• Elizabeth Hogue, Esq

Home Care Runs Toward the COVID-19 Fire

Much of the focus thus far in the treatment of COVID-19 patients has been on hospitals and rightfully so. Practitioners on the front lines of treatment of COVID-19 patients and policy makers are now beginning to advocate for the treatment of COVID-19 patients at home instead of in hospitals. Are home care providers ready to run toward the fire?

Italian physicians led the way, as reported in an article, “A Plea From Doctors in Italy: To Avoid COVID-19 Disaster, Treat More Patients at Home,” by Sharon Begley that appeared in STAT on March 21, 2020. The article says:

A dozen physicians at the epicenter of Italy’s COVID-19 outbreak issued a plea to the rest of the world…, going beyond the heartbreaking reports of overwhelmed health care workers there and a seemingly uncontrollable death toll to warn that medical practice during a pandemic may need to be turned on its head with care delivered to many patients at home.

Fearful that major hospitals and ambulances transporting sick patients to hospitals became major sources of transmission of COVID-19, physicians said:

Managing patients at home is a brilliant thing…and one that could be augmented by mobile clinics and telemedicine. Bring them nutrition, measure their oxygen levels, even bring them oxygen, and you probably keep many of them at home…That change would decrease transmission and protect other patients as well as health care workers.

Then, in “Will 2020 Be the Year That Medicine Was Saved?” that appeared in The New York Times on April 14, 2020, Ezekiel J. Emanuel and Amol S. Navathe, who direct the Healthcare Transformation Institute at the University of Pennsylvania, pointed out that treatment of chronic conditions has been slowly moving from hospitals to home care. The authors said:

In general, patients treated at home recover faster, with fewer tests, fewer readmissions and high satisfaction. And care in the home typically costs less than care in hospitals. Covid-19 has shown that even more patients can be treated well without being hospitalized.

Among the authors’ recommendations in the article is that: “hospitals should be required to offer all low-risk patients a care-at-home option, so they can stay out of the hospital…”

Finally, in “Senior Care Innovator Bill Thomas: COVID-19 Rewriting Health Care Rules, Pushing Home Care into the Spotlight,” by Joyce Famakinwa that appeared in Home Health Care News on April 20, 2020, Mr. Thomas characterized the COVID-19 virus as a “home-and community-based emergency.”

Thomas went on to say:

Let’s say that the intense focus on hospitals, ventilators and ICU beds was the right thing in the early weeks of the outbreak. Maintaining that focus, going forward, is actually counter-productive. If we’re going to control the virus in the months before we have a vaccine, it’s not the hospitals that are going to get control of the virus, it’s the home. That’s where we will hold the virus at bay.

Thomas closed with this prediction:

First, we’re going to finally see an awareness from health care systems that home care is an essential part of the equation and not just someone to call at the end of a hospitalization. Home care providers need to be at the table, working side-by-side with health care systems to design responses…In order to manage the second, third and fourth wave of this COVID virus, we’re going to need a really powerful, well organized, well-resourced home care system nationally.

Yes! Yes! Yes!

The focus on home care providers as first responders, however, means that they must be prepared to “run toward the fire” as first responders do instead of “mopping up” after patients are discharged from hospitals. Scary as this idea may be seem to some, there is no doubt that home care providers are up to the challenge. As a longtime friend to home care, I know it’s so! Make it so!

Elizabeth E. Hogue, Esq.

Office: 877-871-4062

Fax: 877-871-9739

E-mail: ElizabethHogue@ElizabethHogue.net

Twitter: @HogueHomecare

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