Mixing old and new: House-call doctor uses cutting-edge technology in patient care
As a physician whose sole business is house calls, Devang Patel, DO, racks up quite a few miles seeing patients in the Plainfield area of Illinois.
Dr. Patel begins every morning with a paper printout of his patient roster for the day, and more than a little technology. With his laptop and medical supplies in his car and the morning’s first patient address punched in to his GPS, Dr. Patel is ready to begin his day as a 21st century house-call doctor.
Dr. Patel’s desire to stick to house calls developed during his residency, when the idea of working in a clinic began to make him feel boxed in. After a stint at a practice that allowed him to do house calls, Dr. Patel said he fell in love with this truly personalized method of patient care.
Dr. Patel is board-certified in family medicine and focuses on geriatric care. His main goal is preventing hospitalizations in a patient population that he says is typically on four or more medications on a chronic basis—exactly the sort of population that would benefit from the YouScript Personalized Prescribing System.
“At first it felt unreal,” Dr. Patel said of the idea of YouScript drug-sensitivity testing.
“Genetic testing? I don't have time to sit there figuring out, going through basic pharmacology for every single medication out there."
But Dr. Patel said he soon learned the benefit of the technology, particularly the wallet-sized card his patients get and carry with them to show during a hospital stay or visit to a specialist. The card, included with the patient’s test results, lists variations in that patient’s enzyme-coding genes that will have an impact on drug metabolism.
“If they're normal metabolizers for everything, we're fine, and I don't have to say anything special,” Dr. Patel said.
“But if they're ultra-rapid or slow metabolizers of any one of the [gene] systems, which are commonly used as metabolic pathways, I tell them, ‘This is very important. Keep it next to your Medicare card. Make sure that wherever you go, if you're [seen] by another doctor, tell them to look at that.’”
For most of his patients, Dr. Patel said he uses the companion YouScript software to review medications they may have been on for a long time and see if their genetics might put them at risk for any potentially serious drug-gene or drug-drug-gene interactions. Dr. Patel would then use YouScript’s alternative medication feature to see if other similar drugs could reduce that risk.
It’s this extra layer of protection, achieved through the use of technology, that allows Dr. Patel to optimize patient care while practicing the increasingly rare art of house-call medicine.
“Medication-related errors and adverse reactions [are] one of the most common reasons for hospitalization,” Dr. Patel said.
“[That] goes into our core philosophy; we want to prevent [those]. So anything we can do in anticipation is good.”