Last month, Nevada-based health system Renown Health announced it would begin monitoring patients sick with COVID-19 through a “hospital at home” program. Patients were outfitted with a blood oxygen saturation cuff and a mobile app that asks them questions, such as “are you having trouble breathing?” twice daily.
A few days earlier, Home Health Care news reported on a similar program by Carolinas-based Atrium Health. Their program, which launched in the early days of the pandemic, gave patients the option of a virtual at-home observation unit, or a virtual at-home acute care unit. During two weeks in March and April, Atrium Health treated 1,477 COVID patients at home.
As hospitalizations skyrocket around the country and hospitals struggle to cope with unprecedented stress on the system, hospital at home (HaH) programs are providing part of the answer to a nation-wide crisis in hospital capacity management.
The list of major health systems with an HaH is already large, and growing: the Mayo Clinic, Johns Hopkins, Illinois-based Quincy Medical Group, and Intermountain Healthcare have all either launched or expanded HaH programs this year — and there are many more around the country.
COVID-19 is in some ways the perfect use case. Most COVID-19 infections are not serious and do not require hospitalization. But a COVID-19 infection can go from mild to serious very quickly. Signals like a plummeting blood oxygen level could indicate that it’s time to go to the hospital. And with cases surging across the nation, it’s important that only patients with the most serious cases go to the hospital for treatment.
Barriers to Hospital at Home
According to a recent MarketWatch story, the biggest barrier to expanding these HaH programs further is (you guessed it) reimbursement. Most private insurers still don’t cover these services, even though they could reduce hospitalizations and thus dramatically lower costs. This is beginning to change now that these programs have become such a crucial tool.
Since the start of the pandemic, CMS has implemented sweeping, if temporary, changes to the amount and scope of services it will cover, from reimbursing for telemedicine visits everywhere, to waiving HIPPA enforcement for physicians who communicate with patients via common communication platforms such as Skype of Facetime.
For doctors like Per Danielsson, of Swedish Hospital Medicine in Seattle, such changes are no doubt a welcome development. Danielsson has been on what he calls a “quixotic” quest to get CMS to cover Hospital at Home services at least since 2013. That was the year Danielsson helped launch Swedish Hospital’s own program.
Another barrier to HaH programs is a familiar technical problem: slow Internet speed in many parts of the country where these programs are needed most. But that too is showing signs of progress, from upgrades in cellular speeds (5G anyone?) to mobile technology that can be moved from room to room and relies on less bandwidth.
Finally, there is the problem of finding the staff to do the monitoring itself. With COVID-19 hitting healthcare workers particularly hard, many hospitals don’t have the providers to cover everything they need — part of the reason for an acceleration in remote telehealth solutions in the first place.
If your hospital or health system is one of these, Daily Care Telemedicine stands ready to help with specialists on call and an enterprise technology solution. As Fast Company recently reported, the hospital of the future is coming faster than we expected. It’ll be smaller, specialized, more comfortable for the patients, and, perhaps more than anything: flexible.
