Comprehensive Inpatient Care. All the Comforts of Home
Hospital-at-Home is a new program offered by University Hospitals that provides comprehensive, inpatient care at the patient’s home instead of the hospital. The Medicare-sponsored program reflects a growing trend across the country in which health care is shifting away from hospital-based care to a home-based model. UH is one of the first health systems in the region to offer this option to eligible patients.
Who is Eligible for Hospital-at-Home Care?
Eligibility for Hospital-at-Home care will be determined by the patient’s medical needs and their willingness to receive care at home. The program is voluntary and some people may feel more comfortable receiving care in a traditional hospital setting and that is entirely their choice. Both the patient and their physician must agree that receiving care at home is both safe and appropriate. Other eligibility requirements include:
- Must have a diagnosis that requires inpatient hospital care, as determined by a medical provider
- Must have traditional Medicare insurance coverage
- Must have and be able to use the required communication tools (Smart phone, iPad or tablet)
- Must be able to independently manage the activities of daily life, including going to the bathroom
For their safety, patients with a secondary condition such as active cancer (other than melanoma or prostate cancer), end-stage renal disease, or acute heart & vascular disease are not eligible for hospital-at-home care.
How Are Patients Cared For at Home?
The evaluation of the patient for the program will typically begin in the emergency department. If the patient is determined to be eligible, the Hospital-at-Home team will have an initial meeting to plan for their meals, medications, and the delivery and set up of any specialized medical equipment that may be required. The patient will then be safely transported to their home by paramedics.
Once settled at home, the patient will be actively cared for with the following services:
- 24/7 Remote Patient Monitoring (RPM)
The UH Hospital-at-Home team uses the most advanced technology available to monitor patients’ vital signs remotely, including oxygen levels, respiration rate (breathing), temperature and pulse rate. Each patient is given a monitoring device to wear which automatically transmits this information to their hospital-based care team, 24 hours a day, 7 days a week. With this system, our medical providers can continually assess the patient’s health status, monitor their medical stability, track treatment compliance and recommend interventions when necessary.
In addition, twice daily, or as directed by the care team, patients are contacted via their smart device and asked some basic health questions, such as “are you having trouble breathing?” Their responses to these questions are relayed to their hospital-based team along with the physiological monitoring data to provide a more comprehensive profile of the patient’s overall well-being.
- Daily In-Person and Virtual Visits
Patients receive at least two daily in-person visits from a nurse or a paramedic who will check on them, monitor their progress and answer any questions they might have. In addition, there will be daily in-person or virtual visits from a doctor, nurse and/or other medical professionals. Virtual visits will be conducted using Zoom on a smart phone or computer. If you need assistance in getting Zoom set up on your device, your care team can help. These visits help your team understand how you are doing and if you need additional medical care or services.
- Meals and Medication Delivery
Hospital-at-Home patients receive three meals a day, just as they would in the hospital. We provide a menu from which the patient can select and order their meals for the next three days. Your care team will monitor your selections to ensure any dietary restrictions or requirements are met – diabetic or low-salt meals, for example. Meals are delivered daily.
Your prescription medications and/or oxygen will also be delivered to your home. There will be frequent in-person or virtual meetings with your team to review or make changes to your medication schedule, ensure you are taking them correctly and that the dosage is effective in managing your condition.
- Specialty Care & Services
Depending on each patient’s specific needs, other medical professionals may be involved in their care at home, either in-person or virtually. These specialty services may include respiratory care, laboratory or radiology services, and physical/occupational/speech therapy services.
- 24/7 Access to Your Care Team
While receiving inpatient care at home, patients have 24/7 phone access to the UH Hospital-at-Home care team. This real-time connection ensures that patients can always reach a clinician if they have questions or concerns. If a new health problem arises or your condition worsens, based either on your input or the information being transmitted through your monitor, arrangements will be quickly made to send paramedics to your home and transfer you to the hospital. There is no additional charge if transfer is required.
Receiving hospital care at home can have a significant positive impact on patient recovery and health outcomes. Benefits may include:
- Reduced stress and length of stay associated with traditional inpatient stays
- Improved recovery times, due to a familiar environment and the presence and support of loved ones
- Decreased use of emergency medical services
- Less risk of hospital-acquired infections
- Family members can be included in care planning, even those who are geographically distant
Read one patient’s account of the care she received under the UH Hospital-at Home program and why she would recommend it to anyone who is eligible.