Kaiser, Mayo, Medically Home found coalition to promote advanced hospital-at-home services


2021-10-14 22:00:18 Healthcareitnews


A group of healthcare organizations announced this week the launch of the Advanced Care at Home Coalition, an advocacy effort aimed at creating a pathway toward safeguarding access to hospital-level services.   Founded by the Mayo Clinic, Kaiser Permanente and hospital-at-home vendor Medically Home, the coalition says it hopes to work with Congress to ensure continuity of care beyond the COVID-19 public health emergency.   "The advanced care at home model has been the apple of our eye for the past two to three years," said Dr. Stephen Parodi, executive vice president of the Permanente Federation, part of Kaiser Permanente, in an interview with Healthcare IT News.   Because of the public health emergency and its attendant regulatory flexibilities, Parodi explained, "we've been able to jump-start and provide services in the home that include remote patient monitoring." Those services allow a select group of patients to receive hospital-level care from their own homes, through the use of connected monitoring devices and mobile tools such as iPads.    "The pandemic helped accelerate things," added Dr. Michael Maniaci, physician leader for advanced care at home at Mayo Clinic. "The pandemic winding down is great from a public health standpoint, but we know Congress doesn't want to just open the floodgates" with no virtual care regulations. The coalition's perspective, he said, is that regulators should "put guardrails on, but let us continue the good work." Key to moving forward will be a delivery model through the Centers for Medicare and Medicaid Services Innovation Center that will enable testing and implementation of a long-term advanced care at home framework.   However, given the time launching a center could take, the coalition plans to urge Congress to extend PHE flexibilities and bridge the gap. Following in the footsteps of other coalitions such as Moving Health Home, It plans to build momentum via educating policymakers about advanced home care's importance and benefits, protecting the current flexibilities and expanding on them through the creation of the aforementioned center.     So far, coalition partners include Adventist Health, ChristianaCare, Geisinger Health, Integris, Johns Hopkins Medicine, Michigan Medicine at the University of Michigan, Novant Health, ProMedica, Sharp Rees-Stealy Medical Group, UNC Health and UnityPoint Health.   Parodi noted that policymakers often want to be shown the data, as if to say: "Show me this improves care. Show me that it's more cost-neutral than current models." But Maniaci said it's a bit of a chicken-and-egg situation: The data can't exist without patients enrolled in the programs. That said, some information is emerging from pilot programs, including the partnership between Mayo and Medically Home announced this past year. At Mayo, said Maniaci, readmission rates for advanced home-care patients are 65% lower, with equivalent if not lower rates of infections and falls.    Parodi also flagged the patient satisfaction component: "We're consistently running at 4.95 out of 5," he said. Part of the reason for that involves provider responsiveness. "We're able to measure it more readily. We can tell someone has answered that person's virtual call. We can tell how fast we dispatch someone and when they arrive in the home," he said. Patients also have much more agency over their days, rather than waiting in a bed for providers to come to them. From a social determinants of health standpoint, too, the advanced home-care model allows providers to get a new perspective on food security and medication adherence. "These are the things that are somewhat intangible," Parodi said. "We're going to need to have a few different ways of measuring this."   Through the work of the coalition, the organizations hope to develop common solutions for implementing a hospital-at-home model at scale, such as common definitions to hold themselves – and the rest of the industry – to the same standards. "There's no vanity here. We want to help everyone," said Maniaci. "We just need our handcuffs taken off to show it's an important model of care."    Kat Jercich is senior editor of Healthcare IT News.Twitter: @kjercichEmail: kjercich@himss.orgHealthcare IT News is a HIMSS Media publication.
一组医疗保健组织本周宣布启动家庭高级护理联盟,这是一项倡导工作,旨在创建一条保障获得医院级服务的途径。 该联盟由梅奥诊所、凯泽永久医院和家庭医院供应商医疗之家成立,表示希望与国会合作,确保新冠肺炎公共卫生紧急情况之外护理的连续性。 “在过去的两到三年里,高级家庭护理模式一直是我们的掌上明珠,”凯泽永久医疗联盟的执行副总裁斯蒂芬·帕罗迪博士在接受医疗保健信息技术新闻采访时说。 帕罗迪解释说,由于公共卫生紧急情况及其随之而来的监管灵活性,“我们已经能够启动并在家庭中提供服务,包括远程患者监控。” 这些服务允许选定的一组患者通过使用连接的监控设备和iPad等移动工具,在自己家里接受医院级的护理。 “这场流行病有助于加速事情的发展,”梅奥诊所家庭高级护理的医生负责人迈克尔·马尼亚奇博士补充说。“从公共卫生的角度来看,这场流行病的消退是伟大的,但我们知道国会不想在没有虚拟护理法规的情况下打开闸门”。 他说,该联盟的观点是,监管机构应该“设置护栏,但让我们继续做好工作。”前进的关键将是通过医疗保险中心和医疗补助服务创新中心的交付模式,该模式将能够测试和实施长期家庭高级护理框架。 然而,考虑到启动一个中心可能需要的时间,联盟计划敦促国会扩大PHE的灵活性,弥合差距。它跟随其他联盟的脚步,如将健康搬到家,计划通过教育政策制定者了解高级家庭护理的重要性和好处,保护目前的灵活性,并通过创建上述中心扩大灵活性,来建立势头。 到目前为止,联盟合作伙伴包括基督复临安息日会健康、ChristianaCare、Geisinger健康、Integris、约翰·霍普金斯医学、密歇根大学密歇根医学、Novant健康、ProMedica、夏普·里斯-斯蒂尔医疗集团、UNC健康和UnityPoint健康。 帕罗迪指出,政策制定者经常希望被展示数据,好像在说:“告诉我这改善了护理。告诉我,它比目前的模型更不影响成本。” 但是Maniaci说,这有点像鸡和蛋的情况:没有患者参加项目,这些数据就不可能存在。也就是说,一些信息正在从试点项目中出现,包括梅奥和医学之家去年宣布的合作伙伴关系。 马尼亚奇说,在梅奥,高级家庭护理患者的再住院率低65%,感染率和跌倒率相当,如果不是更低的话。 帕罗迪还指出了患者满意度的组成部分:“我们一直在5分中保持4.95分,”他说。部分原因涉及提供者的响应性。“我们可以更容易地测量它。我们可以告诉某人已经接听了那个人的虚拟电话。我们可以告诉我们派遣某人的速度以及他们何时到达家中,”他说。 病人在他们的日子里也有更多的代理权,而不是在床上等待提供者来找他们。 从健康的社会决定因素的角度来看,先进的家庭护理模式也使提供者对粮食安全和药物坚持有了新的看法。 “这些都是一些无形的东西,”帕罗迪说。“我们需要有几种不同的方法来衡量这一点。” 通过联盟的工作,这些组织希望为大规模实施家庭医院模式制定共同的解决方案,例如共同的定义,以使自己和行业其他成员遵守相同的标准。 “这里没有虚荣心。我们想帮助每个人,”马尼亚奇说。“我们只需要摘下手铐,以表明这是一种重要的护理模式。” 凯特·杰西奇是医疗保健IT新闻的高级编辑。推特:@kjercichemail:kjercich@HIMSS.orghealthcare IT新闻是HIMSS媒体出版物。