Everything old is new again. There was a time that when you needed to see a doctor you would call one and the doctor would appear at your home. This was known as a house call. It was a convenient practice for the patient but posed problems for doctors. House calls made it difficult for doctors to bring all of the diagnostic equipment to the patient’s house. In order to economize their practice doctors started to request patients come to their office for a visit.
A variety of pandemic related disruptions have created an opportunity to modernize “house calls.” This has led to an expansion of services provided outside of doctor’s offices and hospitals due to the Covid-19 pandemic. With the need to mitigate the spread of disease we are seeing an increase in adoption of telehealth visits. Providing healthcare services outside of offices and health systems provides for additional capacity when brick and mortar hospitals are filled to capacity. This also frees up hospital beds for the most complex patients. This is considered “Hospital at Home.”
Hospital at Home is an innovative care model which provides hospital level acute care to patients in their homes. These patients experience better clinical outcomes, lower mortality rates, better patient satisfaction scores, decreased readmission rates, and decreased health care costs. There are some basic rules patients who utilize Hospital at Home programs must adhere to. For many, they need to be admitted to a hospital and then transferred to the Hospital at Home program; they need to have a condition that befits a remote approach; they must live within a certain distance to a hospital; and the patient’s physical home must be reviewed for safety.
Hospital at Home won’t replace the need for hospitals. There won’t be any surgeries completed within someone’s home. But the capacity exists to provide more than just skilled home health care. Hospital at Home can be utilized for patients needing care for conditions such as pneumonia, heart failure, pulmonary disease, and diabetes. The success of both telehealth and Hospital at Home programs may rest with telemonitoring or Remote Patient Monitoring (RPM).
These telehealth programs can bring the office visit with a physician or nurse practitioner to the comfort of your home and a virtual exam can be completed. But it’s only with the data collected by RPM that the health care practitioner or Care Team can fully assess the situation. Then the patient receives a treatment plan, medication prescriptions and referrals for tests or to other specialists.
RPM can assess a patient’s blood pressure, heart rate, temperature, oxygen saturation and body weight. The data collected is reviewed by medical staff who will report significant findings or changes to the patient’s medical provider. The goal of RPM is to intervene before the patient’s condition worsens and prevent hospitalization.
Having services performed from the comfort of a patient’s home will help ease any anxiety and hopefully offer better well-being for patients. Hospitals will always be necessary, but with so many programs that can be utilized from home their use may shift to one that focuses on intensive care units and operation sites.
