ORLANDO, Fla. – Hospitals at home are poised to change the traditional in-hospital experience for participating patients. Instead of getting care in a facility, the care comes to the patient using a hybrid of technology and in-home care.

"Some people, when they are talking about hospitals at home, are talking about a post-discharge hospitalization ... where I think we want to get to with hospital at home is replacing the entire hospital stay. There are patients that would be in-patient in the hospital, but instead, we are doing that entire stay at home," Nathan Starr, lead at TeleHospitalist at Intermountain Health, said during a panel at HIMSS22. 

According to a HIMSS white paper, in-home hospitalizations save between $5,000 and $7,000 per episode. Increasingly, health systems are offering hospital-at-home services. According to the paper, 82 health systems and 186 hospitals across 33 states are cleared for Medicare's Acute Care at Home program. This program allows for CMS to reimburse the hospital-at-home service at in-patient rates, if patients meet certain criteria for admissions, under the Public Health Emergency waiver, according to the white paper. 

However, deciding what patients are right for this kind of care can be difficult. 

"How do we identify the right patient? It's very easy to say they have to be at the right level of home situation, and they are the right amount of sick but not too sick. How do we more broadly identify patients that are safe to treat at home? You can narrow your patient population down too much; it's really hard to get patients in here if you narrow it too much," Starr said. 

But it's not just providers that need to adapt to the hospital-at-home model. Patients also need tools to safely transfer to at-home services. Providing patient and caregiver education and home visits from trained medical professionals can help ease this transition, according to the panelists. 

"Patients struggle with figuring out how to communicate back and forth," Sriram Bharadwaj, vice president, digital innovation, at Franciscan Alliance, said at HIMSS22. "What we do is have a virtual visit with the patient, plus we have a physical visit to go with EMS workers and a home healthcare partner. When you talk about the difficulties the patients encounter, first it is the mind block – it's a change – then the technology." 

However, if the challenges can be ironed out, the panelists agreed that patients and hospitals could benefit from a hospital-at-home system. 

"Patients love it. We nearly universally see that patients want to be at home. They want to have their own food, their own pets; there is less anxiety; there is less delirium; there is less family stress and less caregiver stress," Starr said.