Virginia Commonwealth University (VCU) Health has rolled out a hospital-at-home program — the first in central Virginia.
Richmond, Virginia-based VCU Health is an academic medical center in the Piedmont region. VCU Health at Home’s service lines includes home-based primary care, primary and specialty telehealth appointments, remote patient monitoring as well as skilled home health and hospice care.
Now, its home-based care offering will include this acute-level care program where care is delivered via video, with aid of remote patient monitoring and with a physician overseeing patients in the program. The program will also include in-person visits from nurses and other clinicians.
In a way, VCU Health is the culmination of the organization’s past success in the home-based care space.
“Coming into 2021, we had the necessary resources on the table — the home health agency for skilled, the remote monitoring program, and we had this experience of going into home and community settings,” Jay Holdren, senior director of continuum integration at VCU Health at Home, told Home Health Care News. “We felt like it was a really great opportunity for us, as a health system, to jump into the waters of hospital-at-home.”
To achieve this, VCU Health joined the U.S. Centers for Medicare & Medicaid Services’ (CMS) Acute Hospital Care At Home waiver program.
“We consider Medicare our primary and first partner on the payer side to implement the program,” Holdren said.
For an institution facing high-demand, Holdren believes the program will create greater access to care.
“When I say high-demand, our institution can commonly be on ambulance restrictions, meaning we can’t take incoming patients because our beds are full, so we start the day at 90% occupied,” Holdren said. “When you’re a quaternary care center, that is looked upon to serve the high-intensity needs of patients of Central Virginia, and beyond, and those beds aren’t available, that’s a real issue. The home hospital program could carve off some of the low-intensity patient population and serve them in their home in a way that was patient centric.”
Holdren noted that it makes sense for care to also go this route at a time where various on-demand services can be delivered to the home.
He also said he believes that delivering care in the home gives clinicians greater insight into their patients’ conditions.
“You get to the patient’s home, you’re able to see their medication regimen, see their adherence to such,” Holdren said. “You see what they eat, you see how they sleep, we see their support system, the social determinants of health, firsthand. You get to understand what their goals are, and help them reach those goals.”
Looking ahead, VCU Health aims to serve nearly 2,000 patients during its first year.
“You have to have creative thinkers and you have to have people with open minds willing to innovate and break the mold,” Holdren said. “We’ve had that, so it’s been very rewarding even getting to this place where we’re now, on our third day, but getting here was quite fun.”