What your doctor is reading on Medscape.com:
APRIL 26, 2020 — Tufts Medical Center in Boston is partnering with Medically Home, a Boston-based company, to provide hospital-level care at home for non–COVID-19 patients who don’t require intensive care, freeing up beds needed by more critically ill patients.
“Long before the COVID-19 pandemic disrupted our way of life, we began researching innovative ways to provide care for the subset of patients who could receive hospital-level medical services in the comfort of their own homes,” said Tufts Medical Center President and CEO Michael Apkon, MD, PhD, in a news release.
“In the face of this crisis, we’ve been able to accelerate our timeline in the hopes of having as many beds available as possible for patients whose care can only be delivered in the hospital, especially those who will require a ventilator.”
Medically Home is currently treating 14 non–COVID-19 patients who were discharged from Tufts Medical Center.
“Right now, we’re only evaluating and discharging patients [to at-home treatment] who don’t have COVID,” said Sucharita Kher, MD, a pulmonologist and director of the outpatient pulmonary clinic at Tufts, in an interview with Medscape Medical News. “We’re in the process of developing criteria to identify and assess which COVID patients can be safely discharged to be cared for at home.”
Among the patients who can be treated safely at home, she noted, are those with congestive heart failure, pneumonia, exacerbations of asthma and COPD, cellulitis, and urinary tract infections.
These patients can be discharged to the hospital-at-home program either from the emergency department (ED) or from inpatient wards. “As soon as they come into the ED, we evaluate whether they can be cared for at home under our criteria,” Kher said. “They can go from the ED to home [treatment] if they can be stabilized in the ED. Alternatively, they can be stabilized for a day or so in the inpatient setting and then be sent home to continue their care at home.”
The criteria that Kher and colleagues are developing for COVID-19 patients, she said, are related to oxygen levels, breathing rates, vital signs, and new blood tests “that have been shown to predict more serious disease, potentially requiring ICU stay or long hospitalization. Those are not the patients you want to be sending home.”