Intermountain Healthcare announced this week that it is expanding the scope and services of its hospital at home program, more than a year since it was first launched in May 2020.

WHY IT MATTERS
The initiative now serves patients at 12 hospitals across Utah, with new locations soon to come. Remote care clinicians have also broadened the treatments they offer, to include COVID-19 and other acute and chronic conditions, according to officials at the Salt Lake City-based health system.

The virtual hospital is staffed 24/7 by remote monitoring technicians, and includes tele-nurses, tele-hospitalists and tele-advance practice providers, depending on patients' acuity.

The services are offered to patients who meet specific clinical and non-clinical criteria who come in through an emergency department visit or have been admitted to the hospital and qualify for early discharge, officials said.

Conditions treated at home include community-acquired pneumonia, congestive heart failure, chronic obstructive pulmonary disease, some kidney conditions, some intestinal or vein conditions, some infections and some cancer diagnoses.

The hospital at home service is provided in partnership with Castell, the population health spinoff that Intermountain launched two years ago.

Caregivers from Intermountain Homecare deliver remote patient monitoring equipment and provide hands-on training to the patient and other household members, as well as provide equipment maintenance.

Homecare caregivers make in-person visits according to individually prescribed care plans; mobile imaging and lab services are also available. Patients and family agree to have phones nearby at all times, so tele-nurses and technicians can reach out to validate new alerts.

When patients need additional interventions, there are three care options that can be used, depending on the urgency:

• Intermountain Homecare skilled nurses can help with care that can wait two to three hours
• 911 can be called for urgent needs
• And for patients who live in Salt Lake and Utah counties whose needs fall between those options, a partnership with Gold Cross Ambulance emergency medical services providers helps fill the gap.

"Through this innovative partnership, our EMS Rapid Response Team providers can arrive within 15-20 minutes and do a physical assessment of the patient in their home and consult with Intermountain tele-providers via video-visit to determine if the patient needs intervention and can safely stay at home, or needs to come to the hospital," explained Jamon Smith, director of training/paramedic at Gold Cross Ambulance, in a statement.

To be eligible for hospital-level care at home, patients must have SelectHealth insurance, either SelectHealth commercial, Medicare Advantage, Medicaid or be self-pay. Other value-based payers will be added.

THE LARGER TREND
Intermountain has long been an innovator in providing hospital-level care at home, and predicts that the trend will only increase, given the cost savings and better outcomes it can enable, and the fact that many patients prefer it.

Intermountain points to research that shows some patients spending a smaller proportion of the day sedentary (12% vs. 23%) or lying down (18% vs. 55%), with less frequent 30-day readmissions (7% vs. 23%).

This past March, Intermountain, along with other major health systems and technology services such as Amazon Care, launched the Moving Health Home initiative – with the goal of "[changing] the way policymakers think about the home as a site of clinical service."

ON THE RECORD
"Since hospital-level care at home services began, Intermountain has shifted 1,400 patient-bed days from participating hospitals to the home," said Christine Lipson, RN, director of home services at Castell.

"Our goal is to be able to offer patients the right level of care in the right place at a lower cost." added Nathan Starr, DO, internal medicine physician and medical director of home services for Intermountain at Home and Intermountain’s tele-hospitalist program. "Our comprehensive in-home services provide the technology to monitor vital signs remotely, plus daily in-home nurse visits, daily tele-health rounding by a medical provider, and access to 24-hour on-call nurses and physicians."

Twitter: @MikeMiliardHITN
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.