Make yourself at home — Reduce spending by bringing acute care to a patient's home

Many hospitals haven't changed the design and aesthetic of patient rooms in decades. Patients can at times feel cramped, stuffy and uncomfortable due to outdated rooms.

Renovating hospital rooms is out of the question for most organizations due to expense, inconvenience and disruption to patient care. However, there is an alternative to renovation that can actually help hospitals reduce spending while enhancing patient satisfaction. The solution: allow patients the opportunity to receive certain types of acute care in the comfort of their homes. Providing patients at-home care not only relaxes the patient but can help hospitals significantly reduce spending.

In a March 28 webinar sponsored by Everbridge and presented by Becker's Hospital Review, David Levine, MD, a general internist and investigator at Brigham and Women's Hospital and Harvard Medical School, both in Boston, explained how hospitals can reduce costs 52 percent by implementing an acute at-home care plan for patients.

"Home hospital models are all about getting the right care to the right patient at the right time," Dr. Levine said. Home hospitals are designed to provide care to patients in the middle of the acuity spectrum. Dr. Levine emphasized home hospitals can cherry-pick those patients who need medical floor care but who do not require intensive care unit services.

At Brigham and Women's Hospital, Dr. Levine and his research team conducted a study to determine the success of at-home care. The first step was determining which patients would be included in the study. Of patients who were admitted to the hospital from the emergency room, Dr. Levine determined which patients met the criteria for home hospital care. Those patients were then split between a control group, who were admitted to the hospital, and the group that received at-home care.

Overall, nine patients were included in the home hospital study and 11 were in the control group. Results showed 30-day readmission rates dropped significantly when a patient received home hospital care. Of the nine at-home patients, one (11 percent) was readmitted to the hospital in 30 days compared to 36 percent of hospital patients. Additionally, the hospital saved money on lab orders per admission, as six lab orders were from the home hospital group, compared to 19 labs ordered in the control group. In all, the hospital experienced a 52 percent cut in spending with home health.

How do I introduce home hospital care at my hospital?

Just as it is important to choose the appropriate patients for home hospital care, it is equally important to design a care team to meet patients' needs. "Our team was very sleek, and that's how we designed it," Dr. Levine said. "As opposed to [saying], 'This is the staff a hospital has — how should we share it with our patients?' we started with the nurse and a physician. We were then able to reach up or down an entire home health team to complement the nurse and physician."

Being in a patient's home does not mean physicians and nurses must leave their equipment behind. Home health teams can transport point-of-care blood tests, ultrasounds for echocardiograms and X-ray machines. Additionally, physicians can bring acute inpatient medications, chronic outpatient medications and urgent care medications to a patient's home depending on his or her needs. Other equipment easily transferable for home health includes ambulatory infusion pumps, peripheral IVs and oxygen concentrators.

Physicians also need a way to communicate with the patient while the patient is at home. Hospitals can deploy encrypted messaging, video conferencing and remote monitoring devices, among others, to ensure physicians can communicate effectively with the hospital and their patient.

How can I stay ahead of the home health curve?

Home health is not a new concept in healthcare. Throughout the U.S., hospitals and health systems are looking at ways to improve their home hospital models. Technology will become a bigger player in home hospital models in the coming years. Brigham and Women's Hospital is working on developing drone delivery methods. Additionally, patients can expect to incorporate sensing devices into their homes. As digital health technologies continue to penetrate the home environment, and as advancing medical technologies empower clinicians to deliver higher acuity care outside of the hospital, health systems can get ahead of the curve by focusing on their home health models.

To watch the webinar, click here.
To view the webinar slides, click here.
To learn more about Everbridge, click here.

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