Untangling the capacity challenge
With new program, patients will receive hospital-level care – without leaving home
In June, Yale New Haven Health is scheduled to launch a program that will provide high-acuity, hospital-level care to patients in their homes.
The Home Hospital program will serve Medicare patients meeting certain clinical and social criteria who live within 25 miles of Yale New Haven and Bridgeport hospitals. Yale New Haven is partnering with a private company, Medically Home, to provide the program, which is expected to expand to other YNHHS hospitals in the future.
Through a combination of in-person visits and telehealth technology, the program will bring a range of hospital services to the homes of patients with heart failure, pneumonia, chronic obstructive pulmonary disease, cellulitis, sepsis and other conditions.
“Many patients prefer to be cared for in their homes,” said Olukemi Akande, MD, physician executive director, Post-Acute Care, and Home Hospital program physician co-lead with Scott Sussman, MD, physician executive director, Telehealth. “With the growth of telehealth and other mobile health technologies, we can provide a high level of care and 24-7 accessibility to these patients.”
Each patient will receive a physician video visit once a day through a Wi-Fi-enabled tablet, in-person visits from a nurse twice a day, plus additional nurse home visits as needed. Other healthcare professionals will provide in-home infusion therapy; physical, occupational and speech therapy; phlebotomy; mobile diagnostic services such as X-rays and echocardiograms; behavioral health care; and nutrition services. Stat lab, imaging and IV services will be available for urgent situations.
A Home Hospital “mission control,” staffed by a nurse and physician, will remotely monitor all program patients and are available 24-7 to handle patient and family member questions or concerns. In addition, each patient will have a personal emergency response device.
The daily physician video visits and twice daily nursing visits are two ways the Home Hospital program will differ from other types of home-care services YNHHS provides through its Home Care Plus (HCP) and Home Care Plus South Central Connecticut (HCPSCC).
The main difference is that the Home Hospital program will provide acute care to patients who would otherwise be in the hospital. Patients will be in the program for two to six days, on average, then transition back to the care of their primary care physician.
HCP and HCPSSC provide post-acute care, often after a patient is discharged from the hospital. During post-acute care, a patient’s care plan usually includes one to three home visits a week by a nurse, along with physical, occupational, speech and IV therapy and other services as needed. Post-acute care usually lasts up to 60 days.
The number of home hospital programs has grown dramatically nationwide since 2020, when the COVID-19 pandemic prompted the federal Centers for Medicare and Medicaid Services to launch its Acute Hospital Care at Home waiver program. That program was designed to give hospitals greater flexibility to care for patients in their homes, freeing up hospital beds for COVID-19 patients.
Home hospital programs can also help reduce overall hospital overcrowding. YNHHS’ hospitals, like many others nationwide, are facing significant capacity issues as they treat more, and sicker patients who delayed care during the pandemic’s height.
“Just as telehealth has transformed outpatient care, it is helping us rethink the way we provide inpatient care,” Dr. Sussman said. “We believe we can provide the same high-quality care in patients’ homes, reduce the risk of hospital-related complications and enhance our patients’ experience by caring for them in familiar surroundings.”
