Orlando Health Hospital Care at Home
For more than 20 years, hospital care at home programs have successfully provided acute inpatient care to patients in the comfort of their homes. Orlando Health is proud to bring this program to Central Florida, with innovative technology allowing us to provide high quality care to our patients, while improving their outcomes, reducing health care costs and providing an overall improved patient experience. The most common medical conditions most suitable for hospital care at home services include cellulitis, COPD, heart failure, asthma, UTIs, COVID-19, pneumonia, and gastroenteritis.
This innovative care model uses 24/7 virtual monitoring via home-based Bluetooth-enabled patient monitoring systems connected to our Patient Care Hub in addition to twice daily home visits by the nursing teams. Other care team members visit as necessary based on the treatment plan and could include lab, imaging or therapies and all patient care documentation is maintained in the Epic EMR.
Patient Eligibility Criteria
- Geographical and social criteria must be met
- Live in the geographic catchment area within15 to 25 miles of Orlando Health Orlando Regional Medical Center
- Not anticipated to need CT, MRI, nuclear study, or procedure / surgery in the next 72 hours
- Med/surg level of inpatient care required
- Not anticipated to need any controlled substances
- Does not require Hemodialysis
- Requires no more than 4L O2 via nasal cannula
- RR < 28, SBP > 90, O2 sat > 92%
- GCS 15, A&O x 3
Patient Inclusion Considerations:
- Frequent hospitalizations
- Anticipated inpatient LOS >3 days
- Ability to provide all necessary services, supplies and equipment to the in-home environment.
- Meet inpatient criteria, pass clinical, social and payor screening
For patients meeting the clinical criteria set for this program, providers and the clinical care team are able to successfully and cost-effectively treat acutely ill patients in an alternative environment to inpatient settings while improving their overall quality outcomes, safety and satisfaction.
Potential Patient Diagnosis-Related Groups Suitable for Admission into HCaH:
- COPD / Asthma exacerbation
- CHF exacerbation
- UTI / Pyelonephritis
- And others
In addition to being able to remain in their home and near family and friends, patients who have experienced hospital care at home benefit from overall increased patient satisfaction.
- Improved outcomes
- Up to a 50% reduction in readmission rates
- Decreased infection rates
- Increased mobility
- Enhanced patient experience
- Top decile for patient satisfaction
Services Provided In-Home
For a full listing of services offered through the Hospital Care at Home program, please click here (insert HCaH Services PDF for download)
These services are offered 24 hours a day, 7 days a week, 365 days a year, unless otherwise indicated.
If the patient is in need of a service not offered in-home, appropriate transportation will be provided by Orlando Health for the patient to take them to the closest Orlando Health facility that the service is provided.
How does the program work?
The patient’s care team will identify if the patient meets the clinical criteria for inpatient hospital care at home and if the patient is eligible to participate.
This process is initiated by the provider by informing the Hospital Care at Home Patient Care Hub (PCH). The PCH provider will discuss the case with the care team to see if the patient meets the clinical criteria, while simultaneously, a PCH RN completes the geographical screening to ensure the patient lives within the HCaH catchment area.
If the patient meets all initial criteria and the PCH team agrees the patient may be a suitable candidate, the HCaH acquisition coordinator and/or PCH RN will introduce the patient to the program, complete a social screening, and obtain the verbal consent from the patient.
Once the patient agrees to be admitted into this program, the process of setting up the patient’s home begins. (Please note: If at any point in the screening process, a ready to be admitted patient fails to meet eligibility / screening criteria, or declines the program, a PCH team will handoff patient to the hospital admitting team for admission into the hospital)
- Patient care team conducts a home evaluation based on several factors including the patient your diagnosis and needed treatment, available support system at home, proximity to the hospital and insurance coverage.
- Upon completing a home evaluation, the team sets up a home technology kit to monitor the patient’s vitals including blood pressure, heart rate, oxygen levels, and temperature, as needed.
- The information is automatically transmitted to the 24/7 Patient Care Hub with real-time patient monitoring, including on-demand and immediate audio and visual connections.
- Patient receives in-home care throughout the day as needed for general monitoring or any necessary testing, imaging or therapies as required.
For more detailed instructions on how to accept a transfer patient from an inpatient hospital unit in to the HCaH program, please click here.
For more detailed instructions on how to admit an ED patient into the HCaH program, please click here.