Mass General Brigham plans to expand its hospital-at-home program to more specialties in 2025 and evolve beyond episodic care toward a "seamless home-based care continuum," a program leader told Becker's.
The Somerville, Mass.-based health system already has one of the largest home hospital initiatives in the country, treating an average of 50 to 60 people with inpatient-level care at home per day. In 2025, Mass General Brigham Healthcare at Home expects to care for more postoperative patients and also more people overall after — or, better yet, before — they require acute care.
"So being able to take a patient with heart failure, for example, and for future episodes we'll preferentially enroll you in home hospital and keep your equipment in your home so we can monitor you between those episodes as well," said Stephen Dorner, MD, chief clinical and innovation officer of Mass General Brigham Healthcare at Home.
Mass General Brigham Healthcare at Home recently expanded to treat women with postpartum hypertension and patients recovering from lumbar spine surgery. Over time, lengths of stay have also been decreasing, allowing the program to care for more patients.
For hospital at home to truly meet its potential, the federal government will need to show a stronger commitment to the care model, Dr. Dorner said. Congress recently prolonged the CMS waiver for acute hospital care at home for three months, through March 31, while a five-year extension remains on the table.
"Personally I've had a whole slew of interested hospitals as well as folks in the technology space who've been reaching out asking, 'How do we deploy this care model? How do we support this care model?'" Dr. Dorner said. "A lot of folks are waiting in the wings for the congressional extension."
In the year ahead, Dr. Dorner also predicts more hospital-at-home technological and care coordination advancement, including the growth of medication dispensing and point-of-care lab testing in the home as well as better "care orchestration" to combine all the various logistical elements required to power inpatient care at home.
"We've spent so much time and energy advancing the sophistication of our hospitals, but we're just at the starting line, really, with the advancement of sophistication for mobile and home-based care delivery," he said.
He also anticipates better data analytics powered by artificial intelligence to identify eligible patients and drive more predictive, proactive care in the home.
"So you can anticipate who's going to clinically deteriorate, or who's somebody who's going to have an increased risk of falls, that you can more proactively intervene, instead of waiting until they fall and have a broken hip and require surgery," he said.
The uptick in data analytics can also fuel better research to prove the efficacy of the care model to policymakers.
In the future, Dr. Dorner also foresees accreditation bodies like The Joint Commission getting involved in hospital-at-home certification and envisions medical residencies and fellowships that focus on the care model.
"Those are critical steps towards the mainstreaming of home hospital care," he said.