FOUR DECADES OF LEADERSHIP IN HOME HEALTH CARE SERVICES LAID THE GROUNDWORK FOR HACKENSACK MERIDIAN HEALTH’S HOSPITAL FROM HOME SERVICE AN INNOVATIVE, FULLY INTEGRATED CARE MODEL THAT BRINGS HEALING HOME
BY AMANDA McCOY PHOTOS BY AMESSE PHOTOGRAPHY AND JACKI KRONSTEDT
In New Jersey, the spring of 2020 was a time marked by urgency, innovation, and unprecedented collaboration to provide medical care and services at a moment of national fear and uncertainty. The first confirmed case of COVID-19 in the state was reported on March 4, but by the end of the month, New Jersey had the second highest infection rate in the country, trailing only New York. Emergency rooms swelled. Hospitals reached capacity. But through the crisis emerged remarkable progress in envisioning what was possible in providing care outside the walls of a hospital: New Jersey’s largest healthcare network, Hackensack Meridian Health (HMH), worked closely with state leaders and public health agencies to quickly adapt to the rapidly shifting landscape. A waiver by the Centers for Medicare & Medicaid Services allowed HMH to expand its telehealth and home health care services and participate in a national pilot program for patients with acute, but non-lifethreatening conditions to have the option of receiving care at home. The primary goal at the time was to preserve hospital beds for the most seriously ill patients, but also demonstrate how hospital-level care could be successfully delivered at home for patients that would typically be admitted for inpatient hospital care not merely as a crisis response initiative, but as a safe, effective, comfort-driven alternative for eligible patients.
This extraordinary effort helped pave the way for HMH’s Hospital From Home service, a transformational care model that brings hospital care best practices into the comfortable and familiar setting of a patient’s home.
After a successful 2022 pilot program, Hospital From Home officially launched last April at three HMH campuses: JFK University Medical Center, Jersey Shore University Medical Center, and Hackensack University Medical Center. The service recently expanded to two additional hospitals: Ocean University Medical Center and Southern Ocean Medical Center. Though the service – an alternative to an inpatient stay for care is relatively new, Hackensack Meridian Health has had a visionary commitment and passion for home health care services for more than 40 years.
“Home care is in our DNA and has been a foundational component of our mission and vision,” said Patrick Young, president of Population Health at Hackensack Meridian Health. “We are always looking at innovative ways to meet the needs of our patients. Before COVID, there was an evolving opportunity to meet our patients where they are, so with Hospital From Home, we were able to create a fully integrated ecosystem of care with assets we already had in place.”
At its core, Hospital From Home delivers all the key elements of hospital-level care 24/7 access to a care team, monitoring, diagnostics, treatment therapies, and physician and nurse oversight directly to a patient’s residence.
“At HMH, our mission is to provide the right care for the right person in the most convenient place, so providing care in the home is a part of our long-term strategy,” noted Rajan Gurunathan, MD, FACP, chief medical officer of Hackensack Meridian Health Hospital From Home. “This service gives us the opportunity to take the hospital to the patient’s doorstep.”
Once a patient is made aware they are eligible to receive care at home and chooses this care model, a nurse manager arranges home delivery of everything they need, often on the same day. A team delivers and installs the home monitoring and communications tech (including a blood pressure cuff, thermometer, and connected tablet), and guides the patient through the user-friendly tablet and equipment, which instantly connects them to a nurse and physician with the simple touch of a button. Every patient is monitored by a physician-led virtual care command center that operates 24 hours a day, seven days per week. Patients receive two in-person visits every day from a nurse, and meet with a physician virtually once per day or more if needed. Diagnostic services like labs and X-rays are performed in-home, and all prescribed medications are delivered daily, including IV and infusion therapy. Patients even receive three nutritious meals a day, providing patients with everything they need for a worry-free recovery at home.
“Every patient receives a comprehensive set of services: twice daily nursing visits and daily physician visits, plus labs, X-rays, and all medications,” explained Dr. Gurunathan. “The model can be tweaked depending on the patient’s individual needs. They might require more intensive nursing services or multiple physician check-ins each day.”
Patients don’t need to be tech savvy to reach their care team with the fully connected tablet, phone, and call console, either. “The tech is a large touch-screen with easy-to-read text that really glues all the pieces together,” continued Dr. Gurunathan. “It’s a set of tools, very similar to your smart phone, that go into the home to provide the patient with easy access to their doctors and nurses. It doesn’t require a lot of sophistication to operate; with one touch of a button, patients are interacting with us in 30 seconds or less.”
The program is 100% voluntary, and patients undergo a comprehensive medical evaluation and assessment to determine eligibility based on three criteria: diagnosis and overall medical stability, geography, and social screening.
“We confirm that the patient meets all the criteria to be safely and effectively treated from their home, that they live near a hospital and other medical services if needed, and that we can support all their needs outside the hospital walls,” added Dr. Gurunathan.
The home care model provides a wide variety of benefits, both medical and emotional. The risk of hospital-acquired infections is almost entirely eliminated, and studies show that patients often recover more quickly in home environments due to factors like less stress and better sleep. To date, more than 1,000 people have been admitted to the service, and patient satisfaction scores are extraordinary.
“We’re now a few years into our growing service, and patients and families are now asking about the Hospital From Home service themselves this would have been unusual not too long ago,” said Dawn Jacobson, RN MSN, a 25-year nursing veteran and senior vice president of the program. “Our nurses and care teams have also truly embraced this service. They believe so passionately in this service. It facilitates one of the great joys of nursing: to build a relationship with patients in their homes and see them thrive beyond the walls of the hospital.”
Another program benefit is the ease in which families and loved ones can visit the patient. “There are so many success stories that touch the hearts of the care team,” continued Jacobson. “We recently had a patient celebrate his 100th birthday at home with his friends and family, complete with a party and a cake. That wouldn’t have been possible if he were in the hospital. Our central command center even joined the celebration and got on the phone with him to sing happy birthday.”
Today, five hospitals in the HMH network offer the service, but according to Young, that’s only the beginning. With the program’s overwhelming response and success, Hackensack Meridian Health’s leaders have plans to eventually expand the service across the entire network.
“The program is designed to be scalable and consistently deliver an exceptional care experience,” said Young. “Nothing is limiting us from offering the service to patients and families across more areas of New Jersey. We have the opportunity to change the entire dynamic of what is possible for patients to receive more care at home today, and in the future. This would not have been possible without the incredible passion and dedication of our care teams: the nurses, physicians, tech, medical support personnel, and central command center. They are the reason this program is so successful; they are committed to making a difference and improving the quality of life for our patients.”
Hackensack Meridian