New York’s Largest Private Employer Launches Home-Based Care Program

One of the largest health care providers in New York — and the state’s largest private employer — is leaning on a home-based care initiative to help get itself and its patients through the COVID-19 crisis.

Northwell Health is a nonprofit, integrated health care network that employs roughly 72,000 people. Headquartered in New Hyde Park, it has 23 hospitals and 14,200 physicians in its network.

Recently, Northwell Health launched a program that cares for COVID-19 patients with minor to severe symptoms by helping them stay in their homes after contracting the virus. In addition to helping patients, the program helps ensure hospital capacity during potential surges.

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The idea for the program first came to fruition when hospitals were overrun in New York City in April. Providing care in the home needed to become part of the solution, so Dr. Gita Lisker created the Coronavirus Related Outpatient Work Navigators (CROWN) program.

Lisker is the medical director of the respiratory care unit at Long Island Jewish Medical Center, an affiliate of Northwell Health.

The program keeps spread to a minimum by allowing patients to recover in place. That also increases Northwell’s reach by preventing ill people afraid of the hospital from going without care.

“There was just a terrifying fear among many people to go to the hospital during this time period. Family and visitors weren’t allowed, and there were limited time interactions — even between the hospital staff and the patients in the room,” Lisker told Home Health Care News. “People were saying, ‘No matter what, I’m absolutely not going to the hospital.’”

New York has reported over 445,000 confirmed cases of COVID-19 as of Tuesday. New York City has more deaths on its own — over 23,000 — than any other state in the country.

So far, Northwell’s home-focused program has taken care of nearly 200 COVID-19 patients, including many who have been seriously ill and some who have underlying health conditions.

“We’ve learned a lot from the at-home model,” Lisker said.

The program includes a telehealth segment, run by Northwell’s pulmonologists, and an in-person group of nurses. Services offered through the program range from mobile X-rays to the delivery of IV fluids and more.

“It’s very important that we give [patients] reassurance, because there’s a lot of anxiety that’s related to the COVID-19 symptoms right now,” Lisker said.

There have been other successful hospital-at-home type models that were spawned by COVID-19. In Minnesota, Lifesprk — a home-based care provider — partnered with North Memorial Health to take care of infected patients. The Mayo Clinic and Medically Home — a tech-enabled care services provider — made a similar partnership.

To its credit, Northwell’s program has been a success thus far. Only two of the patients that were treated under the model ended up having to go to the hospital.

“Most of the [early-on hospital cases] could have been managed at home, and some just need the encouragement,” Lisker said.

One of the biggest successes of the at-home model, Lisker said, has been the peace-of-mind aspect. Patients have written letters and made phone calls since the program’s launch thanking Northwell for allowing them to stay home.

It’s been another learning experience for a patient population that may have not known about home-based care options before.

“I think [this is] going to be the way of the future,” Lisker said. “I think it’s going to be one of the beneficial things that came out of this. We’re going to realize that we are able to transition care into the patient’s home instead of into the hospital, which is just better for hospitals, patients, their families and insurance companies.”

Northwell’s home health affiliates include Northwell Health At Home and Peconic Bay Home Health Services.

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