During Becker's Shift to Digital Podcast, Health Recovery Solutions’ VP of Client Growth, Doug Lang, discussed an increasingly popular topic: the Hospital at Home model. Across the country healthcare providers have been implementing the Hospital at Home model at an increased rate.
There are many benefits of the Hospital at Home for both patients and clinicians including limiting COVID-19 exposure, increasing hospital bed capacity, offering personalized care plans, and more. Throughout the podcast, Doug answered some of the most common questions from health systems about the Hospital at Home model.
Goals for Your Hospital at Home Model
When a health system is considering implementing a Hospital at Home model and remote monitoring, it’s important to understand the goals of the program. Doug walked through common goals that health systems and hospitals often consider:
- Reduce length of stay (LOS) – health systems and hospitals want to discharge patients when it is safe to do so, without foregoing quality care. This model offers patients the convenience of at-home care by providing hospital level care to patients at home and offering the necessary equipment for video visits with clinical teams, bluetooth peripherals for vital monitoring, and access to a care team whenever necessary.
- Increase patient satisfaction – most COVID-19 patients were isolated in the hospital while receiving care. A top goal of the Hospital at Home model is to enable patients to receive quality care at home surrounded by loved ones, pets, and their possessions for an added layer of comfort.
- Decrease total cost of care – 68% - or close to $1 trillion - of all hospital care is offered in the brick-and-mortar setting. Separating care from the brick-and-mortar setting allows a greater focus on providing clinical care at home while achieving the same clinical results for lower costs.
- Competitive advantage – for competitive marketplaces like Texas, Florida, and California, this model is a way to separate one organization from another in what can be an extremely competitive market.
- Divert from the ED – this was extremely important during COVID-19 and also a driver of early program adoption. Health systems started asking “how can we manage COVID patients outside the hospital?” “How can we keep less acute patients out of the hospital and provide them care at home?” Health systems began expanding beyond COVID-19 when they started seeing success and better patient outcomes because of the Hospital at Home model.
“The goal of shortening length of stay through early discharge is the easiest to start with because the patient is already in the hospital and workflows are very similar. While the patient is in the hospital, clinicians can educate them on the program, introduce them to the technology, and upon discharge, the patient has a clear understanding of what’s coming.”
- Doug Lang, VP of Client Growth, HRS
The Role of Remote Patient Monitoring
RPM is an integral part of the Hospital at Home and home care model because it meets CMS requirements for acute care at home. That includes providing the video platform to enable RNs to conduct home visits, collecting two sets of daily patient vitals (with the use of peripherals), and having an emergency response system for patients to contact their care team immediately. Health systems and hospitals can provide RPM services in one of two ways – by leveraging in-house or affiliated home health agencies or by building a centralized monitoring team of telehealth nurses, RNs, and hospitalists.
Once a patient is discharged to home it’s important to ensure an open channel of communication to get in touch with their care team when they need it.
The next step for the health system is to leverage all resources at their disposal. This can be done by:
- Working with a Home Health agency, either owned by the health system or affiliated with.
- Partnering with paramedics to provide transportation for the patient.
- Getting the patient set up in the home and familiar with the RPM technologyLeveraging organizations like Meals on Wheels to ensure the patient has access to food and nutrition.
Understanding all the resources and capabilities of the teams, what and how they can deliver, and coordinating effectively helps ensure a fluid transition from brick-and-mortar care to the at-home setting.
Download the White Paper: 5 Lessons Learned About Hospital at Home Programs
With Insights from Michigan Medicine and Allina Health
Defining Enrollment Criteria for the Hospital at Home Program
Hospital at Home programs can serve a range of populations including COVID-19, CHF, COPD, diabetes, acute pneumonia, cellulitis, urinary tract infection, and more. Defining inclusion and exclusion criteria and educating clinical teams on each condition helps ensure a smooth and effective process for at home monitoring. This enrollment criteria help the provider determine which patients are eligible for the Hospital at Home, and which are not. Health systems work with insurance carriers and specific commercial payers to look at geography, demographics, and patient referral status to determine acuity level, connectivity restrictions and proximity to care, and helps ensure successful patient outcomes.
The team needs to make sure the patient will benefit and be proactive in their virtual care management. Does the patient need more hands-on monitoring? Do they have a condition that should be treated in person as opposed to virtually? Will they be open to the technology?
While the Hospital at Home model has been around since the mid-90s, it recently, due to COVID-19 has become one of the most talked about care delivery models in health systems around the world. The Hospital at Home has quickly shown health systems and hospitals that there are many effective ways to care for patients in the home.
With help from the community and clinical teams, the Hospital at Home model can result in better patient outcomes, decreased LOS, increased bed capacity, and importantly, improved patient satisfaction and quality of life.
