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Hospitals offer home care as an alternative to some acute illnesses: Shot

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Dr. Michael Maniac and Dr. Margaret Paulson will meet at the Mayo Clinic Home Hospital Command Center in Jacksonville, Florida.

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Dr. Michael Maniac and Dr. Margaret Paulson will meet at the Mayo Clinic Home Hospital Command Center in Jacksonville, Florida.

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At the end of last year, Janet Yetenekian became seriously ill with COVID-19, enough to justify going to the hospital. But instead, the hospital came to her. She received medical care at her home in Glendale, California.

“It was better than the hospital,” laughs Yetenekian. “They were constantly reaching out — it was when you did your vitals or when you took your medicine.”

Yetenekian was infected with the coronavirus in December after a friend invited her family to an afternoon barbecue. It was like a safe antidote to pandemic quarantine. However, the day after the rally, the organizers got feverish. Testing confirmed that it was COVID-19.

Within two weeks, Yetenekian’s husband and two teenage children developed a mild case of the disease. However, she fell into a more serious case and her blood oxygen levels plummeted to dangerously low levels.

She went to Glendale’s Adventist Health hospital, where doctors told her that the antiviral drug remdesivir needed intravenous injection and continuous monitoring. And it surprised Yetenekian when her doctor offered to move all her care home to be virtually monitored.

Doctors and nurses at the Command Center, about 200 miles away in the town of San Joaquin Valley, Hanford, California, are part of a new federal government effort to free hospital beds in a public health emergency. As managed the care of the Yetenekian. Approximately 60 illnesses, including COVID-19, are eligible for home treatment in this model.

“Heart failure, pneumonia, skin infections-these are all patients we can safely treat at home,” he said. Dr. Margaret PaulsonLeads the Mayo Clinic’s new home care program in the countryside of Wisconsin.

Home hospital care is nothing new for patients with low levels of health needs. However, since the pandemic, more and more healthcare systems, such as Adventist Health, Mayo Clinic, and Kaiser Permanente (not affiliated with Kaiser Health News), are comfortably hospital-level at home for people with more serious health conditions. Offers medical treatment. ..

When patients understand that home care does not mean a departure from hospital care, according to Paulson, they enthusiastically accept it.

“It’s really encouraging to know that you can actually go home, sleep in your bed, stay with your family and take your pet with you, especially for many patients in the hospital.” Says Paulson.

Dr. Margaret Paulson interacts with patients via tablets as part of the Mayo Clinic Home Hospital Care Program. Paulson says he accepts when patients understand that care at home hospitals does not mean less care.

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Dr. Margaret Paulson interacts with patients via tablets as part of the Mayo Clinic Home Hospital Care Program. Paulson says he accepts when patients understand that care at home hospitals does not mean less care.

Mayo Clinic

And research suggests that home care provides Better results and less cost for patients Provides more than traditional inpatient treatment.

“This is actually a higher level of contact from doctors and senior practitioners,” he says. Dr. Kabita Patel, Brookings Institution Physician and Health Policy Fellow.

Regular video conferencing and 24/7 monitoring are enhanced by direct visits twice daily by nurses and other healthcare professionals who provide basic care such as antibiotics.

“This isn’t just about sending moms and dads to the bedroom,” says Patel.

The technical infrastructure is important for patients and doctors, Patel says. This would provide patients with a one-way phone that rings directly to the hospital’s command center, a specially programmed iPad that links instantly via video conferencing with a healthcare professional, and a wearable device with an emergency call button. It is included.

Home hospital care began last year when the Medicare & Medicaid Service Center launched. Extend the program It aims to increase the flexibility of the medical system for treating patients with COVID-19 and other acute conditions outside of overcrowded hospitals. Hospitals that are part of this program can now charge Medicare.

Mayo Clinic and Kaiser Permanente will invest a total of $ 100 million in Medical Home, a Boston-based technology company that supports home programs for healthcare systems, including Adventist Health, to help expand its services on May 13. Announced.

Raphael Rakowski, co-founder of Medically Home, states that another selling point of the home care model is the absence of facility relocation when the patient heals.

“We stay with the patient until he is fully recovered, which averages 20 to 30 days, and sometimes even longer,” he says. “So we are a substitute for all subsequent care, not just the hospital.”

Still, not all patients are appropriate. Patients must live within 30 minutes of emergency medical care to qualify for home care. They also need high-speed internet, and Patel says, they can’t get sick too much.

“It’s as complicated as monitoring a patient, and it’s not like worrying that the patient may have to be in the ICU within minutes of a crash,” she says.

However, in moderate COVID-19 and dozens of other conditions, more healthcare systems adopt the program and include more illnesses, making acute hospital care at home a more common option. There is a possibility of becoming. It is currently offered at 129 hospitals in 30 states.

Kaiser Health News is an editorial, independent, non-profit national news room funded by the Kaiser Family Foundation. KHN is not affiliated with Kaiser Permanente.

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