Complex medical transport situations are SentinelMED’s specialty. We handle routine cases, but specialize in planning, executing and overcoming the tough obstacles a patient may face when trying to return home after a major medical event. This is one of those cases.
Traumatic Situation
In early 2015, a 54-year-old Filipino, who was in the United States with an expired passport, suffered a severe stroke in West Virginia. Sadly, the stroke left the patient paralyzed on the left half of the body. The patient required a feeding tube because she was unable to swallow, a urinary catheter and a diaper. She was very deconditioned. While the patient could stand with assistance, she needed help with walking, and had borderline oxygenation at sea level.
The patient’s financial resources were also severely limited. There was no local family to provide support, and the patient did not have access to any form of payment for the medical care. The only identification the patient had was an expired passport with the address of the family back in the Philippines.
A Tough Case for Hospital Case Managers
Patients in the United States are able to receive care from hospitals even if their financial situation makes it impossible for them to pay for treatment. These patients are assigned a case manager in the hospital who acts as an advocate for the patient. Typically, hospital case managers have very large caseloads, overseeing a wide range of patients, from citizens with insurance plans to uninsured nonlocal patients. In all instances, the case manager works to get the patient discharged and long-term care arranged when needed. The case manager’s goal is to ensure the patient receives the care he/she needs, but to also get him/her discharged at the appropriate time to free up space and resources for other patients being admitted to the hospital. For this particular patient, a daunting list of obstacles faced the busy hospital case manager with an already overwhelming workload.
How SentinelMED Helped: Identify and Organize a Plan
With this patient, long-term care was needed, but in the United States there were no family or funds to support her long-term. The best option for the patient was to arrange a medical transport back to the Philippines where she could be with family that could care for her.
The hospital case manager priced air ambulances and was looking at a cost of over $100,000 just for the ride home. But the case manager, who had heard of SentinelMED at a case management conference, knew to call SentinelMED for a creative and cost-effective solution for this tough case.
After the initial contact, the case manager supplied SentinelMED with the patient’s medical history, expired passport and the family’s address back in the Philippines. From that point forward, the case manager's involvement was minimal and SentinelMED handled nearly all of the logistical planning and execution. The first step was to have SentinelMED’s physicians review the medical records and speak with the treating doctor and medical team in West Virginia. SentinelMED was able to determine that a commercial air medical transport with upgraded seating was a viable solution. They worked to arrange ground transportation to and from the airport, and sent a registered nurse from their pool of escorts who served as the medical escort and administered medical care and oxygen in-flight. The total cost was $35,000 door-to-door – a much more financially attractive option than the air ambulance.
How SentinelMED Helped: Arranging Long-Term Care
While cost is one major factor to consider, the patients care during and after the medical transport is the highest priority. The next step was to contact the patient’s family in the Philippines to see if they would be able to care for him at home, or if other long-term care needed to be arranged. Our agent in the Philippines found the patient’s adult son, who agreed to accept the patient at their home, as long as appropriate supplies were provided to him. These were sent with the patient.
As a precautionary measure, SentinelMED always identifies a nearby medical facility to administer long-term care in the event the home situation does not work out upon arrival. Our agent was able to locate an excellently rated hospital close to the son's home where they could send medical records and establish a relationship with the local doctor. Our physicians, in coordination with the agent, were able to identify, contact and retain a local physician who would see the patient at home and make sure that he was receiving the care that he needed. In addition to handling the transport of the medical supplies and home health supplies to the patient’s son's home in the Philippines. SentinelMED’s registered nurse medical escort also provided the family in the Philippines with training on home health needs to ensure continued care for the patient and that her special needs were met.
How SentinelMED Helped: Financing the Medical Transport
While $35,000 is much more attractive than a $100,000+ air ambulance ride, it is still a large expense. In this instance, the case manager presented a proposal to the hospital’s administration for $35,000, plus a small fund for the medical supplies (suction, feeding tube supplies, etc.). Compared to the cost of financing a nursing home stay or an indefinite hospitalization, the repatriation to the Philippines and medical air transport was a much better financial option and was quickly approved. It also removed any possible financial repercussions on the patient and her family.
How SentinelMED Helped: Securing Necessary Travel Documentation
With the funding approved, the SentinelMED team proceeded with securing the necessary travel documents for the patient. They contacted staff from the Filipino consulate, whom they had worked with before on several other medical repatriation cases. The consulate became personally involved in the case, to the point where one of the consulate staff went to see the patient in the hospital to obtain fingerprints, photo identification and supply the one-time travel document authorizing passage back to the Philippines.
How SentinelMED Helped: Flight Logistics
The patient required upgraded seating for any flight more than 1-2 hours. The patient needed oxygen, medications and specialized feeding during her transport. SentinelMED made ground medical transport arrangements via ambulance to and from the airports. To ensure continuous care for the patient, loading directly from the ambulance to the commercial aircraft was necessary. SentinelMED obtained all necessary clearances to go through TSA at each airport and for the ambulance to bring the patient to the aircraft. FAA certified equipment was used in-flight.
The letter from the Filipino consulate was only able to authorize direct passage to the Philippines. This meant that the patient needed to go directly from the United States to the Philippines, and would not be able to take any flights through any other countries. This stipulation required SentinelMED to devise a unique route to the final destination. The solution was a United Airlines flight in a first-class section that featured proper fully-flat seating through Texas to Hawaii to Guam (a U.S. territory) and finally, Manila.
How SentinelMED Helped: Returning Home
With all the planning and preparation done, it was time to execute the extensive plan. Prior to the trip, the medical escort, a veteran emergency room registered nurse, visited the patient and completed the final assessment of the patient’s condition. The medical escort also met and consulted with the medical staff caring for the patient at the referring hospital. She collected hospital-supplied equipment for home health needs, which was packed by the SentinelMED staff for easy transport during the trip. The ambulance ground transportation picked up the patient and medical escort at the hospital three hours prior to the initial flight departure. Medical care was provided every step of the way, and after a relatively uneventful 32-hour trip, the patient was delivered home. The entire extended family, over 37 members, were assembled and waiting eagerly for the patient’s arrival. It was a long trip, but the tears, hugs and continued gratitude from the family just reaffirmed that the patient was where she needed to be – back home, receiving the care she needed from the family she loved.
Arrange an Affordable Medical Transport Service
Each medical situation is different and every individual’s health needs vary significantly. SentinelMED is a medical travel assistance company that knows the ins and outs of medical transports. Our team of qualified logistics and medical professionals are able to determine the most appropriate form of affordable medical transportation service and help manage the process from bed-to-bed. We understand the complexity of delivering exceptional care to the sick, elderly or injured patient in an unfamiliar environment. Please contact us if you’d like to learn more about our services and staff.
