Orlando Health is expanding its acute Hospital Care at Home program, which uses remote monitoring of patients by health professionals, to Lake and Osceola counties.
The Central Florida hospital group began last year offering patients at-home care, which was made possible through a program by the federal Centers for Medicare & Medicaid Services as a way to free bed space during the height of the COVID-19 pandemic.
Orlando Health is continuing the program despite a decrease in COVID cases.
After opening the program in early 2023, Orlando Health had 200 at-home patients by August. At the beginning of March, the program had grown to treat more than 650 patients for chronic obstructive pulmonary disease (COPD), asthma exacerbations, congestive heart failure, superficial skin infections, cellulitis, gastroenteritis, COVID and more.
Overall, these patients experienced fewer infections and readmission rates, said Dr. Siddharaj Shah, quality director of the program.
“It's safer for patients. They heal faster, and they have better experience scores than the traditional brick and mortar,” he said.
Proven results
That appears to be true outside of Orlando Health, as well. According to the National Library of Medicine, a 2023 study found that when “compared with patients in a hospital setting, patients in a (hospital at-home setting) had better clinical outcomes.” The researchers also noted that readmissions were lower.
Perhaps most intriguing to bill-paying patients was the observed reduction of costs through at-home care. The study found this health service reduces the cost of health care as patients undergo fewer diagnostic and lab tests. A trial comparing inpatient hospital models with at-home settings found a 38% cost reduction citing fewer lab orders, imaging studies and consultation orders. Readmission rates were also cited as a reason.
Expanding the program
The expansion led to the program now being available at Orlando Health St. Cloud Hospital and Orlando Health South Lake Hospital.
Hospital at Home stemmed from CMS’ “Hospital Without Walls”initiative in March 2020. This allowed Medicare-certified hospitals to seek waivers that would suspend the requirements for nursing services to be provided on premises 24 hours a day, seven days a week, and for a registered nurse to be immediately available.
Patients are monitored via portable technology, which is observed by the Patient Care Virtual hub 24/7. The program added satellite hubs to accommodate the recent expansion. The hub can keep track of a patient’s vitals using a patch that will stick to the patient's body and send nurses information on vitals. Patients can communicate with the nursing staff or doctors using a hospital-provided tablet.
To be eligible, a patient’s home must be a safe environment located within 25 miles of an Orlando Health location in case emergency care is required.
Prior to the expansion, Hospital at Home was available through seven of campuses, including Orlando Health Orlando Regional Medical Center and Orlando Health South Seminole Hospital as well as locations Orlando Health Dr. P. Phillips Hospital, Orlando Health Emergency Room–Osceola, Orlando Health Emergency Room–Randal Park, Orlando Health Emergency Room–Lake Mary and Orlando Health Winnie Palmer Hospital for Women & Babies.
Siddharaj said there are plans to keep expanding the program, but he isn’t sure when or where that will take place at this time.
“Definitely. We want to continue to offer hospital care at home to as many appropriate patients as we can seeing how it is in fact shown to be a better model of care once,” he said.
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