The Rise of the Hospital-at-Home Care Model

Healthcare has been in a slow push towards more patient-centered healthcare for years. Patients are more educated about health choices, and reviews and ratings of healthcare providers are easily available.  Many programs such as Value-Based Purchasing, Pay for Performance, and Meaningful Use all drove care organizations to redesign the system-based processes they had relied on in favor of more patient-involved approaches. In 2020, the COVID-19 pandemic has turned that slow change into a tidal wave. To meet the needs of the population and continue to remain viable, health care providers must innovate and adapt to the new normal and a new healthcare model.  

Changing Service Models

Even prior to the 2020 pandemic, many service industries moved to an at-home or delivery model. Retail has transformed from the local mall to online with rapid front door delivery. Food delivery is at an all-time high, with options to order virtually anything, and takeout becoming a significant portion of even upscale restaurant business [1].  Healthcare had been reluctant to follow suit, with slow movement in home-based models, until 2020 began. As the COVID-19 pandemic ramped up in March of 2020, the US healthcare system was strained to its limits in some areas of the country. This strain brought with it permanent forced change in at-home care delivery that will outlast the pandemic. The new normal is here to stay.

COVID-19 brought with it permanent forced change in at-home care delivery that will outlast the pandemic. The new normal is here to stay.

Telemedicine usage has exploded, showing growth of over 60% from March to June 2020.  In April, at the height of the pandemic, nearly 50% of primary care visits were via telehealth [2].  This trend has continued, even after many communities have shown declining numbers of COVID-19 cases and a return to in-office appointments.  Services are learning to move to the patient, instead of the patient going to various locations for healthcare.

One of the biggest concerns during the COVID-19 epidemic became protecting the nation’s elderly population.  Long term care facilities and hospitals became risky places for seniors, leading to poor outcomes.  Forced isolation for safety reasons has resulted in increased rates of depression and other mental illnesses [3].

Hospital at Home

The Hospital at Home (HaH) model pioneered by hospitals such as John Hopkins presents a viable answer to many current healthcare struggles. This model has successfully met the challenge of providing acute-level hospital care to older adults, while the patient stays in their own home. This service creates better outcomes, while reducing costs of care and reducing hospital crowding [4]. Seniors can remain safer and enjoy being around loved ones while remaining comfortable and preserving their mental health and dignity.  

This model has since been adopted by several leading HCOs around the nation, in some VA hospitals, by home care providers, and managed care organizations [4]. The collision of the advent of this model and a pandemic have created a huge catalyst for growth of hospital-at-home.

Impressive Outcomes

When compared to traditional hospital care, the hospital-at-home care model boasts some impressive outcomes. With the HaH model, patients and families reported better satisfaction with care, less caregiver stress, and faster recoveries.  The clinical outcomes consisted of lower rates of mortality, less delirium and use of sedative medications, and much less incidence of restraint use. Risk of contracting secondary infections is also greatly reduced. Lastly, HaH patient care episodes had a cost savings of 19% to 30% compared to traditional hospital care [4].

These positive outcomes, coupled with a global pandemic, have resulted in an unprecedented demand for at-home healthcare.  

Healthcare Redefined

Healthcare used to be defined by place.  Patients were “in the hospital” or “in long-term care”, or somewhere in-between.  Rather than defining levels of care by location, the new care model will be defining care by level of services provided, wherever that patient may be.  More and more services are available at home, and independent providers are taking advantage of this increasing market.  Just as in retail and food service, logistics and service delivery are poised to enter the market in a big way.

Rather than defining levels of care by location, the new care model will be defining care by level of services provided, wherever that patient may be.

The best thing about this mobilization of healthcare services to the home setting, is that patients are inherently treated as more than a number.  Patient-centered care can be no more personal than in a person’s living room.  The hospital-at-home care model is about more than keeping patients safe in a high-risk environment, it is also about mental and social health, the family unit, and patient choice.

Connecting Patients with Services

Healthcare-at-home, while effective, also creates a need for new delivery tools.  Traditional hospital interdisciplinary care teams can meet in person, coordinate care, plan goals and outcomes.  HaH is no different, but the way in which that occurs looks different.  A combination of connected services, sophisticated logistics and delivery systems paired with smooth communication and transitions makes HaH a consistent reality.

As companies staffed with trained healthcare professionals enter the marketplace and begin to provide these in-demand services, the need to streamline delivery is apparent. Groundbreaking companies like VectorCare are meeting the needs of patients and caregivers by providing the patient care logistics software needed to create networks of local service providers, schedule, and execute any healthcare service a patient may require.  VectorCare collaborates with equipment providers, licensed health professionals, delivery services, laboratories, pharmacies, and medical devices to orchestrate the compassionate, complete care patients deserve.  With new patient-centered software tools, healthcare is poised to transition to a model that embraces the patient’s home, rather than healthcare facility, as the nexus of their path to wellness.

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Want to read more from the Patient Care Logistics Journal? Check out our last podcast interview with Melanie Combs-Dyer, the Director of Innovation at Mettle Solutions.

1. Demand for Food Delivery Explodes During the COVID-19 Pandemic as Consumers Self-Isolate and Restaurants Close Down. (2020) Retrieved 31 August 2020, from https://www.prnewswire.com/news-releases/demand-for-food-delivery-explodes-during-the-covid-19-pandemic-as-consumers-self-isolate-and-restaurants-close-down-301049240.html

2. ASPE Issue Brief: Medicare Beneficiary Use of Telehealth Visits: Early Data from the Start of the COVID-19 Pandemic. (2020). Retrieved 21 August 2020, from https://aspe.hhs.gov/pdf-report/medicare-beneficiary-use-telehealth

3. Graham, Judith. 2020. "For Seniors, COVID-19 Sets Off A Pandemic Of Despair". Kaiser Health News. https://khn.org/news/for-seniors-covid-19-sets-off-a-pandemic-of-despair/.

4. Hospital at Home | Johns Hopkins Health Care Solutions. (2020). Retrieved 21 August 2020, from https://www.johnshopkinssolutions.com/solution/hospital-at-home/