Earlier this year, a patient at an Oklahoma hospital had been in and out of the emergency room six times in the past 10 days for a serious bone infection.
But because of his lack of trust in the healthcare system, he didn’t want to stay in the hospital. So he is taken care of at home. The only problem is that he doesn’t have a traditional home; he lives in a trailer in his friend’s yard.
This is not a problem for partner hospitals medical homean organization that works with providers to provide home care.
Pippa Shulman, chief medical director of Medically Home, said: “They were able to take in this guy who was so distrustful of the system, living in a situation where you might not consider a home and being cared for for the first time in his condition.”
Shulman last week Mayo Clinic Platform Conference About how the Boston-based organization is working to reach people in disadvantaged communities. Founded in 2016, Medically Home works with 13 health systems in 14 states, including Mayo Clinic and Kaiser Permanente. The company provides training, protocols, procedures and technology to help health systems deliver care and manage the goods and services patients need. In return, Medically Home charges its partners a fee.
Currently, in a public health emergency, Medicare and many state Medicaid programs cover home hospital care, as well as multiple Medicare Advantage plans and commercial insurers, Schulman said.
Not everyone needs a traditional home to receive home care, Schulman said. As long as they are in an area with a roof, electricity, running water and a bathroom, Medicly Home can provide the service. Some patients are treated in a friend’s living room, sofa or Airbnb. In the event of a natural disaster such as an ice storm, Medicly Home can even place patients in hotels, Schulman added.
For those without a home, Medically Home will ask if there are any family members or friends who would like to host them. In this case, the group will talk to family or friends and explain how care is going, and the company is trying to keep its home footprint relatively small, Schulman said.
Patients themselves do not need any technology to receive home care; Medically Home provides all the necessary equipment, further making care easier for patients. The company brings patients tablets, cell phones and personal emergency response equipment they wear, all leading to a command center. For internet access, Medicly Home also offers a connected device. With these devices, patients can also connect with their care team 24/7, Schulman said.
Like patients receiving care in a trailer at a friend’s house, many patients lack trust in the health care system. Providing care at home restores that trust, Schulman said.
“When we think about vulnerable patient populations, the advantage of moving care to a place they call home is that we really put the patient at the center of care. We are guests in their home,” Schulman said. “While yes, we have everything we need at the time fashion demands, they know when we’re coming, they know who’s coming… They don’t think, ‘Who am I going to meet today?'”
Not only do patients benefit from this setup, but so do their caregivers.
“We don’t require paramedics to be nurses or provide care, but they have the same transparency about who comes and what happens next,” Schulman said. “They can attend doctor and nurse visits. That’s often a very big change for paramedics compared to what they see in brick-and-mortar hospitals.”
While Medically Home is providing care to many patients in non-traditional home settings, some remain out of reach. The next frontier is rural communities, where broadband access is challenging, Schulman said. She added that companies are exploring a variety of ways to improve the problem, such as using devices that can increase the strength and power of wireless signals, or using satellite technology.
“We’ve worked in multiple rural communities, but that’s where we have the greatest connectivity challenges,” Schulman said. “I just want to make sure we’re creating a reliable and robust connection path for as many patients as possible, and I think rural areas can be challenged.”
Photo: selimaksan, Getty Images
