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Clinical Experience General Hero

Case 5 - Hasan Prasetyo

Hasan Prasetyo

History

You are performing an outreach call to Hasan Prasetyo. He is a 72-year-old man who was discharged 4 days ago from Methodist Hospital. You review his medical records prior to the phone call, and you discover that he had first presented to the Methodist ED with a 1-day history of lower abdominal pain and mild URI symptoms. At that first visit, he was hypoxic (93% on RA), tachypneic (RR 26), and febrile (100.6F). His ED workup included a chest X-ray (bilateral multifocal infiltrates), CT of his abdomen/pelvis (negative), extensive blood work (only notable for lymphopenia), and a positive COVID swab.

Portable Chest X-ray with Mutifocal Pneumonia
CT Abdomen/Pelvis with Multifocal Pneumonia at Lung Bases

[Click for larger detailed image.]

Mr. Prasetyo was admitted for monitoring based on his tenuous respiratory status. During his inpatient stay, he initially required 2-4L per nasal cannula to maintain his oxygen saturations >92%. As his oxygen requirement improved, he was able to be discharged on hospital day 4.

Prior to your outreach call, you discover from the patient's Epic chart that the patient requires interpreter services (Indonesian). You refer back to the Canvas Virtual Outreach Calls (How-To Guide) and go through the steps to performing a language line call to the patient.

During your call with the patient/interpreter, you find that Mr. Prasetyo is feeling better since discharge – no difficulty breathing, no fevers. He appreciates the call to check up on him. You proceed to perform your Health Leads screening (Spanish version). Of note, he has no issues with medications, transportation, housing, or utilities. However, he reports issues getting food since he's been self-isolating due to COVID.

Ask Yourself

  • What other food insecurity-related questions would you have for Mr. Prasetyo?

Mr. Prasetyo is currently living alone and lacks a social support system. He does receive $175/month in SNAP benefits. However, he doesn't know how to access food since he's supposed to stay at home. There are a couple of corner stores within a few blocks of his house where he typically buys basic supplies. Otherwise, he usually takes the bus to the local grocery store. He definitely would like information about food banks, food pantries, and any other community food resources you might offer. As an aside, he says a nephew has been checking in on him daily – and his nephew is fluent in English.

Ask Yourself

  • Come up with a plan to manage his food insecurity needs.

A reasonable plan to manage his food insecurity needs:

  • SHARE Contact free food delivery (register online) – 215-223-2220.
  • If the patient has a computer, they can order online through most food chains and use their SNAP benefits (or call 311 for locations).
  • Contact WHY Hunger at 1-800-5-HUNGRY or by having the patient text his zip code to 1-800-548-6479.

Read Article about food insecurity during the COVID Pandemic

In the article, Wolfson et al. provide a harrowing analysis of food insecurity pre-COVID and the possible/probable health consequences of food insecurity as a result of the pandemic.

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