The Future of Virtual Health: The “Hospital at Home”

By The SHSMD Team posted 09-23-2020 12:49 PM


A “Virtual Hospital” in 10 Days
On most days prior to the COVID-19 pandemic, Atrium Health, based in Charlotte, North Carolina, already exceeded its inpatient bed capacity at hospitals in its core service area. Leaders were anticipating needing upward of 50 percent additional inpatient bed capacity. Atrium came up with the idea of a “virtual hospital” to treat COVID-19 patients at home and free up hospital space. It took the 45-hospital system just 10 days to implement the concept in the spring. By August, the service had treated nearly 16,000 patients through the program, and only about 3 percent became inpatients.

“As an organization, we always thought about ways that we could deliver care in a virtual environment, but COVID-19 was definitely the catalyst for creating our virtual hospital,” said Jhaymee Tynan, assistant vice president of integration at Atrium. “We asked ourselves: How can we use innovation to make sure that patients can recover in the comfort of their own homes, without spending time in a physical hospital?”

Tynan and Scott Rissmiller, M.D., Atrium’s chief physician executive, discussed the new program as part of Navigating a New Reality, a virtual conference from SHSMD and the AHA Center for Health Innovation focused on COVID-19, from recovery to rebuilding.

During the session, they explored the integrated applications of this new approach for health care leaders and strategists, including how the organization quickly put the new care model in play, and shared some of the early successes. “You have to have the right infrastructure in place and a very strong provider network to be able to deploy nurses into patients’ homes,” Tynan said. “But I do think that the model is replicable, provided that you’ve thought through your protocols and processes, and you have the right pieces in place.”

How it Works

The COVID-19 Virtual Hospital operates with two separate “floors”—one for observation patients and the other for acute care patients. This consistent metaphor helps patients understand the concept and feel familiar with it. Typically, the process starts with a community member phoning or visiting an Atrium facility to discuss their symptoms. Patients suspected of having COVID-19 are tested and a provider assesses those with a positive result. The provider typically assigns those with severe symptoms to come to the emergency department at a physical hospital and those with minor, moderate or no symptoms are eligible for the virtual hospital program and assigned to the observation or acute care “floors.”

Virtual acute care patients receive a kit that includes a blood pressure monitor, pulse oximeter, thermometer and detailed instructions for at-home care. They are tasked with monitoring and logging their vital signs throughout the day and engaging in daily check-in calls. "Through 24-hour monitoring, we can spot any trends or worsening symptoms and intervene early before it becomes an emergency,” Rissmiller said. "It also allows the hospital system to reserve critical resources for those who truly need them the most,” he added.

Patients on the virtual observation floor receive a telephone assessment every other day from a nurse, along with access to an app that provides regular engagement and feedback. Providers also make in-home visits for care and Atrium set up a 24/7 phone line for any questions from patients on either hospital “floor.”

Atrium’s messaging strategy has been key thus far to the initiative’s effectiveness, including providing culturally relevant materials for the large Spanish-speaking community in the Charlotte area. Atrium has also focused on providing clear instructions about testing and treatment.

About 95 percent of Atrium’s COVID-positive patients have been treated by the virtual hospital as of August. Tynan credits early leadership support, and cross-training of staff on the virtual hospital to allow for flexibility as the pandemic has evolved, as key factors to their success.

Navigating a New Reality virtual conference post-event access

Conference attendees have full access to recordings of the presentations and transcripts of the live chats for 90 days. To access the conference, use the same link and login that you received to access the conference. If you need assistance, please email us.

Did you miss registering for the live event? Check back here for more details soon and how to purchase to watch on-demand.

SHSMD Connections Bytes virtual conference: October 27-28

For more education and networking for marketing, digital strategy, strategic planning, communications/PR and business development professionals, check the agenda for SHSMD Connections Bytes on October 27-28. Bytes is an all-virtual conference and, like Navigating the New Reality, attendees will have access to recordings and content after the event.

This blog post and the Navigating the New Reality presentation featured:

Jhaymee Tynan
Assistant Vice President, Integration
Atrium Health
Charlotte, North Carolina

Scott Rissmiller, M.D.
Executive Vice President and Chief Physician Executive
Atrium Health
Charlotte, North Carolina