Physicians in the emergency department at Brigham and Women’s Hospital in Boston are sending some patients back home with medical and technology support in a new “home hospital” program.
Through the program, any necessary medications and equipment go home with the patient along with a physician and nurse, for at least several hours a day for as long as needed—the clinicians set up everything necessary for home treatment and make sure the patient’s condition is improving.
Patients favor the approach because they’re in familiar surroundings—they get to sleep in their own beds, rather than share a hospital room with another patient, and get to eat their own food.
Patients in the home hospital program are being continually monitored by the hospital through a large wearable badge affixed to their skin. Called VitalPatch, the technology collects vital signs such as heart rate, respiratory rate, skin temperature, telemetry and maybe how they are sleeping, walking or if they fall.
The device is a product of VitalConnect. It is an adhesive patch with an integrated sensor module that uses electrodes to detect heart rate, thermistor to detect skin temperature and an accelerometer to detect motion, among other capabilities.
The home hospital pilot program was launched in late 2016 and will relaunch in May, says David Levine, MD, a general internist and investigator focusing on digital health and connected care initiatives. In the pilot, Brigham and Women’s Hospital learned how to integrate technology with the patient using VitalPatch, which is a passive data monitoring device.
“There are lots of other interesting things we can do with VitalPatch; we’re just scratching the surface,” Levine adds. For example, the patch could support telemedicine in the home or secure messaging.
Now, the program is expanding to support patient-physician video visits along with the addition of community health workers and a handyman for construction of any needed support services, such as handrails or a ramp.
While the program is tailored to each patient’s needs, intensive monitoring by clinicians typically occurs during the first three days at home, just as it would be in the hospital, where most patient stays are about the same length of time, according to Levine. “Patients are happy to be at home even when acutely ill, and we’re able to deliver care with a little help from the IT department and our excellent clinical care teams.”
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