Young male caregiver with face mask measuring blood pressure to senior woman indoors at home during home visit.

Blessing Health System in rural Quincy, IL, is a guinea pig of sorts for hospital-at-home in the heartland. In late February, the 300-bed hospital in the small Mississippi River community became part of the Rural Home Hospital Model. The three-year pilot aims to provide insights on how hospital-at-home can be streamlined and scaled to meet the needs of rural patients.

Blessing Health System Chief Quality and Safety Officer Mary Frances Barthel, M.D., told McKnight’s Home Care Daily Pulse the model could bring relief to patients who travel from small towns in Illinois, Iowa and Missouri for care.

“We are a tertiary referral hospital. We get patients transferred up to 100 miles away in all directions to come to us, so there is always demand outside of our immediate area,” Barthel explained. 

The Rural Home Hospital Model is the brainchild of Ariadne Labs, a joint center for health innovation at Boston’s Brigham and Women’s Hospital and Harvard University’s T. H. Chan School of Public Health. 

Brigham and Women’s Hospital successfully implemented a hospital-at-home program in Boston but wanted to develop a program that was adaptable in rural America where nearly 80% of residents are medically underserved. Hospital-at-home lets patients receive acute-level care in their homes instead of a facility. Patients are monitored 2/7 by clinicians in a central location and receive some in-home care from nurses, paramedics or emergency medical technicians. 

Boston-based  Biofourmis is providing Blessing Health with technology, which includes software and a wearable patch, to connect clinicians with patients. 

“I will have a dashboard on my laptop and on my cell phone, so I can monitor the patient’s heart rate, respiratory rate and some intermittent blood pressure checks with a device that is connected through bluetooth,” Barthel said. “The patient interacts with me via a tablet.” 

Hospital-at-home game-changer 

Hospital-at-home was a game-changer for healthcare during the COVID-19 pandemic as hospitals became overburdened with sick patients. The Centers for Medicare & Medicaid Services’ Hospital Without Walls  waiver program fueled the model by giving hospitals more flexibility to treat patients outside of their facilities. More than 200 U.S. hospitals and 90 health systems now participate in the waiver program.

Nashville-based Contessa Health – a division of home care giant Amedisys – is one of the biggest players in hospital-at-home and has partnerships with rural hospitals in Wisconsin, South Carolina and Tennessee. Contessa CEO Travis Messina told McKnight’s Home Care Daily Pulse in an email the company is looking to expand to more rural communities.

“We believe that rural health systems are uniquely positioned to reach critical mass with the hospital at home care model,” Messina said.  

Barthel said so far only a few patients have participated in Blessing Health’s home hospital program. But she is confident more patients will embrace the opportunity as they become comfortable with the idea of receiving hospital-level care at home.