Healthcare has been forced to stretch their muscles during the COVID-19 pandemic. For both safety and efficiency, providers must be creative in caring for a growing patient population. After reading CMS’ recent announcement of the Acute Hospital Care at Home program, it is clear that clinical care will continue to expand beyond the four-walls of the hospital.
COVID-19 has drastically changed patient perception and preferences for care. Previously, patients were presenting in the ED pleading to be admitted because they felt terribly ill; providers were placed in the stressful situation of having to both validate illness, but also educate on the appropriate care setting for their clinical severity. Now, patients are doing anything and everything to avoid the hospital, and even a doctor’s office, out of fear of contracting COVID-19. TeleHealth utilization has skyrocketed during the pandemic, and rapidly changed from a "nice to have" service to a necessity in our healthcare delivery model.
Effective care management is a key pillar in successful adoption of our "new normal". Patients need to be made aware of options for care outside of the hospital. Chronically ill patients must be engaged and connected with appropriate clinical support. In many instances, when exacerbation and symptom progression are identified and addressed promptly, TeleHealth can help the patient remain on track and safe in their home. Additionally, if the patient declines or symptoms progress, they can be evaluated in the ED and transitioned back to their home for care.
Promoting collaboration, transparency, and interoperability is imperative to meet the changing demands of our patient populations. Data driven care management will promote high quality outcomes and appropriate utilization, as well as provide an avenue to educate patients on care available in the community. Although patients previously felt comforted by the 24/7 care and attention inherent to an inpatient hospital stay, they are now frightened and want to be home with their families.
Expanding beyond the hospital setting requires strategic partnerships with community providers. There must be collaboration with home health clinicians, including data exchanges and shared clinical documentation. Additionally, providers will need support of specialized pharmacies, DME vendors, outpatient labs, and community EMTs. These changing delivery models demand sophisticated data to drive strategic collaboration and efficient intervention. The only constant is change, and healthcare providers are forced to change and adapt their clinical patterns to safely manage patients and capacity during these trying times.