More than 1,000 COVID patients received hospital care at home

It was an answer to a patient influx and also a solution to patients wanting to return to the comforts of their home. The Hospital at Home program is an innovative plan for off-site COVID care.

By IU Health Senior Journalist, T.J. Banes tfender1@iuhealth.org

For many, the return to “normal” has been a slow process. Those hospitalized with COVID-19 say they have symptoms that linger for months. But not all of those symptoms require hospitalization.

As a result, IU Health launched the “Hospital at Home” program last spring. Since then, more than 1,000 COVID patients have convalesced at home.

“This program has been a success and is necessary because it actually off loads our hospitals. It allows our hospital to discharge our COVID patients earlier to their homes because we have support with remote monitoring equipment, virtual care nurses, advanced practice providers, and hospitalists to do that care remotely and virtually,” said IU Health’s Dr. Michele Saysana, medical officer of virtual care.

While virtual care has been used for other patients, those recovering from COVID have placed an especially high demand on hospital staff.

“At any given time in the last months we’ve had about 40 patients a day in the Hospital at Home program which is larger than one of our critical access hospitals and more than a unit at a hospital. It’s like having our own unit at home,” said Dr. Saysana.

What that means is when a patient is well enough to be discharged from the hospital, the patient and caregiver are educated about ongoing needs. Those needs may include regularly checking blood pressure, oxygen levels, and blood sugar. Patients then connect daily with a care team of doctors and nurses by phone and virtual visits. If a patient’s condition changes – such as a spike in fever, difficulty breathing, drinking, or eating, or a loss of appetite, or chest pain – they are given a number to call and identify as an IU Health COVID-19 telemonitoring patient.

Key to the success of the Hospital at Home program is the day-to-day work by IU Health’s distribution team. Chad Fruits, who has worked at IU Health for just over four years, is one of those team members. As referrals come in from IU Health sites, Fruits works with other team members to respond to dozens of emails, check equipment, keep up-to-date on inventory, and prepare equipment for patient use. The preparation starts in the emergency room and then moves into the home. Fruits and the team assemble hundreds of kits to be sent to the patients’ homes. Kits include a blood pressure monitor and cuff, pulse oximeter, spirometer, and thermometer. There is also a computer tablet. Wireless connectivity provides instructions and reminders for equipment use.

“COVID has taken a toll on many and there are a lot of people working behind-the-scenes trying to limit the stress as much as we can,” said Fruits.

Since the start of the Hospital at Home program IU Health hospitals have seen a decrease in the number of readmissions and emergency visits by COVID patients, said Dr. Saysana.

“There is something to be said for being comfortable in your own surroundings. Hospitals can sometimes be noisy night and day. Something about being home helps patients rest better and rest helps with healing,” said Dr. Saysana.

“I think we will continue the program much longer after COVID,” she added. The plan is to expand Hospital at Home to patients with such conditions as congestive heart failure, pneumonia, cellulitis, and urinary tract infections.

“Our goal is to continue to expand and grow it just as other national Hospital at Home programs have done with success,” said Dr. Saysana.

Photos by Mike Dickbernd, IU Health visual journalist, mdickbernd@iuhealth.org