Mayo, Kaiser execs detail their joint investment in Medically Home

In May, two of the largest healthcare providers in the U.S. — Oakland, Calif.-based Kaiser Permanente and Rochester, Minn.-based Mayo Clinic — made a joint strategic investment in Medically Home Group, a Boston-based tech services company that powers hospital-at-home programs.

The two systems made the investment to expand access to Medically Home's virtual and in-person care model so that other providers can adopt it.

Below, Maneesh Goyal, chief operating officer of the Mayo Clinic Platform, and Stephen Parodi, MD, executive vice president of the Permanente Federation, answer questions about the investment and future of hospital-at-home.

Editor's note: Responses have been edited lightly for clarity and style.

Question: What made Medically Home an attractive investment opportunity?

Maneesh Goyal: Mayo Clinic implemented its advanced care at home program in partnership with Medically Home, which was selected due to the industry knowledge it has gained over more than a decade of providing care in patients’ homes, and its one-of-kind technology and services platform that orchestrates the supplies and services needed to enable advanced-level care in the home or home-like setting.

Our partnership with Kaiser Permanente demonstrates our commitment to provider-led transformation of healthcare delivery. We wanted to expand access to serious and complex care at home for patients in partnership with like-minded organizations that have proven track records of putting patients at the center, so that more people have the choice to experience this unique model of care in the comfort of their homes.

Dr. Stephen Parodi: Kaiser Permanente’s partnership with Mayo Clinic to invest in Medically Home represents a provider-led transformation of high acuity level care delivery to expand access to serious and complex care at home for patients. This transformational model of care brings together the best we have to offer in both in person and virtual care in the comfort of a person’s home.

Q: How does this investment fit into your health system's greater digital health strategy/goals?

MG: It is an excellent example of the Mayo Clinic mission and values optimized for the digital age. Mayo Clinic continues to advance technological capabilities so the organization can improve diagnoses, discover new cures and make treatment accessible to patients in places beyond hospital walls or a doctor's office. Mayo Clinic Platform is at the cornerstones of digital innovation, enabling Mayo to transform the way healthcare is delivered and experienced. Our digital and data-centric initiatives will allow us to better anticipate the needs of people we serve, and meet them when, where and how they need us. This highly reliable in-home ecosystem will allow us to further expand our connections worldwide.

SP: Access to care that is simple and seamless is a priority so we can meet our members where and when they need us. Mobile and digital technologies are a part of our everyday lives, so using these capabilities to "extend the stethoscope” through the power of the healthcare system is a natural next step.

Kaiser Permanente has invested in telehealth for decades, and our clinical expertise combined with a comprehensive infrastructure rapidly scaled to meet rising demand during the COVID-19 pandemic. Our integrated telehealth program makes it easy for members to receive high-quality care while staying safe at home and it will continue to be an important way for how we deliver care. Our investment in Medically Home builds upon that foundation and is a crucial component to a full complement of digital health options for our members.

Q: Which benefits has your health system already experienced from Medically Home's care model?

MG: Mayo’s implementation of the Medically Home model, advanced care at home, is currently implemented around Mayo’s sites in Jacksonville, Fla., and Eau Claire, Wis., while expansion to our campus in Arizona is planned for later in the summer. It turned on its head the notion of where patients with serious or complex conditions can be cared for by proving we can provide high quality acute care outside of a hospital building.

Patients have immediate video and phone access to the Mayo Clinic care team, real-time remote monitoring 24 hours a day, as well as an orchestrated set of care services that enable care for patients with complex or serious conditions in the home. The patient and family members can ask questions of the care team in the command center at the touch of a button.

We were able to demonstrate a great patient experience, achieve high patient satisfaction, lower the admission rate and create flexible capacity in our hospitals, which was incredibly helpful during the peaks of the pandemic, when hospital beds were occupied with COVID-19 patients. It is a win-win in that that it increases health system capacity and resiliency, while meeting the needs and preferences of patients who prefer to be cared for at home or at a homelike setting. And we will apply the learnings to improve the model as needed.

SP: KP@Home is Kaiser Permanente’s implementation of Medically Home, which was implemented in our Northwest and Northern California regions in 2020. In our Northwest region, we recently reached a milestone of treating 500 patients in the comfort of their homes over the first year of KP@Home’s implementation. In Northern California, where KP@Home launched late in 2020, we have treated more than 40 patients to date. 

Planning is underway for an expansion of the advanced care at home program throughout the organization. We have seen improvements in patient satisfaction and reductions in healthcare acquired conditions when compared with traditional hospitalization. We are also finding a greater ability to identify social determinants that are affecting a patient’s health and making community connections to address issues such as food insecurity. We are really working to provide whole person care.

Kaiser Permanente’s overall, long-term goal is to make our integrated model of high-quality, affordable care and coverage even better, and available to more people, as part of our mission to improve the health of our communities. This partnership is a significant step in our commitment to providing the right care in the right setting for every member.

Q: How does this investment position your health system as a player in the future of at-home care?

MG: We see tremendous opportunity to scale this model together. The model can address a broad spectrum of clinical applications, including cancer care and bone marrow transplant. The high-acuity patients envisioned in our partnership could potentially serve about 30 percent of current hospitalizations. 

As an academic medical center, Mayo Clinic is known for its integrated approach of clinical practice, research and education. We study this model with scientific rigor, apply and share the learnings and train the workforce of the future, which will need to be proficient in digital or virtual care delivery models.

SP: Kaiser Permanente’s investment in Medically Home extends our reach beyond the walls of our hospitals, accelerating the expansion of novel and high-quality virtual care delivery options by providing a patient-centric model of care from the comfort of patients’ homes. Medically Home aligns with our values of putting patients first while upholding the highest standards of excellence in innovation. 

This program will provide learnings from years of first-hand market experience while expanding access to virtual hospital care at a much larger scale. As many as 30 percent of patients treated in hospitals can safely receive care in their homes, potentially impacting millions of patients.

Q: Why do you think at-home care is such a rapidly growing innovation area in healthcare?

MG: A confluence of forces has converged, with the pandemic serving as a catalyst. The pandemic revealed gaps in our health system as well as inequities. Medical science, powered by technology, has outpaced the advancement and innovation in healthcare delivery, but the pandemic produced an alignment of policy and we are now able to meet patient demand for consumer-centered models. 

The state and federal flexibilities provided during the pandemic made it possible for many providers across the healthcare system to revisit how we conceptualize bringing the best medical science to our patients, moving away from an a prior anchor in bricks and mortar models. Hospitals will continue to need flexibility capacity, and the regulations unlocked nonhospital spaces to be used for patient care during the COVID-19 emergency. With the rise of telemedicine and positive experiences with it, patients will expect to have home hospital care available to them. There is no going back.

SP: This innovation is occurring because the technology has come of age, people want it, and we believe this is an effective, affordable way to provide excellent care. The technology for home monitoring, rapid response to clinical needs and the management of supply chain logistics is now available. We see the greatest demand and potential for Medically Home’s care model being for patients with higher acuity, seriously complex illnesses because a lot of people would rather stay at home instead of going to a hospital.  

Ultimately, it should reduce the number of transitions of care that right now occur because of a particular venue. Instead of the step downs from hospital to post-acute care to home, we can provide true continuity of care and help patients on the road to recovery quicker than ever before. The time is truly now for this model.

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