Hospital at Home: Holy Name is first in N.J. to introduce formal program

Perhaps the biggest health care revelation during the pandemic has been this: Telehealth works. Holy Name Medical Center in Teaneck is embracing the concept like few others.

Last week, Holy Name became the first hospital in New Jersey to institute what it is calling its Hospital at Home program — a government-approved plan that allows Holy Name to send some patients that normally would have required a hospital stay home for treatment.

Cedar Wang. (File photo)

Cedar Wang, the vice president of nursing operations at Holy Name, said the hospital has had a positive reaction in its opening week from both patients and its health care professionals.

“We’re excited about it, because it opens up the ability for us to care for acute patients at home, where they not only are more comfortable, but are less susceptible to infections,” she said.

The hospital, which entered its first patient in the program June 16, chose not to disclose how many patients are currently receiving care at home. Wang, however, said the number is growing.

Here’s how the program works:

  • Patients come to the hospital first, generally to the emergency department;
  • Patients are evaluated by a physician;
  • Patients with conditions that normally require a hospital stay but can be treated at home, such as an infection of the skin, pneumonia, respiratory treatments and even some mild congestive heart failure and others, are eligible for the program;
  • Hospital officials make a home visit to ensure it is a safe environment, one with power and internet access as well as full-time help for the patient, before a patient can join the program;
  • Patients are provided a tablet with which they can communicate with the hospital at any time;
  • Patients receive two in-house visits from a registered nurse;
  • Patients must be within 8 miles of the hospital, should an emergency arise.

“As long as we are able to send them home with telehealth monitoring so that we can check in on them and see how their vital signs are doing at any time, it works,” Wang said.

Wang said health care professionals are always monitoring the at-home patients to be available for questions.

“We still have two-way, constant communication,” she said. “It’s no different than using a call bell at the hospital. In some cases, it may actually be faster.”

Of course, this all sounds good — until someone has a serious complication, and they are not in a hospital to receive care. Wang said Holy Name has worked through the scenarios.

“We signed on to the program in January, and we admitted our first patient in June,” she said. “So, we spent six months putting together a thorough plan so that we could ensure that we were caring for patients safely.”

Here’s how: For starters, Wang said only patients with low to little chance of having an emergency are allowed in the program.

“We have very strict criteria,” she said. “We don’t just admit anyone to our Hospital at Home program.

“Patients who require inpatient therapies like intravenous antibiotics, close monitoring of their fluid status, frequent laboratory tests — these are the type of things that we can care for at home.”

And, because of the 8-mile limit, Wang said the hospital is confident it can have personnel at the location within 10-15 minutes — just as they would be in the case of calling for an ambulance.

The key here, Wang said, is to make sure patients are able to communicate with the hospital during their in-home treatment.

“If they can articulate their symptoms if they’re having any issues — those are the kinds of patients that we feel really benefit from this program,” she said.

The other beneficiary is the hospital itself. Fewer patients in the actual hospital mean more services are available for those who do require an in-hospital stay.

“I think this program enables us to utilize technology to provide a better experience for patients and to preserve our resources at the hospital,” she said.

“We want to make sure we’re caring for the right patients in the right place using the right resources. I think that’s the big takeaway from this program.”

And, Wang said, the hospital is reimbursed at the same rate as if the patient were in the hospital — so there are no revenue issues, either.

Wang feels the concept is an idea whose time has come —and an idea whose time has come because of the pandemic.

“There is a broad acceptance of visiting your doctor on a video screen now,” she said. “I think people appreciate the access. Think about it: When you’re in the hospital, you’re waiting for your doctor to round once a day. Here, if you’re in our Hospital at Home program, you just push a button on your screen and you could be talking to your doctor in 30 seconds.

“I think that kind of access to health care providers is has really been opened up by COVID.”

Wang acknowledges this is only a trial program from the federal government. It could go away when the pandemic does. Wang doesn’t think it will.

What she has seen in the first week has shown her the program should be here to stay.

“It has been a complete success,” she said. I think this is definitely a positive thing that came out of COVID. I think it’s going to be the wave of the future.”