In our series celebrating hospital award winners, we’re highlighting medical institutions that have innovated patient care with cutting-edge methods. The need to innovate often arises from challenges, and the COVID-19 pandemic was a significant catalyst. Tampa General Hospital (TGH) is one such institution that adapted by creating the Hospital at Home program. Initially devised as a crisis management strategy, this initiative has now permanently enhanced their services.
The Hospital at Home program allows patients meeting specific medical standards to recover at home rather than in a hospital. They receive daily in-person healthcare visits, participate in virtual consultations, and are continuously monitored through wireless devices that track their vital signs. This arrangement was facilitated by a waiver from the Centers for Medicare & Medicaid Services during the pandemic. According to Dr. Peter Chang, TGH’s vice-president of healthcare design, the waiver enabled the hospital to deliver at-home care on par with in-hospital services and ensured that hospitals could receive reimbursement for this care. TGH applied for the waiver in 2021, and the program began in mid-2022.
This initiative differs from usual home healthcare, where discharged patients typically receive one or two home visits a week. Participants in the Hospital at Home program are visited by a nurse or clinical team member twice daily since their condition would usually require hospitalization.
April Bennett Cabral, who has stage 4 breast cancer, is one of the beneficiaries. After testing positive for COVID following chemotherapy, she was admitted to TGH with a fever and high heart rate. Once stabilized, she needed several days of IV treatment, usually necessitating a hospital stay. However, she was given the option to continue treatment at home under the Hospital at Home program. Conveniently residing within 25 minutes of TGH, she agreed, allowing her to receive the same level of monitoring at home as she would in the hospital. Her healthcare experience at home was similar in quality, with constant monitoring and regular vital checks, providing her with more comfort and convenience.
Hospital at Home revisits the era of house calls but incorporates modern technology. The program offers healthcare providers insights into patients’ daily habits that aren’t typically visible in a clinical setting. Providers can identify and address issues like medication noncompliance by offering advice on scheduling and dosage.
Patients in this program use a Remote Patient Monitoring device attached to their chest. This device records vital signs such as blood pressure and temperature, sending the data to the hospital via Bluetooth to a cloud-connected tablet. A separate platform facilitates telehealth exams and virtual consultations.
For Medicare beneficiaries, standard hospital readmission rates range from 10 to 20%, yet among the 70 participants in Hospital at Home, only one has been readmitted. Dr. Chang believes this success is largely due to the insights gained from at-home visits and the transitional care provided at discharge.
Looking ahead, Dr. Chang sees potential for Hospital at Home to expand across the U.S., driven by its demonstrated reduction in readmissions, improved patient satisfaction, and decreased costs. He emphasized that expanding this model doesn’t require constructing new hospital facilities.
