Since the pandemic, some hospitals have started offering to let patients with acute illness recuperate at-home, with 24-hour remote access to medical professionals and daily home visits.
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Since the pandemic, some hospitals have started offering to let patients with acute illness recuperate at-home, with 24-hour remote access to medical professionals and daily home visits.
FG Trade/Getty Images
David and Marcia Elder packed their bags anticipating a month-long stay at the Mayo Clinic in Jacksonville, Fla., when David went in for a bone-marrow transplant in late February, as part of his treatment for multiple myeloma, a blood cancer.
A few hours after surgery, the couple were amazed when staff offered them the option of returning home that day. “They came to us and said, ‘We have this hospital-at-home program’ and I was like, ‘What? I’d never even heard of it,'” Marcia Elder says.
By dinnertime that day, paramedics had set up a make-shift recovery room in their living space and they returned to convalesce at home.
Such a thing was unimaginable, just a few years ago. The Mayo Clinic was among the first hospitals in the country to experiment with sending acute patients home for remote care four years ago. Now, some 250 similar programs exist throughout the country.
That’s largely because during the pandemic, the federal agency that runs Medicare and Medicaid relaxed normal rules requiring around-the-clock, on-site nurses for hospitals requesting the exception. This allowed at-home hospital care programs to rapidly expand. Those pandemic-era waivers will remain in place until at least the end of 2024, although some experts anticipate policy changes allowing such programs to remain in place permanently.
David Elder flashes his hospital bracelet from the comfort of an easy chair in his own home, which he was sent back to just a few hours after his bone marrow transplant surgery. He said it was a lot more restful to be home.
Marcia Elder
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Marcia Elder
As a result, at-home hospital care is fast becoming an option for acute care for many conditions, even for treatment of cancer, or for patients like Elder, recovering from complex procedures. Such shifts could potentially reshape the future of hospital care, affecting many more patients.
The practice has been enabled by other recent trends as well – for instance the increase in traveling medical staff and the prevalence of portable Internet-enabled devices to connect with medical help remotely. The crisis of the pandemic also normalized remote care. And dealing with COVID surges made hospitals — as well as regulators and health insurers — more receptive to the notion that at-home care might be healthier, cheaper, and generally more pleasant than at a hospital.
“People do better; they’re more mobile, they recover faster,” says Michael Maniaci, an internist who directs virtual care for the Mayo Clinic. “They use physical therapy or skilled nursing care less. You ask: Why is that? Because there’s something magical about being at home.”