Pandemic awakens need for at-home hospital care in Northern California

With the pandemic escalating at the end of 2020, the Centers for Medicare and Medicaid Services began a temporary program to allow some non-COVID-19 patients to be cared for at their home rather than the hospital. Nearly two years before the pandemic, Providence Health embarked on a pilot program that didn’t rely on being reimbursed by Medicare, said Czartoski.

“We were planning on doing this because the ability to care for our growing communities in the facilities we have was being tested,” he said, adding that higher quality of care and lower costs were big factors. “COVID really accelerated the work and forced us to pull things together more quickly.”

Advances in technology, including telehealth and virtual care, have made providing hospital care at home more feasible, but that’s not the whole story.

“Logistically, it's very complicated,” Czartoski said, explaining such a program requires mobilizing nurses in the field and a virtual command center of hospital physicians and nurses to watch the patients 24/7 in their homes. Trained hospital nurses make one or two in-person visits each day to the patient’s home. “We also have all of the operational pieces” which include, but are not limited to, pharmacy needs, meals, infusions, bloodwork, ventilators and radiology therapies.

The nonprofit health care system is getting ready to expand its acute care hospital at-home program system-wide, with plans to make its way to California hospitals within the next two years, he said. 

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