House Calls and Video Help Guide Pneumonia Care

Pneumonia still leads to about 1.4 million emergency department visits each year in the United States. That is a lot of pressure on urgent care spaces. A mixed care plan tried to help with that. Adults with pneumonia could first meet a doctor by video. Then, a trained health care professional could go to the home with digital diagnostic tools.

The team looked back at records from a primary and urgent care system. The review covered adults diagnosed with pneumonia from January 1, 2022, to January 1, 2024. Cases were found using ICD-10 codes J18.9, J15.8, J16.8, J17, and J18.1. The team screened 30 records, and 28 patients met the study rules.

Across the group, there were 56 clinical encounters. Each patient had a median of 2 encounters, with an interquartile range of 1 to 3. CRB-65 scores, which look at confusion, breathing rate, blood pressure, and age 65 or older, ranged from 0 to 2. Thirteen patients scored 0. Thirteen scored 1. Two scored 2. The data also tracked visit type, treatments, health conditions, and emergency department referrals.

Eight patients, or 28.6 percent, were sent to the emergency department. Those patients had higher CRB-65 scores than those managed without an ED referral. The median score for the ED group was 1, with an interquartile range of 1 to 1.5. The non-ED group had a median score of 0, with an interquartile range of 0 to 1. The Mann-Whitney U test found a significant difference, with U=34.0 and P=.01. The useful question is not whether this model works for everyone. It is which patients may be safe for this approach and which need faster emergency care. Larger prospective studies with longer follow-up are still needed to test safety, outcomes, referral accuracy, and effectiveness.

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