Bring the hospital to the home
Popular programs let patients get treatment under their own roofs
As hospitals care for people with COVID-19 and try to keep others from catching the virus, more patients are opting to be treated where they feel safest: at home.
Across the U.S., “hospital at home” programs are taking off amid the pandemic, thanks to communications technology, portable medical equipment and teams of doctors, nurses, X-ray technicians and paramedics. That’s reducing strains on medical centers and easing patients’ fears.
The programs represent a small slice of the roughly 35 million U.S. hospitalizations each year, but they are growing fast with boosts from Medicare and private health insurers. Like telemedicine, the concept stands to become more popular with consumers hooked on home delivery and other internet-connected conveniences.
Eligible patients typically are acutely ill with — but don’t need round-the-clock intensive care for — common conditions including chronic heart failure, respiratory ailments, diabetes complications, infections and even COVID-19.
They are linked to 24/7 command centers via video and monitoring devices that send their vital signs. They get several daily home visits from a dedicated medical team. Just like in a hospital, they can press an emergency button any time for instant help.
Research on such programs around the world over the past 25 years shows patients recover faster, have fewer complications and are more satisfied, while costs can be a third lower.
Doctors, hospital officials and patients tout other advantages: People get more rest sleeping in their own bed. They can eat what they want, start moving around quicker and go outside for fresh air. They’re less likely to fall in their familiar surroundings, where they have support from family and even pets.
“I would recommend it in a heartbeat for anybody to be able to stay at home,” said William Merry, who received care for pneumonia in July at his Ipswich, Massachusetts, home. “There was never any problem.”
Merry, who had endured an uncomfortable hospital stay six years ago, refused another one when antibiotic pills didn’t help and his temperature hit 103. So his doctor arranged care through Bostonbased Medically Home.
Merry and his wife, Linda, a retired nurse, said they were amazed at how quickly the service transformed their dining room into a mini-hospital room. Technicians set up medical equipment, gave them supplies and oxygen tanks, then explained how everything worked.
That eased their stress, as did regular video calls with a doctor. They got daily schedules listing planned medical staff visits, blood draws, tests, IV medicine administration and other care, she said.
“I think it’s really important,” she cautioned, “that the person has somebody that’s able to be at home.”
Dr. Bruce Leff, a geriatrics professor at Johns Hopkins School of Medicine and a home hospital pioneer, did pilot studies years ago. He found benefits for elderly patients who, as he said, were otherwise “basically going to get crushed by the hospital” due to risks of developing blood clots and infections, losing mobility and developing delirium.
Even before the pandemic, some hospitals were considering at-home-care programs to absorb temporary patient spikes — and avoid the high cost of new buildings.
It’s unknown how many U.S. programs exist, but when COVID-19 struck, some institutions rushed to sign up with Medically Home and similar services.