Providing hospital-level care at home for acutely ill patients in rural areas
Nearly 80 percent of rural America is deemed medically underserved by the federal government. One in five Americans live in rural areas and depend on their local hospital for care. Rural hospitals, however, are closing and consolidating in record numbers. Residents must drive farther not only for emergencies but for the kinds of diagnostic tests and treatments usually provided in a hospital.
To meet the growing need for acute care in rural areas, Ariadne Labs has launched the Rural Home Hospital program. With initial funding from the Spark Grant Program, the initiative is testing whether a home hospital model — which was successfully implemented in an urban setting by Brigham and Women’s Hospital in Boston — could be adapted for a rural setting.
Under the Rural Home Hospital Model, a specially trained in-home clinician visits a patient’s home and uses portable, internet-connected diagnostic tools and video technology to remotely connect with a physician. A satellite-linked communications system ensures a reliable video link and continuous flow of data. The in-home clinician takes the patient’s vital signs and performs other diagnostic tests that are transmitted in real time to the physician. The physician is able to guide a medical exam and speak directly with the patient about diagnosis, treatment, and follow-up.
In September 2019, Ariadne Labs partnered with University of Utah Health to stage mock hospital admissions in two remote Utah communities. The effort provided key insights to how a home hospital model could be streamlined and scaled, and demonstrated how the right technologies, personnel, and protocols can bring new options to rural communities in need.
With additional funding from the Rx Foundation, Ariadne Labs and University of Utah Health have launched a feasibility pilot study to measure the outcomes of home hospital care in rural Utah with real patients. Ariadne Labs is also working with the Indian Health Service to build a comprehensive home hospital program for rural Native Americans.
“We aim to get the right care to the right patient at the right time in the right place so we can begin to solve what is a crisis in rural health care in this country,” says David Levine, MD, MPH, MA, who is spearheading Ariadne Labs’ rural home hospital efforts.