6 questions health systems should ask themselves about 'hospital at home'

To partner or to build? That is the question health systems are asking themselves with many digital health technologies, "hospital at home" being the latest example.

For instance, Cleveland Clinic, Oakland, Calif.-based Kaiser Permanente and Rochester, Minn.-based Mayo Clinic partner with company Medically Home, while DispatchHealth is another at-home care vendor, the American Medical Association reported July 18. Meanwhile, Pittsburgh-based Highmark Health and Richmond, Va.-VCU Health opted to build their own hospital-at-home programs. VCU did so by connecting patients to more than 40 community-based resources.

"We don't need to send a nurse practitioner if they need somebody to do some coaching and education for them to be successful, or if they need socialization and they live by themselves," Ryan Raisig, associate vice president for coordinated care and continuum integration for VCU Health, told AMA. "It's a wellness model."

Here are questions health systems should consider when deciding to partner or build for hospital at home, according to the AMA:

1. What is the need and purpose of our program, and which aspect(s) of that would be accomplished through a partnership?

2. Do we need to partner to provide this offering initially? To scale? Both or neither?

3. Based on our existing offerings, capabilities, staffing, resources and other circumstances, are we able to address needs internally? At what cost and do we have the budget?

4. Is a hybrid approach for our program an option?

5. Based on our needs, geography, financial resources and other circumstances, with whom could we partner?

6. What would we give up in a partnership (e.g. financial resources, clinical control)? What would we gain (e.g. increased capacity, shared risk)?

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