JOINT BASE ANDREWS, Md. –
With staffing by nurses 24 hours a day, 7 days a week, the NurseAdvice Line puts medical advice as close as the nearest phone for military personnel and their families.
For Air Force Capt. Stephanie Raps, Easter weekend went from fun excursion to ordeal in a matter of hours. That's how long it took for her two small children to become ill as her own sinus infection worsened.
"We were nine hours from home, traveling in rural Ohio, and I knew we were at least two hours away from the nearest military treatment facility at Wright-Patterson Air Force Base," she said.
Raps, a nurse herself, had already contacted the Nurse Advice Line (1-800-TRICARE, option 1). Resources there provided guidance on all three "patients" and told her to call back if she needed additional help. When seven-month-old Leah's ear infection worsened to include a high fever and fluid oozing from the ear, Raps knew she had to take further action.
"I was worried it was a rupture, as was the nurse on the phone, and they got me to the appointment center, which set me up with a pre-authorization at a civilian clinic within six hours," she said. "It was reassuring to talk to another nurse professional who I know was giving good advice."
Such reassurance makes NAL especially valuable to military personnel and their families. Nurses follow a strict protocol and walk callers through a series of questions to help determine the level of care needed. Options include visiting the emergency room right away, waiting for a regular appointment or taking care of the issue at home.
For safety reasons, the patient -- even if it's a child -- must be present when calling NAL.
"It ensures the patients receive the right care at the right time from the right provider," said Jeannine Leonard, clinical coordinator for TRICARE Prime clinic in Chesapeake and Virginia Beach, Virginia.
A managed care option available in Prime Service Areas in the United States; you have an assigned primary care manager who provides most of your care.
"It gives our patients a place they can call 24 hours a day and get the advice they need for their concerns. In addition, NAL helps our clinic manage its access to care; ensuring patients are seen according to protocols," said Leonard.
Tamika Nelson, a retired Army sergeant with 22 years of service, faced that very issue. When a urinary tract infection became too much to bear, she got in her car to face the possibility of gridlock in Washington, D.C. trying to reach her regular military clinic at Fort. Belvoir, Virginia. But then she remembered what a friend told her about NAL and made a quick call.
"The nurse was very helpful," said Nelson. "She said while I did need to be seen within the next eight hours, I didn't have to drive all the way to Fort. Belvoir. She sent a referral to an acute care clinic just around the corner from where I live, and I was seen, got my prescription and was back home in about an hour and half. It was the best thing ever!"
Nelson was referred to an urgent care clinic because she was beyond the 30-minute drive time specified in access-to-care guidelines.
In addition to being an extra health care resource, NAL increases patient safety, especially as the patient is handed off from one care provider to another. To further ensure a safe patient experience, military Medical Treatment Facility Patient Centered Medical Home team members can access live NAL information so they are aware of their patients' situation and can provide follow-up, if needed.
"Anytime you move from one level of care or one facility to another, your patient is at risk," said Sherry Herrera, who oversees military clinical operations for the Colorado Springs, Colorado, area. TRICARE beneficiaries enrolled at her military treatment facility call NAL more than 1,700 times each month. "The information gathered over the phone is available electronically to the military treatment facilities, enhancing patient safety because there is a much greater chance that the caller's primary care manager will have access to those records when the patient needs follow-up care."
Depending on call volume, some beneficiaries might experience a delay when they call, but NAL is working to address this issue. Even with potential delays, callers agree telephone wait times are shorter than those in an emergency room.
When a military treatment facility is close enough and can offer the acute care or emergency room services needed, callers are directed to that facility, even if they prefer to visit a civilian urgent care clinic. This ensures primary care managers know about the visit and have access to care records.
For Capt. Raps, the advice line provided a triple win: It addressed her daughter's potentially serious ear problem, saved mother and children from hours of waiting in an emergency room and allowed the weekend road trip to proceed.
"Easter was saved," she said. "We were able to enjoy more time with our family. And I had peace of mind."
The Nurse Advice Line is available at no cost to TRICARE beneficiaries in the Continental United States, Alaska and Hawaii and is available 24 hours a day, seven days a week. Call 1-800-TRICARE and choose option 1.