After a year in operation, the UNC Health Advanced Care at Home program has received the 2022 Highsmith Award for Innovation from the North Carolina Healthcare Association.
Advanced Care at Home delivers hospital-level care including infusions, diagnostic tests, nursing assessments and physician visits to patients in their homes through a combination of in-person and virtual care.
During the pandemic, more than 100 health systems have taken advantage of a waiver from the Centers for Medicare & Medicaid Services to provide acute care services in the home setting. But the waiver ends whenever the public health emergency does, so that investment in innovation is threatened. A 16-member group called the Advanced Care at Home Coalition is seeking to get a legislative extension of the waiver in the short term to ensure that there is stability and predictability around the investments that hospitals are making.
The program at UNC Health began by serving patients from UNC Medical Center in Chapel Hill and UNC Health Rex in Raleigh who had specific diagnoses such as heart failure, COPD, and pneumonia. However, the program quickly expanded clinical abilities to cover additional medical conditions. Also, it increased patient access to other parts of North Carolina including: UNC Hillsborough and UNC Holly Springs. Since the program went live on Aug. 30, 2021, it has so far provided care to 456 patients ranging from age 37 to 103 across 46 Zip codes in the state.
NCHA represents North Carolina’s individual and multi-hospital health systems. Named for Dr. John Highsmith, the first president of NCHA, the innovation award is presented to a member institution or to an individual/team employed by an NCHA member institution in recognition of innovation that creates value for patients/consumers of healthcare.
“It is exciting that others including the NCHA see the value of the hospital at home care model,” said Meera Udayakumar, M.D., Advanced Care at Home medical director, in a statement. “Our team felt from our patient experience and clinical outcome data that we were providing excellent care, but it’s still extremely rewarding to get this recognition. This care model allows patients to avoid certain risk factors inherent to traditional hospitalization, such as deconditioning and delirium or confusion,” she added. “It also allows caregivers to be more involved in a patient’s hospital care, which is especially important if that individual is going to be supporting the patient after hospital discharge. Additionally, this program also provides the care team insight into a patient’s home situation, which can have a significant impact on their health.”
As the pandemic raged on during the delta and omicron variant waves in the second half of 2021 and early 2022, shifting care to a patient’s home not only kept them safe and comfortable, but also freed up hospital space and staff for critically ill COVID patients, according to UNC Health. “Sick but stable” patients received 24/7 virtual care and UNC Health clinicians carried out patient-care plans deploying a network of in-home service providers including paramedics, skilled nurses, lab services, mobile imaging, therapy, and more.
“This program was designed and implemented by frontline, patient-facing healthcare workers who wanted to create a care model that we would offer to our own families,” said Udayakumar. “Staff from across the UNC Health system collaborated to create a program that provides high clinical quality, safety, and a positive patient experience.”