Setting a New Standard for Care-at-Home Programs
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Shannon Scott is admitted to hospitals often. It’s part of his life with rheumatoid arthritis, which results in his airways being chronically inflamed.
After breathing difficulties sent Shannon, 52, to the emergency room in Jacksonville, Florida, yet again, Mayo Clinic offered him an unexpected opportunity: Would he like to recover in the comfort of his own home with Mayo’s expert medical care within reach 24/7?
Shannon didn’t hesitate to say yes to the Mayo Clinic Advanced Care at Home program.
“Every moment really counts. Spending the maximum time at home with my family is everything to me,” says Shannon, a U.S. Navy veteran who has already used the at-home healthcare program more than a dozen times. “When you have to be in the hospital, most people probably get a little depressed. The bed’s not comfortable. They’re waking you up all hours of the day and night.”
Since 2020, the Advanced Care at Home program has brought the nation’s top-ranked healthcare organization into the living rooms of more than 3,300 unique patients.
With the touch of a button, patients can connect with Mayo providers in the R. Halsey & Lisha S. Wise Family Command Center in Jacksonville for virtual care, including monitoring of vital signs via Bluetooth-enabled biometric devices, creating treatment plans and managing medication. That’s coupled with in-home visits by medical professionals for physical exams, blood draws, IV infusions, therapy services and more. Advanced Care at Home provides patients with all the technology they need and even meals.
“My treatment at home is better than it is in the hospital,” Shannon says. “I think this is the future of hospitalizations.”
Improving Healthcare at Home
Mayo Clinic was already developing Advanced Care at Home when COVID-19 hit and the demand for virtual services exploded. In July 2020, the program launched with four patients in Jacksonville. One month later, it rolled out to Eau Claire, Wisconsin. In September 2021, it expanded to Phoenix, Arizona.
The program allows Mayo to bring outstanding care to more patients even when hospital bed capacity is limited. Keeping patients out of the hospital can also be safer. Approximately 3% of patients develop infections acquired from a hospital stay, according to the U.S. Centers for Disease Control and Prevention.
"In your living room, how many methicillin-resistant staphylococcus aureus (MRSA) infections do you get? That would be zero, right? Because superbugs live in hospitals. They don’t exist in living rooms,” notes John Halamka, M.D., M.S., the Dwight and Dian Diercks President, Mayo Clinic Platform, which includes digital innovation services like Advanced Care at Home.
"In your living room, how many methicillin-resistant staphylococcus aureus (MRSA) infections do you get? That would be zero, right? Because superbugs live in hospitals. They don’t exist in living rooms."
— John Halamka, M.D., M.S.
Hospital readmission rates are 15% lower in Advanced Care at Home. The program’s net promoter score — how likely a patient is to recommend the service to a friend — is 94%, significantly higher than the average for healthcare.
Then there are the benefits that are harder to measure but just as important, like the effect on patients’ and families’ mental health. Thanks to Advanced Care at Home, Shannon wakes up in his own bed, eats meals with his wife and son, cuddles his three dogs, and works on his photography hobby — all while knowing that he’s getting hospital-level care.
“Before the program started, I used to be stressed, and I’d have to take off all this work because I was so worried about him,” says Shannon’s wife, Shelly. “If you’re sitting in the hospital alone, it can wear on you mentally. But if you have the interaction at home, if you have that positive outlook, it really can make you feel better. I think allowing Shannon to be home has actually kept him healthier and alive.”
Evolving to Meet Patients’ Needs
Advanced Care at Home has lived up to its name, not only offering follow-up care for infections and congestive heart failure — the program’s most commonly treated conditions — but also caring for patients with bone marrow transplants, kidney transplants and other postsurgical needs. Patients who travel to Mayo for surgery or a procedure have the option to use Mayo Clinic Care Hotel, which allows them to recover at a local hotel and be monitored overnight by a nurse in the Wise Family Command Center.
At-home healthcare services have grown to include kidney dialysis, IV nutrition, airway suctioning, treatment for small bowel obstruction, and more.
“We’ve seen an acceleration of the patients we’ve taken both in volume and complexity,” says Michael Maniaci, M.D., chief clinical officer for Advanced Care at Home. “As the volumes have grown, our staffing has grown. We’ve evolved our staffing models to go from a physician, a nurse and an advanced practice provider to acquisition teams, people working around the clock to admit patients into the program. We started to take a lot more patients directly out of the Emergency Department, completely bypassing the hospital. That wasn’t a possibility when we first started.”
The technology has also evolved. Mayo partnered with Medically Home, the Boston-based vendor that provides the software technology that powers Advanced Care at Home, to make the system more efficient, faster and safer. Providers now monitor patients’ vital signs in more sophisticated ways with wearable devices and have added MedaCube, a home pill-dispensing device that can be operated remotely. Over the next few years, Mayo seeks to develop the capacity to use drones to expedite medication delivery and specimen processing.
In addition, other healthcare organizations have taken notice of Mayo’s success and have worked together with Medically Home and Mayo Clinic to implement white label versions of Advanced Care at Home in their own hospitals, reaching more than 34,000 people so far.
The Future of At-Home Healthcare
The early lessons of Advanced Care at Home are already shaping new additions to Mayo Clinic’s virtual care services.
“We’re building this ecosystem of care modalities, from basic primary care and e-consults all the way up to hospital-level care and everything in between,” Dr. Maniaci says. “It’s not virtual care anymore — it’s just care. I think ultimately Mayo will continue partnering with other institutions, sharing these advances in decentralized healthcare across the country.”
Dr. Maniaci envisions partnering with retailers that are expanding into virtual and in-person healthcare.
“If a patient in North Dakota can’t come all the way to Mayo, we can bring Mayo virtual care to them,” he says. “If we need to deliver care in person and we can’t do it in their home, maybe we can do it at a pharmacy up the street.”
This type of innovation requires investment, and philanthropy is a key driver.
“A lot of these unique and novel models are not recognized by payers, and we can’t get a payer to recognize it until we show that it works,” says Sally Anne Brown, chair of Advanced Care at Home. “And to show that it works, we need benefactor support to help build the program. That’s how we were able to immediately start Advanced Care at Home in a really robust way in 2020. And to get to the next iteration will also take philanthropy.”
Shannon remains grateful. The Advanced Care at Home program is within reach — whenever he needs it.
“These last two years really have been just awesome,” he says. “My quality of life has been out of this world.”
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