In 2020, as lockdowns and the threat of COVID-19 kept more of us at home, many doctors and patients came to rely on video or phone calls in lieu of in-person visits. According to the Minnesota Medical Association (MMA), in 2019, 3% of patient visits used telehealth. In 2020, that rose to 28%.
Telehealth advocates tout its cost savings, convenience, and accessibility for people with limited mobility or who live in underserved rural areas. And as demonstrated by the growing number of “Hospital at Home” programs, the benefits of telehealth aren’t limited to preventive care.
Rachel Riedesel, population health manager at Allina Health, was in her final year of the Masters of Healthcare Administration program at the University of Minnesota School of Public Health in 2019. For her team capstone project, she partnered with leaders at Allina Health to design a program that would allow patients to receive hospital care in the comfort of their homes.
At the time, funding models and abundant hospital capacity meant there was little urgency to implement the program. All that changed when the pandemic hit. By then, Riedesel was working at Allina Health in the hub of the system’s COVID-19-related activity. “This came forward as an opportunity to increase hospital capacity while we were trying to serve our community and their needs,” Riedesel says. The Hospital at Home plan she had previously worked on was put in motion. “We were able to deploy the program in less than a month because of the plans we’d already prepared.”
Instead of being checked into the hospital, patients who participate in the program are sent home with biometric monitoring equipment. The kit includes a tablet, blood pressure cuff, pulse oximeter, and thermometer—all Bluetooth-enabled. Patients are continuously monitored, and their data is sent to a centralized nursing hub along with personalized parameters. If their biometric markers go outside of a preset zone, nurses are alerted to check on them. If needed, a nurse, physician, or paramedic may also be dispatched to the patient’s home. “We have an escalation process in place to ensure the patient is safe,” Riedesel says.
Allina’s program is now one of the fastest growing Hospital at Home programs in the country. To date, it has served roughly 3,700 patients in the Twin Cities metro and a few regional areas throughout the state. When the program started, 60% to 70% of the Hospital at Home patients were COVID-19-positive. In 2022, it’s closer to 40%. The bulk of the patients are now being treated primarily for other conditions, such as sepsis, chronic heart failure, chronic obstructive pulmonary disease (COPD), and post-surgery recovery.
“We continue to see equal- or better-quality outcomes for people who get to recover in their homes, with their loved ones,” Riedesel says. While in-patient hospital care is necessary for some acute conditions, hospitals are not without risk. The Centers for Disease Control and Prevention (CDC) estimates hospital-acquired infections account for 1.7 million infections and 99,000 deaths each year. “We want to make sure we’re providing the safest care in the safest place, and that can often be the patient’s home,” Riedesel says.
Home-based hospital care programs are growing across the country. Organizations, including HealthPartners and Essentia in Duluth, are building programs of their own, and Riedesel expects consumer demand to drive further adoption in the industry.
One recent Allina Hospital at Home patient was quickly sold on the value of the program following a hip replacement surgery. “They received intensive therapy, nursing visits, and our entire care model in their home, with their loved ones,” Riedesel says. The patient had previously received other orthopedic surgeries that required hospital stays, and they said this was a much better experience mentally and physically. “This is increasingly how patients want to be served,” Riedesel says. “This is the wave of the future for this type of care.”