Bringing health care home

Jane Clark recently contracted pneumonia in both lungs. Normally, such a diagnosis would mean 5 days spent in a hospital. But, through an innovative program, she was able to receive the same level of personal care in her own home in Portland, Oregon.

Even before the pandemic, Kaiser Permanente Northwest was planning the KP@Home program, a virtual hospital that duplicates hospital-level care and treatment in the patient’s home. With the spread of COVID-19, there are concerns about hospital overcrowding and keeping noninfected patients safe. So, the program’s April 2020 launch was perfectly timed.

“The technology is there for us to duplicate a patient’s care at home with the same types of treatments I give in a brick-and-mortar hospital,” said Arsheeya Mashaw, MD, a hospitalist and the medical director of Kaiser Permanente Northwest Virtual Hospital.

How it works

When a physician determines that a patient in the emergency department needs admission and that hospital-level care can be duplicated at home using the KP@Home model, the physician will present the patient with that option.

If additional screening shows that home treatment would be safe and unimpeded by any social or safety issues, a treatment plan is created and the patient is transported home.

Back at home, a paramedic team sets up all the required technology for the virtual hospital. “We hadn’t been home 15 minutes and we were set up,” said Clark. “It was like ‘Troop Kaiser.’”

After that, a doctor does a virtual admission visit via a Kaiser Permanente-provided device such as an iPad or laptop and begins treatment.

Quality care delivered to your door

During a virtual hospital stay, the patient is digitally tethered to a Kaiser Permanente physician who connects with the patient daily and can order hospital-level care, right down to medically tailored meal delivery. A nurse practitioner does home visits regularly, and paramedics can administer medication as needed. Should anything come up, the patient can initiate a face-to-face meeting with his or her nurse via an iPad, phone, or medical alert bracelet.

“I felt very confident,” said Clark. “The minute I met the personnel, I knew that with the touch of a button I had a doctor or a paramedic.”

“It has been a welcome choice to our patients, many of whom are fearful of being admitted to a hospital during this pandemic,” said Dr. Mashaw. “Providing a choice to our patients to receive hospital-level care in their own home with familiar surroundings and family around them instead of being in a hospital has been very rewarding.”

Through this program, Dr. Mashaw says doctors can monitor and oversee the care of more patients while freeing up hospital beds — a valuable resource during a global pandemic, but with long-lasting implications for Kaiser Permanente members.

“We are at the beginning of a tide change in health care across the world,” he said. “In a few years we will look back and realize we were able to create something that will help lead the way for greater access to care with expanded care outside facilities and more into people’s homes. It’s bringing care to people instead of them coming to us.”