Why home care programs have become must-haves for Central Ohio hospital systems
In early March, the Butterfly Guild put on four performances of the timeless classic “Cinderella” at the Palace Theatre as part of its work to support the mission of Nationwide Children’s Hospital. The money raised by the organization of women helps fund the hospital’s Hospice and Palliative Care Program, including the resources that allow these services to be provided where patients are most comfortable—in their homes.
While home-based care has received a slew of attention since the pandemic prompted an increased rate of adoption of new care delivery options, Nationwide Children’s has had a “Homecare” practice since 1990. That’s because being at home often is the best medicine for children and so the hospital offers a full range of home care services to central Ohio kids of all ages.
Home care services are part of a broader push by hospital systems toward a more patient-centric approach that also includes an increase in ambulatory practices in communities across central Ohio. Greater access to health care outside of the hospital setting has the potential to lower health care costs, ease pressure on hospital capacity, reduce emergency room use and improve patient satisfaction and outcomes, sources interviewed for this story say.
Here’s a look at the homecare services being deployed by central Ohio’s hospital systems.
The hospital started its Homecare program so it could return children to the most normal, pain-free life possible. Primary services include:
- Infusion pharmacy
- Pediatric home medical equipment
- Intermittent, short-term nursing
- Private duty, long-term nursing
- Skilled therapy services – physical, occupational and speech
- Hospice and palliative care
There also are special programs that address the respiratory syncytial virus, the administration of Factor medication to treat hemophilia and asthma management services.
David Wessells, vice president of home care services at Nationwide Children’s, says there are several benefits to the home care model—most patients prefer to be in a setting where they’re comfortable and health systems can deliver more affordable care outside the hospital setting. Home care also fits within the movement in the industry toward value-based care that, as Deloitte reports, will reward better results in terms of cost, quality and outcomes.
“As payment systems transition toward value-based care, more services are likely to move toward the home,” Wessells says. “You can manage and prevent hospitalizations and emergency department use by proactively addressing medical issues in a patient’s home. We’re also educating patients and families about how they can prevent infections, reduce trips to the hospital and keep kids safe and healthy at home. Ultimately, we are empowering our families by giving them greater access to care and education to more independently manage complex medical conditions.”
Home care also removes barriers to care, like a lack of transportation, which is helping hospitals increase health equity, Wessells says.
OhioHealth at Home, formerly OhioHealth Home Care, has been serving the communities the health system operates in for more than 30 years. Working directly with a patient’s physician, the OhioHealth teams meet patients where they are on their health care journey. Services include:
- Skilled nursing to help with things like medication education, diabetes care and disease management
- Physical and occupational therapy
- Registered dietitian
- Speech language therapy
- Medical social workers
- Home infusion therapies
- Home hospice
“OhioHealth Home Health provides skilled services to our patients, allowing successful recovery and aging in the home. There are many layers to Home Health, including skilled nursing services, therapy services, social services and more,” Katie Toopes, director, OhioHealth Home Health, said in an email. “Home Health has the ability to provide telemedicine and remote patient monitoring as well as specialty services, such as lymphedema therapy, IV infusion and complex wound care.”
Services inside the home also became an asset during the pandemic, not only for patient care but to free up bed space during surges. Also during the pandemic, Covid-19 patients who required end-of-life care and wanted to be at home were transitioned by the hospice team with comfort and dignity, Christina Massey, director, OhioHealth Hospice, OhioHealth at Home, said in an email. “Coming out of Covid surges, the business has continued to stay steady as the benefits of home health were magnified during the pandemic.”
OhioHealth also formed Advanced Home Services during the pandemic. That allowed for an extra layer of skilled services and care.
These teams provided telemedicine and video monitoring, administered monoclonal antibody treatment and other medications that saved lives, and kept people out of the hospital, Toopes said.
Ohio State University Wexner Medical Center
Home-based care options always have been integrated into patient care at Ohio State University’s Wexner Medical Center. The university’s hospital system formalized these services into a unified division in 2021:
- Home health care through OSU Home Care for everything from skilled nursing, medical social services and physical, occupational and speech therapy.
- Advanced immediate home care in partnership with DispatchHealth to treat everything an urgent care center can treat.
- Bridge care for patients at high risk of readmission who need follow-up care after being discharged from the hospital.
- Home medical equipment
- Infusion therapy
- Covid-19 care
Rachit Thariani, chief administrative officer, post-acute and home-based care division, says home care services have become an important part of the continuum of care, and they have gradually gained traction for three reasons.
First, health systems increasingly are boosting access to services to create a patient-centric system of care. They are developing and deploying integrated care pathways tailored to needs of specific populations such as older adults or patients with heart disease, cancer or diabetes. These pathways also consider non-medical issues people face, such as the social determinants of health.
Second, health care systems always are looking at ways to ease capacity and improve hospital operations, reduce the length of stay and keep readmission rates low. Home care allows hospitals to positively impact all those metrics while providing consistent, quality care.
Finally, consumers expect health systems to provide these services.
“This is an opportunity to view homecare as part of the core of how care will be delivered going forward,” Thariani says. “As a health care system, we can say to the patient, ‘Here are all the options you have, you’re empowered to choose the options that work best for your circumstance.’ That is a true system of care focused on the consumer right at the center. There’s a lot of potential here that we believe we can unlock.”
Laura Newpoff is a freelance writer.