HCCIntelligence™ Webinar Recording: Clinical Conundrums: Three Common Challenges You May Be Facing

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The HCCIntelligence Webinar titled "Clinical Conundrums: Three Common Challenges You May Be Facing" held on July 17, 2019, focused on managing complex clinical issues in home-based care. Presented by experts Thomas Cornwell, MD, Paul Chiang, MD, and Brianna Plencner, CPC, CPMA, the session covered management strategies for patients with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and type 2 diabetes mellitus (DM) with functional disabilities and multiple comorbidities.<br /><br />Key takeaways include:<br /><br />1. **Managing CHF**: Emphasis was placed on optimizing medications such as ACE inhibitors, beta-blockers, and MRAs while avoiding NSAIDs and certain antibiotics. Care should be tailored to patient goals, balancing intervention burden, and lifestyle modifications.<br /><br />2. **COPD Management**: Proper inhaler use, symptom management (e.g., repositioning, oxygen therapy, and anxiolytics), and strategies to prevent hospital readmissions (e.g., smoking cessation, follow-ups) were highlighted. The "alphabet soup" of inhalers necessitates addressing usage barriers.<br /><br />3. **Type 2 Diabetes Management**: Challenges include medication costs, administration complexity, and comorbidities affecting usage (e.g., vision impairment, cognitive issues). Emphasizing realistic lifestyle changes consistent with overall care goals is vital.<br /><br />A case study of a 76-year-old woman with severe COPD, CHF, and type 2 DM illustrated these concepts. Her management included a detailed medication plan and consideration of her social context, physical examination findings, and laboratory results.<br /><br />The webinar also explored guiding principles from the American Geriatric Society, stressing patient preferences, evidence interpretation, prognosis, and care plan feasibility.<br /><br />The session concluded with announcements about future educational offerings and consulting services from the Home Centered Care Institute (HCCI), emphasizing continuous improvement and support for practices providing home-based primary care. Participants were encouraged to attend upcoming webinars and utilize HCCI’s resources for further education and consultation.

Keywords

Clinical Conundrums

Home-based care

Congestive heart failure

Chronic obstructive pulmonary disease

Type 2 diabetes mellitus

Medication management

Patient goals

American Geriatric Society

Home Centered Care Institute

Webinar