Hospital at Home

Hospital at Home programs like the one offered through Roper St. Francis Healthcare are safe and effective. Studies show that eligible patients who choose to receive their care at home express greater levels of satisfaction and have improved health outcomes. While a hospital is sometimes still the most appropriate place to receive care, a patient’s own home can be the setting that helps them heal quickly and effectively.

At home, patients often get better sleep with fewer disruptions, which can help with healing. Recent studies have also shown that patients experience many other benefits when they choose Hospital at Home, including:

• Lower readmission and mortality rates
• A decrease in hospital-acquired infections
• Fewer incidents of delirium – the confusion some patients experience in the hospital
• Fewer falls – in part because patients are in familiar surroundings
• Reduced stress for the caregiver
• A faster recovery
  
  

What to expect

There are four steps involved in Hospital at Home care: eligibility, admission, treatment and discharge.

1. Eligibility: Is Hospital at Home the right option for you?
   Hospital at Home is generally considered for patients who have acute (rather than chronic or long-term) conditions or illnesses with low complication rates. To be eligible for Hospital at Home, you must first either come to a Roper St. Francis Healthcare emergency room or be an inpatient at one of our hospitals. If you meet certain established criteria based on your condition and other factors, our care team will recommend to you and your physician that you be admitted to the Hospital at Home program.
2. Admission: If eligible, what happens next?

   Once admitted, you will be taken home via LifeLink, Roper St. Francis Healthcare’s emergency ground transportation service. A member of the Hospital at Home care team will meet you there, help you get settled, and set up any of the medical equipment needed for your recovery.

   The care team member will also set up the remote patient monitoring technology that will allow you to reach the Roper St. Francis care team with the touch of a button. This technology allows two-way communication. Your care team will be able to monitor you remotely around the clock and set up your daily telehealth visits. It will also allow you to reach out to your care team if you have a question or a specific health need.

3. Care: Who will provide my care?

   You will receive two daily in-person visits from a nurse or community paramedic, a daily virtual visit with your physician via telehealth, and regular in-person visits from other members of your care team as needed. For example, you may have visits with physical and occupational therapists, respiratory therapists, social workers, dietitians and others, depending on your needs.

   Through the remote patient monitoring devices, your care team will also continuously track your vital signs, such as heart rate, respiratory rate, pulse oximetry and body temperature. They will respond to any issue immediately, assess your condition, conduct a telehealth visit and send assistance to your home, if needed.

4. Discharge: What happens when I no longer need Hospital at Home?
   As with any hospital admission, you will be discharged from the Hospital at Home program when your care team and physician determine, in consultation with you and your family, that you no longer need continuous care.

Before admission to Hospital at Home, a care coordinator will work with you and your insurance company to determine your coverage. Once you are admitted, Roper St. Francis Healthcare will bill your health insurance provider for your Hospital at Home stay. You may be responsible for co-pays and other costs determined by your plan.

1. What are the benefits of participating in Hospital at Home?
   Hospital at Home programs like the one offered through Roper St. Francis Healthcare are safe and effective. Studies show that eligible patients who choose to receive their care at home express greater levels of satisfaction and have improved health outcomes. While a hospital is sometimes still the most appropriate place to receive care, a patient’s own home can be the setting that helps them heal quickly and effectively.


2. Can I apply to participate in the program?
   To be eligible for Hospital at Home, you must first come to any Roper St. Francis Healthcare emergency department or be admitted to one of our hospitals. If you meet admission criteria, you can then be assessed by the Hospital at Home team who will determine your eligibility. You may ask your physician or other provider if you can be evaluated for possible admission to the Hospital at Home program.


3. If I am admitted, how will I get home from the hospital?
   We will transport you to your home via LifeLink, our emergency ground transportation program, where a nurse from the Hospital at Home program will meet you.


4. How will care be provided in my home?

   You will receive a kit that contains remote patient monitoring devices that will allow you to reach your care team with a touch of a button. Your vital signs will also be remotely monitored 24/7 by a team of Hospital at Home nurses.

   In addition, you will receive a minimum of two daily in-person visits from a nurse or community paramedic, a daily virtual visit with your physician and regular in-person visits from other members of your care team, as needed. You may have visits with physical and occupational therapists, respiratory therapists, social workers, or dietitians depending on your needs.



