The health system plans to launch advanced care at home May 1, serving up to 12 patients at a time. CMS has granted Stanford a hospital-at-home waiver but the state of California doesn’t allow for that care model.
“That’s not going to stop Stanford. We have to think about how we do it a different way,” Gretchen Brown, MSN, RN, vice president and chief nursing information officer of Stanford Health Care, told Becker’s at the HIMSS conference in Las Vegas. “We’re going to drive this up to treat some pretty complex patients in the home.”
Because of the regulations Stanford can only care for discharged patients at home, but plans to do so in a “robust” fashion, with virtual care, wearables and real-time data flowing back to the health system, Ms. Brown said. She said Stanford wants to become a statewide brand for care at home, as its academic medical center treats patients from Fresno to the Oregon border.
A broader home-care infrastructure will enable a “warm handoff” from the hospital to primary care, she said. And with tightening reimbursements for some surgical procedures, health systems are going to have to find a “more cost-effective way” to care for postoperative patients than the hospital, she added.
She gave the example of an older patient recovering from a total hip replacement (or, she said, “everybody’s mom and dad.”): “They often have some pretty complex medical problems underlying. That keeps them in the hospital, not necessarily the ortho procedure. But if they’re coming in for that total hip, we’re not admitting them for their medical problems. That’s a great example where you can make sure you’re managing that older patient [at home]. Hospitalists will see the patient virtually every day, setting up a plan of care. You have a case manager, you have nurses who are checking out the patient, making sure they’re moving forward. You’re getting data back. We’re really going to nudge up the clinical capabilities.”
Stanford also performs complex ophthalmological procedures on elderly patients and has to otherwise keep them in the hospital or send them to a hotel to monitor them, Ms. Brown said.
Since Stanford doesn’t have home care or home pharmacy licenses, partnerships will be critical, Ms. Brown said. Stanford is also leveraging its Epic EHR for home-care functionality.
Stanford plans to start by treating 12 patients at home at a time and double that number after a few months. The health system intends to use an AI screening tool to determine which patients fit the program well.
“We’re really trying to do this at scale. We’re not trying to take a population health approach,” Ms. Brown said. “We’re trying to send pretty complex patients home.”