Parents are Saying Goodbye Waiting Rooms, Hello At-Home Care

Debbie Laplaca
Many parents are saying goodbye to waiting rooms and hooray to at-home care.

It was 5 a.m. and Emily Gray was worried about her young daughter’s fever. Reluctant to take her into an emergency room during the pandemic, she instead called a Mobile Health Care service. Eric J. Hebert, a board-certified Pediatric Nurse Practitioner specializing in primary and acute pediatric care, was at her door by 5:15 a.m.

“It was so easy to call him and get an immediate response,” Gray said. “I was ready to go to the ER and he was at my house by 5:15. Especially with COVID, the comfort of him coming to my home was great.”

Hebert is now the primary pediatric health care provider for both of her children. The decision, she said, was partly because her pediatrician’s office didn’t offer telehealth.

“It started when I was worried about my one-year-old and I couldn’t make to Worcester to get her to the doctor. I called him and he came right over, and she was a million percent better within one hour,” Gray said of Hebert.

Prior to 2020, little was heard of virtual pediatric healthcare. As COVID-19 spread throughout the country, patients and providers alike welcomed the rapid expansion of mobile and telehealth practices.

Today, at the two-year anniversary of the pandemic, those practices have become commonplace, and many parents are saying goodbye to waiting rooms and hooray to at home care.

“When people are sick, the last thing they want to do is get in the car. There’s no reason why we can’t do old fashioned house calls,” Hebert said. “It’s safer, it’s a better delivery system, and I know parents are concerned about bringing their kids in the emergency room right now.”

When house calls aren’t an option, there’s telehealth.

According to a July 2021 report by McKinsey & Company Health Care Systems & Services, doctors and other health professionals are now seeing 50 to 175 times the number of patients via telehealth than they did before the pandemic and the shift is expected to continue post-pandemic.

Telehealth, sometimes called telemedicine, refers to the use of two-way communication technology for certain health care services.

Massachusetts law defines telehealth to include audio, video, electronic media or other telecommunications technology for the purpose of evaluating, diagnosing, consulting, prescribing, treating or monitoring of a patient’s physical health, oral health, mental health or substance use disorder condition.

Dr. Angela Beeler, division chief, Pediatric Primary Care at UMass Memorial, said telehealth was rare before the pandemic.

“It’s amazing how far we have come in the past two years. We now have a very robust system to do telehealth for all providers. I think it’s here to stay,” she said.

Beeler called it a viable option that offers equity for patients who have physical challenges with getting to an office or have limited access to transportation.

“I think there are places that it works really well, certainly for mental health visits when we don’t need to lay hands on patients,” she said. “It is also helpful to see patients in their own surroundings. It also has benefits for other types of visits such as follow ups.”

As for the advent of Mobile Health Care, Beeler said she favors it when a practice goes mobile to see its patients.

“Sometimes the concern I have with mobile health units doing primary care is they are not an established primary care provider who is familiar with the family or has established a relationship with the patient,” she said. “It’s not the fact that it’s mobile, it’s due to a van showing up, providing care, and then they are gone without concerns with continuity.”

That is not the case for Hebert, who established Advanced Mobile Pediatrics in February 2021.

Today, he is a mobile primary care provider to 35 families and has responded to more than 100 people who have called the doc for urgent care.

“I get several calls per week from people who are curious about how it works,” he said. “There’s no waiting room and there’s no time limit on the appointment. Folks are able to schedule the same day or next day for visits.”

Hebert owns a horse farm in Brimfield where the vets still make barn calls. While he had given thought to patient house calls in the past, the pandemic prompted him to push his medical care out the door.

“I do believe house calls in other parts of the country are coming back and certainly the pandemic is pushing that,” Hebert said. “We do have the capacity to bring the office to the home so this may be the primary health care down the road.”

Hebert’s experience spans more than 30 years of direct patient care as an emergency room nurse, pediatric nurse practitioner at Boston Children’s Hospital Medical ICU, pediatric nurse practitioner at Shriner’s Hospitals for Children Burn Unit and primary care pediatric nurse practitioner in the United States Air Force.

Prior to becoming a nurse practitioner, Hebert worked at Boston MedFlight as a flight paramedic/critical care transport specialist.

His experience and skills are now used for house calls to patients ages birth to 21. When parents call, Hebert himself answers the phone.

“It’s not an emergency service, it’s a sick care service. Parents call me for things they would normally bring their child to their pediatrician or urgent care,” he said. “With today’s modern tech, I come equipped with all the latest and greatest testing. Everything I need comes into the home with me. I carry all the urgent care stuff with me and I do have emergency supplies if needed when I get there.”

In addition to primary and urgent pediatric care, Hebert specializes in ADHD, depression, anxiety testing and medication management, he is also a fellow of the KySS on-line mental health program.

“Twenty to 30 percent of our youth suffer from mental health issues,” he said. “I just did the extra education to make sure I’m well equipped to handle those kids. The mental health referral list and wait list can be several months, so I just wanted to make sure I could be a bridge.”

Studies say that MHCs are successful in reaching vulnerable populations by delivering services curbside.

They offer urgent care, preventative health screenings, handle chronic disease management.

An impact report from Mobile Health Map, a collaborative research network established in 2007, says mobile health clinics are playing a vital role in the U.S. healthcare system and are chiefly used for children.

MHM says mobile programs achieve good patient outcomes, boast impressive returns on investment, and reach underserved communities that otherwise experience barriers to accessing healthcare.

The services include primary care, preventive screening, disease management, behavioral health, dental care, pre-natal care, and pediatric care.