While VCU Health's hospital-at-home program did not meet its initial patient volume targets in its first year, it achieved strong success in terms of patient satisfaction, Julia Siegel Breton, MD, medical director of the program, told Becker's.
Launched in 2023, the Richmond, Va.-based health system's program initially set a goal of serving 2,000 patients in its first year. Despite falling short of that mark, Dr. Breton emphasized the program's notable achievements.
"We slightly exceeded the program census compared to other academic institutions in their first year of hospital at home," she said.
The program provides patients with acute conditions hospital-level care in the home and utilizes technology to help facilitate the care.
Challenges encountered
The first year was marked by some challenges, including staffing shortages and payer participation. Like many health systems navigating the post-COVID-19 landscape, VCU Health faced difficulties in recruiting nurses.
"It has been a desert of a hiring landscape for nurses," Dr. Breton said.
However, she noted that the program still managed to attract committed professionals drawn to the "innovative, patient-centered nature of the care model."
Another obstacle was limited initial payer participation. However, VCU Health has since expanded the program's coverage to include all payers, making the service accessible to a broader patient population.
Additionally, a cultural shift was required to differentiate hospital-at-home care from traditional home health services. Many providers and patients initially misunderstood the program, thinking it was a standard home health service. This confusion prompted VCU Health to bolster its marketing efforts, clarifying that the program delivers acute inpatient care with full monitoring and medical support.
The program's tech use
Patient enrolled in the program are equipped with tablets that connect them to a virtual nursing team, ensuring 24/7 access to medical support. Each patient also receives vital sign monitoring devices that integrate seamlessly with VCU Health's Epic EHR system, and the health system is getting ready to further enhance the program's technology capabilities.
"We're excited to expand our technology capabilities, adding wearable patches for continuous monitoring of vital signs, ECGs and fall detection," Dr. Breton said.
Positive feedback
Patient satisfaction with the program has been overwhelmingly positive, with a 100% approval rating on MyChart surveys. Patients have expressed gratitude for the personalized care and comfort of receiving treatment at home, Dr. Breton said.
She added that many patients reported feeling more confident and less isolated during their recovery, which has contributed to an improved overall experience.
Next steps
As the program evolves, VCU Health has fine-tuned its processes. New screening tools have been implemented to better identify eligible patients, and additional care aids have been introduced to alleviate the burden on caregivers.
Looking ahead, Dr. Breton is optimistic about expanding the program's geographic reach. VCU Health is already partnering with a hospitality house to provide care for patients outside the immediate service area, ensuring that vulnerable populations can access the necessary treatments.
Moreover, the program has begun directly admitting patients from the emergency department— a strategy Dr. Breton said not only enhances patient satisfaction but also helps reduce the strain on hospital resources.