iHuman Virtual Patient Encounter- Musculoskeletal Assessment
Managing Knee Osteoarthritis for an Underinsured Client
If the client in the virtual encounter was underinsured, several aspects of the treatment plan would need to be adapted. Underinsured individuals, defined as those with insurance that does not adequately cover their healthcare expenses, face greater barriers to recommended care (Collins et al., 2020). Out-of-pocket costs are a major consideration. Prescribing cheaper over-the-counter pharmacological options may be necessary, rather than more expensive prescription anti-inflammatories. Acetaminophen is an accessible analgesic that can help manage osteoarthritis pain and inflammation without requiring insurance coverage for costly medications. However, close monitoring of acetaminophen use is essential, given dosing limits that cannot be exceeded regardless of symptoms or insurance status.
Treatment plans may still include costs for non-pharmacological modalities despite their increasing importance. Effective use of braces, taping, topical treatments, heat/cold therapy, and alterations to one’s way of life may provide significant alleviation at little expense. Providing underinsured patients with clear knowledge of proper self-care procedures enables them to properly manage their illness. However, worse results could occur if self-management is relied on excessively in isolation from other therapies. Some underinsured people may not be able to afford the out-of-pocket costs associated with certain procedures, even if they are covered by regular plans. Coverage limits may include limitations or outright bans on access to specialists, injectable therapies, imaging tests, and physical therapy (Faranak Kooranian et al., 2022). Ignoring these supplementary treatments for osteoarthritis, however, may hasten the course of the illness.
Therefore, sophisticated clinical judgment is required to navigate potential resources within the limitations imposed by the client’s insurance profile. According to the National Academies Press (US) (2019), underinsured patients may get more complete care with the help of care coordination services that link them to community health programs, local clinics that provide sliding fee schedules, or enrollment assistance for prescription/treatment financial assistance. Further possibilities may be expanded by establishing referral networks to experts who are ready to handle low-income individuals and provide reasonable care. Clients may learn about governmental and nonprofit programs that assist underprivileged communities in gaining access to resources via their collaboration with social workers. In order to enhance health within the client’s insurance constraints, alternate arrangements might still be made to get essential care components that are considered unmanageable out-of-pocket.
Managing Knee Osteoarthritis for a Client at a Mobile Clinic
A mobile clinic that treats people without homes also has a major influence on clinical decision-making when it comes to osteoarthritis of the knee. Even getting medical treatment may be a huge obstacle for those who are homeless (Currie et al., 2023). This group may get screenings, evaluations, medicine, education, and referrals directly from healthcare providers thanks to mobile care, which removes transportation constraints. However, conventional treatment plans for osteoarthritis will need to be modified to accommodate these unconventional settings. It may not be possible to dispense certain braces, assistive equipment, or quantities of medicine on-site due to storage limitations. An alternative would be to provide coupons redeemable at community resources or independent pharmacies that provide medical supplies. For those in precarious housing conditions with little assets, the emphasis must continue to be on long-term solutions that are realistically achievable.
Taping, topical anti-inflammatories, cryotherapy, and self-massage are non-pharmacological therapies that educate patients on how to manage their illness long-term and provide practical symptom alleviation. Treatment of osteoarthritis pain while minimizing damage may be achieved by cautiously adjusting the dosage of oral analgesics as required and keeping an eye out for signs of abuse. Given the challenges that homeless patients have while trying to take their prescriptions correctly, it is best to administer injectable drugs by directly witnessing on-site injection to maximize adherence. When making referrals, it is important to consider mobility limits and find community partners that can help individuals without insurance. As a result, the clinic’s multidisciplinary team approach is crucial for meticulous care coordination (Lowrie et al., 2021). Promoting therapeutic partnerships crucial to the health of this group requires adjusting suggestions to provide ethical treatment that is consistent with the unique limits of serving a homeless population.
References
Collins, S. R., Gunja, M. Z., & Aboulafia, G. N. (2020). U.S. health insurance in 2020: A looming crisis in affordability. Findings from the Commonwealth Fund Biennial Health Insurance Survey, 2020. http://resource.nlm.nih.gov/101773116
Currie, J., Stafford, A., Hutton, J., & Wood, L. (2023). Optimizing access to healthcare for patients experiencing homelessness in hospital emergency departments. International Journal of Environmental Research and Public Health, 20(3), 2424. https://doi.org/10.3390/ijerph20032424
Faranak Kooranian, Zohreh ParsaYekta, & Rassouli, M. (2022). Barriers and challenges to self-care among older adults with knee osteoarthritis: A qualitative study. Ethiopian Journal of Health Sciences, 32(5), 963–974. https://doi.org/10.4314/ejhs.v32i5.12
Lowrie, R., Stock, K., Lucey, S., Knapp, M., Williamson, A., Montgomery, M., Lombard, C., Maguire, D., Allan, R., Blair, R., Paudyal, V., & Mair, F. S. (2021). Pharmacist-led homeless outreach engagement and non-medical independent prescribing (Rx) (PHOENIx) intervention for people experiencing homelessness: a non-randomised feasibility study. International Journal for Equity in Health, 20(1). https://doi.org/10.1186/s12939-020-01337-7
National Academies Press (US). (2019, September 25). Summary. Integrating Social Care Into the Delivery of Health Care – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK552593/
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Question 
Week 7iHuman Virtual Patient Encounter: Musculoskeletal Assessment
Assignment
Reflection: Address the following questions: Consider how the setting in which you see clients may impact your recommendations for medications, treatments, or follow-up care.
iHuman Virtual Patient Encounter- Musculoskeletal Assessment
I. How would your recommendations have changed for this client if she was underinsured?
II. What about if the encounter had occurred at a mobile clinic for unhoused clients?
Include the following components:
I. Answer all questions in the reflection prompt
II. demonstrate clinical judgment appropriate to the virtual patient scenario
III. Cite at least one relevant scholarly source as defined by program expectations
IV. communicate with minimal errors in English grammar, spelling, syntax, and punctuation