUL: they are really they're sick kids that when they're doing well are just this far away from not doing well.

DAN: Got it right so very narrow margin of error if you will.

PAUL: Absolutely, not a lot of reserve and so we found that if you get some pediatricians some extra training in terms of seeing a lot of these kids and getting used to the technology and they see these types of children every day, they become very good at it and they're able to affect their lives in a really nice way and that these children will be able to stay home more and might get admitted to the hospital less, have a more normal family life the difference really being that if you're a typical type of pediatrician and you see one of these kids every three or four months it's going to be hard for you to know what to do or actually even change out the hardware whereas if you have a complex care medical home, that you can call if your child's g-tube is blocked or there is a difficulty with a ventilator you can avoid being sent to the emergency room and admitted to the hospital to get this fixed you can have an office visit just like going in for an ear infection.

DAN: So a typical parent, if I understand correctly, might call their pediatricians office and they might not have the tools or the expertise of their staff to be able to affect that change and the child might end up in the emergency room.

PAUL: Absolutely and that's no knock on the general pediatrician because they do a great job taking care of these kids it's simply something that they can't do because they don't do enough of it and so they have to either send a child to say children's hospital in the emergency room to have someone with that technological skill or they can be part of a complex care medical home which can either augment the primary-care pediatrician or actually take over and become the primary care place for that child.

DAN: So it's almost in some respects it provides a little bit more comfort for the families taking care of the child at home.

PAUL: Absolutely just a little more special care that's needed to make sure that family can stay at home as much in function like a regular family as much as possible.

DAN: Paul, I learned a lot today about the complex medical home thanks for being here today and thanks for joining us for this episode Of Blue Promise.

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