Virtual Reality

A generous grant helps fund Hospital at Home, the newest version of telehealth and virtual medicine

Written by Lauren B. Johnson
Photograph (tablet) courtesy of Health Recovery Solutions, Inc.

Last fall, Roper St. Francis Healthcare opened a full-service inpatient hospital in Berkeley County. Now, a new hospital vision is under construction in the virtual realm. In April, the healthcare system received a $1.2-million grant from The Duke Endowment, which supports health and education programs in the Carolinas, to launch a Hospital at Home program. Roper St. Francis has used telemonitoring to care for patients since 2013, but this latest effort supercharges the concept of distance care. “Remote patient monitoring serves as the framework for this high-tech approach,” explains Roper St. Francis Healthcare Vice President of Continuing Care Troy Powell. Using virtual technology, the home-based program will be able to observe a patient’s key vital signs around the clock and then immediately transmit results to a medical team. A 24-7 monitoring hub alerts doctors to any high-risk metrics, allowing them to proactively manage their patients’ chronic conditions. “Doctors and nurses can make daily virtual visits and adjust treatments quickly,” says Powell.

“Patients receive the same level of care and attention that they would in a traditional hospital, just in their home,” he continues. In addition to improved quality of care and convenience, this new model is expected to bring about a 20-percent decrease in readmission rates and a 30-percent reduction in direct costs. “We also foresee mortality rates going down by one fifth among targeted groups,” says Powell, noting that the model will initially focus on patients with congestive heart failure, pneumonia, cellulitis and COPD but over time will expand. “This is highly scalable, because we’re not limited to brick-and-mortar space.”

The Hospital at Home program was to be introduced over the next three years, but COVID-19 has accelerated that time line. To better understand what exactly the new system will look like when it’s ready next year, we talked with Aaron O’Brien, quality development manager at the Ryan White Wellness Center, where
the platform is currently being piloted on a small scale.

(Left) Troy Powell; (Right) Aaron O’Brien

HC: Who is currently using this technology?
The Ryan White Wellness Center is an outpatient HIV health center, but many of our patients have comorbid conditions such as hypertension or diabetes. At the end of September, we assigned 12 Hospital at Home kits to those with ongoing chronic health conditions.

HC: What does the Hospital at Home kit include?
The full kit comes with a smart tablet as well as Bluetooth-capable monitoring devices such as a pulse oximeter, blood pressure cuff and scale. The tablet gives medication reminders, conducts daily symptom and lifestyle surveys and provides an interface for virtual visits with the doctor.

HC: How do patients use the equipment?
Every day, patients are prompted to check their vital signs, answer a few questions, and take their medications. Then we can look at weight, blood oxygen levels, steps, heart rhythms and blood pressure to make sure those biometrics are within the limits set by the patient’s doctor. All of that information feeds into an electronic health record that we can view in the office. If anything is out of whack, we get an alert to follow up with the patient and find out what’s going on.

HC: What does the system look like on the center’s end?
Our team can access patient data through a web-based portal, and it’s very visually apparent when something’s off, such as a missed or out-of-range reading—that metric instantly turns red on screen. Our providers can also customize how they want to receive patient alerts, such as via text or e-mail.

HC: What benefits are you seeing with this system?
A lot of our patients have limited access to transportation. On top of the stigma of living with HIV, this can make coming into the center difficult. Hospital at Home lets us meet patients’ needs and provide our usual level of care with the convenience of service at home. Of course, we don’t expect technology alone to solve a patient’s chronic health problems—it’s not as simple as sending home a kit and patting ourselves on the back—so we pair the service with case management, nutrition counseling and home grocery delivery to help support a healthy lifestyle.