A novel virtual hospital at home model during the coronavirus disease 2019 (COVID-19) pandemic

Ryan, Patrick; Hawkins, Kellie; Altman, Stacey; Granatowski, Lisa; Shy, Bradley D.; Long, Jeremy; Hanratty, Rebecca

doi:10.1017/ice.2020.435

Cited by 16 publications

(12 citation statements)

References 5 publications

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“…Hospital at Home has been proposed as a solution to relieve pressure on hospital beds and reduce personal protective equipment (PPE) use and SARS-CoV-2 exposure [6]. Proposed solutions varied from expansion of services for uninfected subjects [7] to rapid development of monitoring services for low risk COVID-19 patients, with the possibility to escalate care intensity either at home [7,8] or in-hospital [9][10][11].…”

mentioning

confidence: 99%

“…To our knowledge, this is the first reported case of the successful management of an oldest old patient with mild atypical COVID-19 in the HaH setting, with the support of a TMS. Larger reports on the impact of HaH management of COVID-19 patients focused on subjects requiring clinical monitoring only [9][10][11] or provided home care to significantly younger patients without major comorbidities or functional impairment [7,8]. Most of these experiences relied on the support of TMS, ranging from simple telephone calls [9,10] to tele-visits and video calls [7,8,11], also featuring patient-reported parameters through dedicated apps [8,11].…”

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confidence: 99%

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Telemedicine-assisted care of an older patient with COVID-19 and dementia: bridging the gap between hospital and home

et al. 2021

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Hospital at Home (HaH) has been proposed as a solution to relieve pressure on hospital beds during the COVID-19 pandemic; however, caregivers' feelings of inadequacy and concerns on the need for tighter clinical monitoring might lead to unnecessary and potentially harmful hospital admissions in frail older patients with mild or atypical COVID-19. Here we report the case of a 91-year old woman with severe dementia and atypical COVID-19 that could be successfully managed by our HaH thanks to her highly motivated caregivers and the support of a telemedicine solution (TMS) to provide caregiver training and support as well as supplementary telemonitoring. Despite some well-known issues on TMS use, the hybrid inperson and tele-visit approach of TMS-assisted HaH could help to create a "secure" environment, empowering caregivers to manage frail older adults with COVID-19 at home, avoiding unnecessary admissions to closed wards and their negative physical, functional and psychological outcomes.

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confidence: 99%

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confidence: 99%

Telemedicine-assisted care of an older patient with COVID-19 and dementia: bridging the gap between hospital and home

et al. 2021

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“…Toda esta actividad ya ha generado evidencias sobre la utilidad de la hospitalización a domicilio en esta crisis (5,6) , ha permitido elaborar guías de actuación (7,8) , y es determinante en la identificación de factores de riesgo de mala evolución de los pacientes con infección por coronavirus atendidos en casa (3) . Por eso, todavía resulta más incomprensible que algunas organizaciones, aun disponiendo del recurso, hayan dejado pasar la oportunidad de aprovechar todo su potencial.…”

Section: Editorial: Mirónunclassified

Las crisis, las oportunidades… y la hospitalización a domicilio

Rubio¹

2021

Hosp Domic

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“…However, their primary purpose was to provide care for patients with dementia in settings where specialists were not available, as opposed to focusing specifically on NPS. Virtual hospital care has recently also been used for patients 87 with COVID-19 [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Virtual Behavioural Medicine Program: A Novel Model of Care for Neuropsychiatric Symptoms in Dementia1

Freedman

Binns

Serediuk

et al. 2022

JAD

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Background: Patients with severe neuropsychiatric symptoms (NPS) due to dementia are often uprooted from their familiar environments in long-term care or the community and transferred to emergency departments, acute care hospitals, or specialized behavioral units which can exacerbate NPS. To address this issue, we developed the Virtual Behavioral Medicine Program (VBM), an innovative model of virtual care designed to support management of patients with NPS in their own environment. Objective: To determine efficacy of VBM in reducing admission to a specialized inpatient neurobehavioral unit for management of NPS. Methods: We reviewed outcomes in the first consecutive 95 patients referred to VBM. Referrals were classified into two groups. In one group, patients were referred to VBM with a simultaneous application to an inpatient Behavioral Neurology Unit (BNU). The other group was referred only to VBM. The primary outcome was reduction in proportion of patients requiring admission to the BNU regardless of whether they were referred to the BNU or to VBM alone. Results: For patients referred to VBM plus the BNU, the proportion needing admission to the BNU was reduced by 60.42%. For patients referred to VBM alone, it was 68.75%. Conclusion: VBM is a novel virtual neurobehavioral unit for treatment of NPS. Although the sample size was relatively small, especially for the VBM group, the data suggest that this program is a game changer that can reduce preventable emergency department visits and acute care hospital admissions. VBM is a scalable model of virtual care that can be adopted worldwide.

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A novel virtual hospital at home model during the coronavirus disease 2019 (COVID-19) pandemic

Cited by 16 publications

References 5 publications

Telemedicine-assisted care of an older patient with COVID-19 and dementia: bridging the gap between hospital and home

Telemedicine-assisted care of an older patient with COVID-19 and dementia: bridging the gap between hospital and home

Las crisis, las oportunidades… y la hospitalización a domicilio

Virtual Behavioural Medicine Program: A Novel Model of Care for Neuropsychiatric Symptoms in Dementia1

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