Implementation and impact of the Rural Older Adult Mobile (ROAM) Care program

Research Objectives: To implement an innovative, cost-effective healthcare model of home-based primary care and preventative healthcare by leveraging community resources to increase access for rural, vulnerable older adults. To improve health outcomes and reduce preventable emergency room utilization and hospital admissions or readmissions through patient-centered care plans and coordination of services.

Design: ROAM Care provided comprehensive in-home geriatric assessments and continuity of care using a mobile health clinic, nurse practitioner (APP), or physician home and telemedicine visits. By bringing the health facility/provider to the patient, care was ensured at no or minimal out-of-pocket cost.

Setting: Clare, Isabella, and Gratiot counties in rural Michigan

Participants: The criteria for inclusion in the program were: 1) no primary healthcare visit in the past 6 months; 2) three or more emergency room visits in the past 6 months; and/or 3) repeated preventable hospital admissions or readmissions.

Interventions: Not applicable

Main Outcome Measures: Participants provided qualitative and quantitative feedback at 6 and 12 months. ROAM, emergency department and clinic visits were recorded and tracked longitudinally for each participant.

Results: 52 adults were recruited in the program over three years. By receiving primary healthcare services more often from the ROAM healthcare team, participants decreased the number of emergency room visits and hospital admissions. Individuals restricted by transportation or medical reasons were able to receive effective care at home.

Conclusions: The ROAM care model proves that individualized care plans and creative integrative partnerships between educational institutions and community partners can lead to improved outcomes, decreased cost, and enhanced quality of care. The pilot program was deemed successful and handed off to a community-based local provider practice beginning in 2023.

Author(s) Disclosures: No disclosures to report