Surging COVID-19 hospitalizations have been putting unprecedented strain on health care systems across the country. News from all corners of the United States has told stories of postponed elective surgeries and a shortage of hospital beds – and workers.
To ease pressure on acute care facilities, prevent – or sooner detect – the need for readmission and provide better continuity of care for patients, Novant Health recently implemented a solution.
Novant Health’s COVID Care at Home identifies patients being treated for COVID-19 who can safely transition to care at home and discharges those patients with on-demand virtual care follow-up appointments and in-home support. New Hanover Regional Medical Center, now part of Novant Health, launched a similar program in April that has served more than 2,400 patients.
“COVID Care at Home … allows eligible patients to be treated in the comfort of their home,” said Dr. Zak Anderson, clinical physician executive with the Novant Health Hospital-Based Medicine Institute.
Before the program’s implementation across the Novant Health system, 22 patients participated in a pilot program. Of the 22 discharged to continue with virtual care and home support, only three needed to be readmitted.
Since its systemwide launch on Sept. 1, more than 50 patients have benefited from the program with on-demand virtual care and home support.
Matt Reynolds, a nurse practitioner on Novant Health’s digital care team, said candidates for the COVID Care at Home program include those with “positive symptom progression, including those meeting certain criteria like improved respiratory function.”
Joy Justice, lead clinician for Novant Health Digital Care Group, added: “These virtual follow-up appointments … improve patient education and transition care, which helps us ensure the best outcomes for patients. By giving patients the tools they need to follow their treatment plan (at home) while still being closely monitored, we can intervene earlier and help reduce the likelihood they’d need to be readmitted for a serious or emergent condition.”
“The No. 1 concern right now is hospitals being overwhelmed,” Reynolds said. “This program allows hospitals to allocate resources to patients who need a higher level of care.”
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All COVID Care at Home patients leave the hospital with a scheduled virtual visit within the first 24 hours with a member of Novant Health’s on-demand virtual care team. (Some are discharged with home oxygen monitoring and administration equipment.) After this initial virtual visit, patients will either get a referral to see their Novant Health primary care provider, if they have one, or will continue to have on-demand virtual follow-up visits, as needed.
If a patient requires a higher level of care than a virtual visit offers, the provider will consult with an acute care physician to coordinate direct admission to the hospital or a referral to a specialist.
Novant Health’s case management team, in collaboration with the guest services team, ensures patients receive education on the tools necessary to facilitate COVID Care at Home. Every patient gets assistance setting up a MyChart account, a step-by-step guide to access their scheduled virtual visit, as well as on-demand virtual visits, and a pulse oximeter – to measure oxygen levels – before being discharged from the hospital.
No one wants to stay in the hospital longer than necessary. This innovative program sends patients home who’ve been deemed ready to return home and prevents overcrowding and potential bed shortages.
“This pandemic pushed us to be even more nimble and innovative in how we deliver safe, quality care,” said Anderson. “We plan to expand this model beyond COVID-19 to reach and benefit even more patients.”