Hospital at Home By Beth Baker
The Future of Health Care in Your Living Room
Technology, affordability and patient satisfaction mean in-home health care solutions could revolutionize medical care for older Americans Jim Petersen, 83, who lives alone in an assisted living community outside Denver, recently had pneumonia. But rather than be admitted to the hospital, he was offered another choice: hospitallevel treatment in his home. Petersen didn't hesitate. "In plain English, there's no place like home," he says. "You can get good care in a hospital, but you never sleep really good."
In the wake of the COVID-19 pandemic, a growing number of older patients like Petersen are more eager than ever to avoid hospitalization. Depending on their condition, many can receive the full complement of professional services in their home, paid for by Medicare as if they were in the hospital. In Petersen's case, nurses and physician's assistants came to his home to monitor him and administer antibiotics. "With the technology today, they can take x-rays
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and EKGs and blood work right here in my apartment," he says. "They were just great. I stayed here and recovered." "COVID has provided tailwinds to pushing care inside the home. The market is demanding it." His physician, Dr. Manny Diaz, used to work in a hospital. But then he was offered the position of medical director with Advanced Care-Denver, an arm of DispatchHealth. "The opportunity that I believe will be the future of health care, moving as much as we can effectively and safely into people's homes to provide comfort at a lower cost, was something I couldn't pass up," Diaz says. In-home visits "invert the relationship" between doctor and patient, he adds. In a hospital, the patient wears a gown and lies in a bed while doctors do rounds. In contrast, Diaz is invited to enter the patient's home. During an appointment with Petersen, Diaz commented on a scenic painting of ducks. The two discovered they both loved fishing and hunting and shared roots in northern Illinois. Being in a patient's home "humanizes
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the patient and the provider," Diaz says. "It makes the ability to connect with a person that much easier, and it's important clinically, determining a plan of care that will work in that context." The Benefits of Hospital at Home In Sioux Falls, S.D., the nurses at Avera@ Home, part of Avera McKinnan Hospital, agree that being in a patient's home leads to better care and a more trusting relationship. Cindy Kannenberg, nurse manager of the new Hospital at Home program offered by Avera@Home, says that rather than give patients a litany of discharge instructions from the hospital, "You can use their home environment…to find a way to help them learn how to take care of themselves better." A health practitioner might spot tripping hazards, say, or suggest ways to eat healthier. Avera@Home expanded its traditional home care and hospice program in the wake of the pandemic. "We were taking care of a lot of patients in their homes during COVID," says Rhonda Wiering, vice president, clinical growth and
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