Atrium Health Hospital at Home Recognized by Annals of Internal Medicine for Innovative Work

At the onset of the coronavirus disease 19 (COVID-19) pandemic in March, Atrium Health clinicians and leaders knew they had a vital responsibility to expand their treatment capacity to best serve their communities during this unprecedented crisis. Atrium Health’s multidisciplinary teams came together and rapidly designed an innovative approach to offset the expected influx of patients, offering patients the best treatments available within the comfort of their homes, while keeping patients, caregivers and Atrium Health’s medical staff as safe as possible.  

In just under a week, this team stood up a new care model that has allowed Atrium Health to expand its care options for COVID-19 patients. Today, we are thrilled to announce that this innovative work now called Atrium Health Hospital at Home (AH-HaH) is published in the Annals of Internal Medicine.  As other health systems continue to navigate capacity limitations, we hope that the insights and early promising results from this article will help others shape their COVID-19 responses.  

Congratulations to Kranthi Sitammagari, MD, FACP, Atrium Health’s co-medical director for quality and assistant professor of Internal Medicine, first author, and Stephanie Murphy, DO, medical director of Atrium Health Hospital at Home, for their commitment to care innovation helping us to lead as we improve care and outcomes for COVID-19 patients! 

The full publication is now available on the Annals of Internal Medicine website.  

This team set out to solve a centuries old challenge with pandemics, as they all pose a threat to overwhelming traditional health care delivery and introduce exposure risk to a limited supply of healthcare providers. These unpredictable times set the stage for an opportunity tackle these challenges differently by pivoting Atrium Health’s existing care innovations and virtual care infrastructure into a new care delivery paradigm. 

This paper describes how within the Learning Health System at Atrium Health, a multidisciplinary care team developed and rapidly deployed a virtual hospital program, while sharing preliminary results on 1477 patients who were diagnosed with COVID-19 from March 23, 2020 through May 7, 2020. 

To plan, launch and sustain the virtual hospital model, the team collaborated with numerous stakeholders from hospital medicine, primary care, nursing, community paramedicine, pharmacy, care management, social work, information and analytic services, the Center for Outcomes Research and Evaluation, and administrative leadership. Together, they developed templates for data-driven patient information and workflows to manage patients in a home setting that mirrored traditional inpatient care. In the midst of the chaos that was the early days of this pandemic, it was critical to build the care innovation around workflows and technology that were already routine and familiar to both the care teams and the support staff. Indeed, this concept of built in familiarity is thought by the authors to have played a key role in successful implementation. 

Patients, who would otherwise meet criteria to be admitted to a traditional hospital, are admitted to the Hospital at Home program and equipped with a home monitoring kit that includes a blood pressure cuff, pulse oximeter and thermometer. Patients can interact with care teams through a mobile medicine app 24 hours a day.  

A dedicated AH-HaH team provides 24/7 monitoring, daily virtual physician rounds, and daily in person visits by the team’s community paramedics with the ability to check labs, perform heart monitoring, give oxygen and intravenous medications.  Patients receive this level of care until their condition improves and then they transition to a lower acuity symptom monitoring app and check-in from a nurse.  

Drs. Sitammagari and Murphy’s work concludes that virtual hospital programs do indeed have the potential to provide health systems with additional inpatient capacity during the COVID-19 pandemic and beyond. Guided by this blueprint, health systems may be able to consider this as one innovative approach to offer their communities.  

“In conclusion, we found that a virtual hospital can be a viable part of a health system’s surge planning and provides an important alternative strategy to care for patients with COVID-19 by mitigating some risks associated with traditional inpatient management. Our framework leveraging a virtual platform, health IT, and data-informed decision making can overcome the challenges inherent to implementing a novel care model.” 

For more information about Atrium Health Hospital at Home, read here.