Second of three parts
The first part is available at thevoice.us/medically-home-shifts-health-care-to-hospitals-at-home
Hospitals in the United States are considering a concept known as “hospital at home.” It is according to an article by Nate Berg, published in FastCompany, magazine and online journal.
“Dr. Margaret Paulson is physician lead for the Mayo Clinic’s advanced-care-at-home program, and she said the experience so far has been positive for patients. “They’re in the comfort of their own home, they’re sleeping in their own beds, they’re with their pets,” she said. It’s helpful for doctors, who are able to get a better sense of their patients’ actual lives. “We can see how they’re eating, how they’re taking their medications, so we really get this great insight into their lifestyle that ultimately, we hope, will help keep them out of the hospital in the future.”
‘“These virtual visits from doctors can become surprisingly intimate,’ said Dr. Pippa Shulman, Medically Home’s chief medical officer. ‘On the video I can notice something in the background, the picture on the wall or something on the desk, or the dog or the cat comes and hops on their lap, you can see who lives there with them,’ she said. Patients end up treating the doctor more like a guest in their homes than a health-care worker coming to deliver bad news, she said. ‘I got into medicine because of the human connection. And I think being in someone’s home, whether it’s virtual or in real life, that allows me to very quickly make that human connection, and that leads to healing, rather than me coming at them with a medical approach right away.’
“Raphael Rakowski’s father died in a hospital through a medical mistake. He and business partner, Rami Karjian made a list of problems for hospital-at-home to work. The named their company Medically Home.
“A key piece of Medically Home’s model—and the model of other companies providing hospital-at-home services—is getting personnel, services, and equipment to patients as efficiently as if they were inside the walls of a hospital. Paramedic services are one solution. ‘We have paramedics everywhere in the country, and they’re dispatched rapidly,’ said Rakowski.
“That’s the basis of another hospital-at-home startup, Dispatch Health. Based in Denver, the company operates hundreds of paramedic-style vehicles with on-call remote medical professionals ready to provide both emergency and ongoing care to patients in cities such as Seattle, Phoenix, Las Vegas, and smaller markets such as Springfield, Mass. and Spokane, Wash.. In partnership with local hospitals and health systems, the vehicles can arrive at a patient’s home within an hour, carrying a suitcase-sized moderate complexity lab capable of running blood tests, administering fluids or medication through an IV, treating shortness of breath, arranging for X-rays, ultra sounds, and EKGs—’basically everything in the ER, short of a CAT scanner, an MRI, and certain higher-level procedures,’ said Dr. Mark Prather, the Company’s founder and CEO.
“Prather would know. As an emergency room doctor with more than 25 years of experience, he’s seen the gamut of what comes into a hospital’s emergency department. Though the variety is wide, most of what ERs deal with are fairly standard afflictions, from pneumonia to congestive heart failure to breathing problems associated with asthma or chronic obstructive pulmonary disease, conditions the moderate complexity lab can easily treat in patient homes. ‘For 60% of what walks into an emergency room, this is actually perfectly appropriate,’ he said.
“There are significant potential savings in treating patients at home. Prather said the average ER visit costs between $1,000 and $2,000. ‘A little bit of that is the physician’s fee, and a lot of it is what we call the facility fee, or what the hospital charges. So if we could do this care for a couple hundred dollars, which is essentially what we charge, we could save five to six times on every single case,’ he said.
“And it’s not just about saving money. ‘The largest meta analysis, which is a look at all of the studies on hospital at home, suggests that hospital at home reduces costs by 25%, reduces readmission by 25%, and, the really fun part for me, it reduces mortality by 20%,’ said Prather. The numbers are persuasive, and not just for medical professionals. The company just raised $135.8 Million in financing and plans to expand to a total of 26 markets by the end of the year.”
Continued next week