Monday, June 11, 2012

Markets in Everything: Hospital at Home

"Soon, Dr. Elizabeth Ward was managing a "hospital at home" admission for patient Frank Blondin -- an arrangement allowing him to receive intensive care and medical monitoring in the quiet of his own bedroom. Medical supplies and medications would be delivered as soon as possible.  A nurse would come within the hour, take laboratory samples, and return later that afternoon and in the days to come.  Dr. Ward would check in by phone, visit daily, and help would be available 24/7 if required.

"Hospital at home" programs fundamentally refashion care for chronically ill patients who have acute medical problems -- testing traditional notions of how services should be delivered when people become seriously ill.  Only a handful of such initiatives exist, including the Albuquerque program, run by Presbyterian Healthcare Services, and programs in Portland, Ore., Honolulu, Boise, Idaho, and New Orleans offered through the Veterans Health Administration.

But the concept – which has been adopted in Australia, England, Israel and Canada -- is getting attention here with increased pressure from the national health overhaul to improve the quality of medical care and lower costs. Hospital at home programs do both, according to research led by Dr. Bruce Leff, the director of geriatric health services research at Johns Hopkins School of Medicine in Baltimore who pioneered the concept."

HT: John Goodman via Peter Parlapiano


At 6/11/2012 5:50 PM, Blogger WCTaxpayers said...

Makes sense to me.

At 6/11/2012 6:10 PM, Blogger Jet Beagle said...

John Goodman is really the expert on health care spending and cost solutions.

Not sure whether hospitals will fight this innovation. If they have anysense at all, they will get in front of it and keep the revenues they would otherwise lose.

At 6/11/2012 7:46 PM, Blogger Henry H said...

What's old is new again? They seem to have gotten rid of the "house call" in favor of the term "Hospital at Home".

At 6/12/2012 6:00 AM, Blogger Larry G said...

word confusion here. If someone has a life-threatening condition and needs to be close to immediate medical assistance and/or the equipment that only a hospital can afford to provide - there is no real advantage to "remote" care. Seems like, you're just putting that person at unnecessary risk.

One doctor in a bricks & mortar hospital can be within seconds/minutes of 30, 50 people in adjacent/nearby rooms only a few steps away.

that same doctor could in no way duplicate that capability if the 30 were located in scattered residential geography.

it actually sounds much more costly and less effective.

At 6/12/2012 7:16 AM, Blogger Jet Beagle said...

Larry G: " If someone has a life-threatening condition ... Seems like, you're just putting that person at unnecessary risk."

"Acute medical problems" does not mean "life threatening condition". Perhaps that's the source of the word confusion.

I don't think a company as large as Presbyterian Healthcare Services is going to risk multi-million dollar lawsuits and put anyone at unnecessary risk.

Consider also that many chronically ill patients might just prefer to be in their own house rather than separated from their families in a hospital.

At 6/12/2012 7:22 AM, Blogger Larry G said...

re: "acute" vs "life threatening".

fair enough.

"Hospital at Home"

the two things that are present in a hospital are the quick availability of medical professionals and medical equipment.

perhaps the phrase itself can lead to questions...about meaning...

At 6/12/2012 8:11 AM, Blogger Jet Beagle said... provides more information about the program. Notice that this is not a new innovation but rather one that was started with a pilot trial back in 1996. The program has been tested extensively.

Reductions in cost and size of medical equipment, plus the enhanced communications capacity available today, have expanded the feasibility of home health care to include many more diseases and conditions. At least, that's how I understand it.

At 6/12/2012 9:14 AM, Blogger Larry G said...

yes... I'm familiar with the programs that already exist - and the fact that innovations are enhancing the services and lowering costs.

I just think the word "hospital" has some connotations of services that cannot be effectively or inexpensively duplicated in a home residential venue.

At 6/12/2012 9:27 AM, Blogger Jet Beagle said...

larry G: "I just think the word "hospital" has some connotations of services that cannot be effectively or inexpensively duplicated in a home residential venue."

That's true. "Hospital at Home" is a bit of an exaggeration. But it is a catchy name.

At 6/12/2012 9:34 AM, Blogger Larry G said...

agree... it's basically a PR "concept" and it "works"! about ..."Doc in the Box"?


At 6/12/2012 11:25 AM, Blogger Jet Beagle said...

An extreme version of "doc in a box" was the creation of tiny medical clinics inside shipping containers. Students and faculty of Rensselaer Polytechnic Institute created the prototype in 2006. Not sure if a production version was ever built.

At 6/12/2012 12:44 PM, Blogger juandos said...

"An extreme version of "doc in a box" was the creation of tiny medical clinics inside shipping containers"...

Hmmm, you know jet b I'm thinking that the armed forces have or had some varient of this...

It seems like I saw something on the Discovery Channel a few years ago...

Do you know anything about that?

At 6/12/2012 12:48 PM, Blogger Larry G said...

well take a regular ambulance

... and take the wheels off..

At 6/12/2012 1:05 PM, Blogger Jet Beagle said...

No, I don't, juandos. But I have read that the U.S. Army has containerized all sorts of combat control and logistics centers. So it would not surprise me if they did the same with medical units.


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