5. Will I see my doctor every day?
   Yes, each day, you will have a virtual visit with your physician via the tablet we provide. You will discuss your treatment plan and will be able to ask questions.


6. Will a nurse stay with me?
   No, but you will receive two in-person nursing visits daily allowing for one-on-one care and education. Also, you will have access to a team of remote nurses around the clock via the tablet or phone.


7. What conditions can be treated by the Hospital at Home program?

   Hospital at Home is for patients who have acute (rather than chronic or long-term) conditions or illnesses with low complication rates. These include, but are not limited to:

   • Certain skin infections
   • Urinary tract infections (UTI)
   • COVID-19
   • Flu
   • Congestive heart failure that has gotten worse
   • Acute kidney injuries
   • Other problems unlikely to have complications

   Your doctors and nurses will speak with you and your family about the Hospital at Home program if it is an option for you.



8. Am I able to participate in the program without internet or Wi-Fi? Do I have to have a smart phone?
   You do not need access to the internet or Wi-Fi, and you do not need a smart phone. All the remote patient monitoring equipment we provide has both cellular and Wi-Fi connectivity to ensure that you can communicate with the care team no matter what service or technology you have at home.


9. What equipment will be set up in my home?
   All necessary medical supplies and equipment will be brought to your home and set up as they are in a hospital. One advantage to Hospital at Home, however, is that you will be able to sleep comfortably in your own bed.


10. How is patient education completed in the home?
    Education is an important part of the Hospital at Home program and is provided in-person and virtually.


11. What is the cost of participating in Hospital at Home?
    Hospital at Home is billed the same way as a traditional inpatient admission to a hospital. The exact costs and details are specific to your insurance plan and treatment. Your care coordinator will work with you in advance to determine what your insurance covers.


12. What happens if I stop making progress or feel worse?
    If your care team notices a concerning change in your vital signs, which are remotely monitored 24 hours a day, they will respond right away to assess your needs, conduct a telehealth visit and send assistance to your home, if needed. We can also transport you to one of our hospitals if that becomes necessary.


13. What should I do in an emergency? Should I call 911?
    Our telehealth care team will facilitate emergency response support.


14. Will I get the same type of care at home as in the hospital?
    Yes. As a patient in the Hospital at Home program, you will receive the same level of care at home that patients receive in a hospital. You get care from the same doctors who would see you in the hospital. We use the newest telehealth technology to bring our clinical experts to you at home.


15. If my doctor refers me to the Hospital at Home program, do I have to participate?
    No. You can decline to participate in Hospital at Home and stay in the hospital instead.


16. Is Hospital at Home safe?
    Your safety is our first priority. The Hospital at Home program takes many steps to ensure that you receive safe and effective care. Before you are admitted to the program, we carefully evaluate your medical condition and home situation to ensure Hospital at Home is a good option for you. Only patients with certain medical conditions with low complication rates are considered. Also, we remotely monitor your vital signs 24 hours a day and can send care to your location rapidly whenever necessary.


17. How is Hospital at Home different from home health care?
    Hospital at Home is for patients experiencing an acute health condition who would be inpatients in a hospital if not admitted to this program. Home health care services, on the other hand, are prescribed by a doctor to help manage an illness, injury, or medical condition, often after a hospital stay. Visits from the home health care team are regular but are not provided around the clock. Hospital at Home patients receive 24-hour monitoring and daily in-person and remote visits with their care team, as if they were in a hospital.


18. What if I need to go back to the hospital? Will there be a bed available for me?
    If your care team decides you need to go back to the hospital, one of two things will happen. If you need emergency care, we will arrange transportation to the emergency room. If we think you will progress better in a hospital, our team will stay with you and continue your Hospital at Home care, until a hospital bed is available for you.


19. Can I participate in the Hospital at Home program if I have pets?
    Yes. Studies show that the bond between people and their pets can have health benefits. However, we may ask pets to be moved to a separate room during our visits.

If you would like more information about the Hospital at Home program, please contact Jason Little at Charles.Little@rsfh.com.

Note: If you are already a patient of the Hospital at Home program and have a question or healthcare need, please talk with your care team.