Intermountain Bringing “Hospital-Level Care” Into Patients’ Homes

June 8, 2020
The health system has explored this service over the past couple of years and recently accelerated its progression due to COVID-19

The Salt Lake City, Utah-based Intermountain Healthcare is now providing what officials contend are hospital-level healthcare services in people’s homes for patients who meet certain clinical and non-clinical criteria, according to a recent announcement.

The 24-hospital health system said it will deliver this in-home hospital-level care in partnership with Castell, a health platform company from Intermountain that is focused on elevating value-based care capabilities with providers, payers, healthcare systems, and accountable care organizations.

At Intermountain, officials explained, healthcare providers will identify patients who need hospitalization but could benefit and qualify for receiving certain hospital-level care services at home. They will offer home hospital-level care as an option for patients who would like to participate and with an insurance plan or payment currently in a value-based arrangement with Intermountain.

The service will treat patients for conditions such as congestive heart failure, some kidney related conditions, some intestinal or vein conditions, infections such as cellulitis, and certain cancer diagnoses.

Providing hospital-level services in patient homes helps reduce unnecessary trips to the emergency room, and shorten or eliminate the time some patients spend in a hospital setting, while allowing them to continue to receive the acute care they need, according to officials.

“The hospitals of the future will expand virtually into homes to provide appropriate acute-level care. This new service supports patients who are at risk for hospitalization or complications, along with their families,” said Rajesh Shrestha, Castell president and CEO and Intermountain vice president and COO for community-based care.

“Many patients find they feel more calm and comfortable at home than in a hospital, and that in itself can be conducive to healing. It also allows people to be more independent,” he added.

Officials say that Intermountain has explored this service over the past couple of years and recently accelerated its progression to help support the health system in the event of a surge of COVID-19 patients.

Last year, the patient care organization deployed a service called “Intermountain at Home,” aiming to prevent or shorten hospital admissions by expanding home-based services it offers patients such as post-hospital, palliative, and end-of-life care as well as medical equipment maintenance. That expansion also included various health IT-related services, such as remote monitoring, expanded telemedicine capabilities, and virtual urgent care visits through Intermountain Connect Care.

Details of this new service include initial set-up and orientation in the hospital, followed by regular in-person and virtual check-ins from a care team of in-home and tele-nurses, as well as a tele-hospitalist. On-call services are available 24 hours a day, seven days per week.

Patients are provided with a remote patient monitoring kit and other home health equipment as needed for their particular diagnoses. Standard equipment includes a blood pressure monitor, pulse oximeter, cellular-enabled digital tablet, and a digital scale. Additional equipment such as a continuous heart rate and oxygen sensor will be added, based on a patient’s diagnosis. All the devices connect to the tablet through Bluetooth and transmit vital signs to a remote monitoring center where a team of Intermountain telehealth specialists monitor patients 24/7.

“When caregivers are able to actually see and treat a patient in their home environment, they gain a better understanding of ways to help the patient make their daily tasks safer, healthier, or easier,” said Josh Romney, M.D., Castell population health medical director and an internal medicine physician with Intermountain Medical Group.

“Enabling hospital-level care in patients’ homes will help advance Intermountain Healthcare’s transition to value-based care, where the goal is to keep patients healthy, improve outcomes and reduce overall costs,” Dr. Romney added.