Hospital at Home Initiatives Gain Traction During Pandemic

Mayo Clinic and Intermountain Healthcare announce programs to care for patients in their own homes.

Two large health systems are taking the "stay-at-home" edict to a new level. Rather than hospitalize certain patients, the organizations have launched services that enable them to receive hospital care at home.

Yesterday, Mayo Clinic announced advanced care at home, "a new care model that will deliver innovative, comprehensive, and complex care to patients" at home. Earlier this month, Intermountain Healthcare launched a similar initiative. Both health systems are partnering with outside entities to provide these services.

Using virtual care and remote monitoring technology combined with in-home visits, hospital-at-home programs deliver hospital-level care to patients in their own abodes. While a handful of hospitals already offer these services, and Johns Hopkins University has a well-established program and provides consultation services to other health systems interested in establishing their own approaches, hospital-at-home initiatives may be among the new healthcare delivery trends that will gain traction due to the coronavirus pandemic.  

Operating under the aegis of the Mayo Clinic Platform, Mayo Clinic's approach involves a team of caregivers directed by the health system's physicians. The program "offers comprehensive and restorative health care services including infusions, skilled nursing, medications, laboratory and imaging services, behavioral health, and rehabilitation services from a network of paramedics, nurses and an ecosystem of support team members," according to a news release.  Patients will receive a "seamless care experience at home, combining technology, innovation, and clinical expertise to ensure that the needs of the patient come first.

"As a physician, I have always believed that patients should receive the right care, at the right time, in the right setting to restore wellness rapidly," said John Halamka, MD, president of the Mayo Clinic Platform in the release. "During COVID-19, we've learned that patients expect more virtual and remote care than ever." He talked about this initiative earlier this week when delivering the keynote address to health system thought leaders gathered for the HealthLeaders virtual roundtable, "The Healthcare System of the Future."

Mayo is partnering with Medically Home, a Boston-based technology-enabled services company, as its implementation partner for this program. The company offers an integrated technology platform and network of in-home services that enable care which is directed by Mayo Clinic physicians and providers.

The combination of patient demand for consumer-centered models, advanced care at home offerings, innovations in technology, regulatory flexibility, and the need for flexible capacity within the health care system is the impetus for this new care offering, according to Mayo Clinic.

"Advanced care at home offers the capability to leverage our integrated practice capabilities to meet patient needs in new ways," said Amy Williams, MD, executive dean for practice at Mayo Clinic.

Dan Liljenquist, senior vice president and chief strategy officer for Intermountain Healthcare, who participated in the HealthLeaders event, also mentioned his health system's initiative in his remarks about how health systems of the future will operate. The Salt Lake City-based organization is partnering with Castell, an Intermountain Company, to provide its platform.  

“The hospitals of the future will expand virtually into homes to provide appropriate acute-level care," said Rajesh Shrestha, Castell president and CEO, and Intermountain vice president and chief operating officer for community-based care, in a news release. "This new service supports patients who are at risk for hospitalization or complications, along with their families. Many patients find they feel more calm and comfortable at home than in a hospital, and that in itself can be conducive to healing."

Intermountain patients eligible for this service receive an orientation and set-up at the hospital, followed by regular in-person and virtual check-ins from a care team of in-home and tele-nurses, as well as a tele-hospitalist. On-call services are available at any time.

Patients receive a remote patient monitoring kit and other home health equipment as needed for their particular diagnoses, according to Intermountain. Standard equipment includes a blood pressure monitor, pulse oximeter, cellular-enabled digital tablet, and a digital scale. Based on need, additional equipment such as a continuous heart rate and oxygen sensor will be added. All the devices connect to the tablet through Bluetooth and transmit vital signs to a remote monitoring center where a team of Intermountain telehealth specialists monitor patients 24/7.

“Enabling hospital-level care in patients’ homes will help advance Intermountain Healthcare’s transition to value-based care, where the goal is to keep patients healthy, improve outcomes, and reduce overall costs,” said Josh Romney, MD, Castell population health medical director and an internal medicine physician with Intermountain Medical Group.