Pilot Program Uses Laymen to Fill Care Gaps for Home Health

As the pressure rises on home health workers and and other health systems for a growing population of patients, one provider is piloting a program to fill the gaps not with caregivers, but with regular people.

The program employs LifeCourse, a new project from Minnesota-based health care provider Allina Health LifeCourse is a late life supportive care project that helps bridge some of the gaps across the health care spectrum.

For a patient with a serious illness in the late stages of life, LifeCourse will act like a care guide, or a lay person, to help manage their care without any clinical component. This helps bridge patients with the services they need, including community-based services.

For a lot of patients who need home health care, some of these health system gaps fall on the shoulders of home health caregivers. But for those who have serious illnesses and may need palliative care or hospice, a lay person or care guide can help set them up and manage their case as they transition through different acuity levels. Unlike providers that seek to expand palliative care services through home care operations, LifeCourse serves patients that may not utilize home care

Care guides allow people to stay better informed about their care and be more vocal about what they want out of their care. LifeCourse began its pilot project in 2012 with a model that does not replace the current care system, but compliments it with an additional coordinator.

A care guide enables patients to “engage in an empowerment model,” Eric Anderson, M.D., principal investigator on the LifeCourse project with Allina Health, said during the 2016 American Academy of Hospice and Palliative Care Annual Conference in Chicago.

These care coordinators provide no clinical care, but the relationship for patients is therapeutic, and the care guides are trained by Allina Health in communication, documentation and palliative care initiatives. The goal is to get these types of care integrated in the health system much earlier in the continuum of care. As the demand for palliative care continues to ride, a care coordinator can connect patients to beneficial services sooner.

With only a few years under its belt and a small patient base, the project has found that a person’s quality of life can be maintained or improved when working with a care guide, even if their serious disease progresses.

The results do not yet reveal any cost savings. However, there are some promising signs the data could be heading that way in the future, according to Anderson.

“Everything we’ve measured is going in the right direction [for cost savings],” Anderson said.

The outcomes of the pilot reveal that hospital admissions and the number of days spent in intensive care could be reduced through a care guide. So far, the study has taken on 1,750 subjects, including about 450 patients and their key family members and friends.

With positive initial results, LifeCourse is expanding its reach in 2016 to primary care settings, specialty clinics and neighborhood services.

Written by Amy Baxter