Health systems, including OSF HealthCare, want the Centers for Medicare and Medicaid Services (CMS) to extend for five more years the Acute Hospital Care at Home waiver program Acute Hospital Care at Home waiver program to allow payment for at-home, hospital level care such as what’s being offered through OSF OnCall, the digital arm of OSF. The additional time would allow health systems to continue to build out logistics, supply chains and staffing and gather enough data to convince lawmakers at-home hospital care is safe, cost-effective and patients love it.

Paesani, who has COPD and a heart condition, was recently discharged from the OSF OnCall Digital Hospital program which she called, “an impossible dream.” She received regular in-person visits from a team of nurses who answered questions, took vitals, dispensed medication and made sure she had enough portable oxygen. An OSF OnCall provider overseeing her care checked in with virtual visits twice daily while Paesani enjoyed being home with her dog and having three meals delivered daily to her home from the hospital.

The one-time marketing coordinator lives alone but enjoyed her family being able stop by so easily each day without having to navigate parking decks and long walks down endless hospital hallways.

Robert Thornton, 78, of Belvidere just outside of Rockford spent five days receiving hospital-level care in the home he shares with his wife, Nancy. He had COVID and pneumonia, in addition to his COPD. His trip to the hospital was scary but his trip back home for a five-day stay in the Digital Hospital program was far better than he expected.

After passing both clinical and social screenings at the hospital, Thornton authorized the OSF OnCall team to set up all the equipment he would need at home to communicate and receive treatment. That includes a personal emergency response system which rings to the OSF OnCall Command Center for a nurse to respond to, triage and send an ambulance if necessary. Think of it as the call light in a hospital, only with someone monitoring it remotely at all times.

Thornton was visited by a field team of a nurse and nursing assistant, in addition to the twice-a-day virtual visits via a tablet that he didn’t even have to turn on and off.

“They came in three to four times a day to ensure that I took my medicine, that I had blood tests done, that I conversed with the main office via phone, and to give me my IVs and to see that everything went smoothly ... that I was progressing towards the final goal of being better.”

Navigating the equipment was easy for Thornton and his wife who recommend the program to anyone who qualifies. He points out a month ago, he was winded climbing just a few steps to get into his house. Now, he can manage that without a problem. His advice, “Just go for it.”

Care is safe and convenient for patients

Research to date shows patients in digital hospital programs recover faster, experience fewer falls and hospital acquired infections. OSF OnCall Digital Care Manager Melissa Meier, MSN, RN says the model also increases capacity to provide acute-care without additional costs. As patients are brought home, it frees up beds within the medical center for the most critically ill patients.

Courtney Dahnert, MSN, RN, supervisor of Clinical Digital Care for OSF OnCall Digital Hospital in Rockford, says the care team at the OSF OnCall Command Center will identify patients aged 18 and older who could be enrolled. Criteria includes their diagnosis, condition stability, whether their insurer offers coverage, and they must live within 30 minutes of OSF Saint Anthony.

Dahnert loves the return to a more personalized approach that includes Bluetooth enabled devices for patient-specific data which offer valuable insights into how the patient is doing, allowing proactive interventions. Personalized care plans for digital hospital patients are developed around individual routines – even must-see TV shows.

“It takes us back to being able to provide that really good care; getting to know someone even though we're only caring for them for two or three days and making their health relevant to them. And it gives us time to breathe. So it's an amazing opportunity for both the patient and the provider.”

OSF was the first provider of hospital-at-home care in Illinois and has served more than 400 patients since the program was launched in 2022 in Peoria. CMS is currently gathering comments about hospital-at-home and will make recommendations to Congress this fall about whether to extend the waiver program, make it permanent or end it. 

Video clips with patient Robert Thornton and  Courtney Dahnert 

B-roll of first OSF OnCall Digital Hospital patient in Rockford area

The success of the OSF OnCall Digital Hospital in Peoria has paved the way for expansion to Rockford, Illinois.

OSF HealthCare Saint Anthony Medical Center is preparing to launch OSF OnCall Digital Hospital – an option to receive hospital-level care at home for some patients such as those with heart failure, COPD, COVID, infections, pneumonia, or other illnesses. Patients who qualify have been admitted through the emergency department or referred for admission directly by their provider.

Courtney Dahnert, MSN, RN, supervisor of Clinical Digital Care for OSF OnCall Digital Hospital in Rockford, says the care team at the OSF OnCall Command Center in Peoria will identify patients aged 18 and older who could be enrolled. Criteria to be enrolled includes their diagnosis, condition stability, they live within 30 minutes of OSF Saint Anthony, and have an insurer that covers hospital care at home. Medicare is among the payers willing to support home-based acute care.

OSF OnCall Digital Care Manager Melissa Meier, MSN, RN, says patients are also screened to make sure their home environment is safe and that they have the ability to be cared for at home. Once enrolled, a tech kit, providing 24/7 instant connection, is set up in the home before a patient arrives.

“A tablet, which is how we do our video visits, as well as Bluetooth enabled biometric equipment for us to be able to do vital signs remotely. We also bring a backup power source as well as a backup internet source and a device which is a personal emergency response system, which functions much like a Life Alert button.”

For potential candidates worried they’re not tech savvy, Pam Anderson, a patient from Morton enrolled in the program through OSF HealthCare Saint Francis Medical Center in Peoria says everything is so easy to use.

“The phone … you don't dial it. You just pick it up and it rings directly to the (digital health) center. And once you do that, then somebody will appear on the iPad. So, if you do need something, you're actually speaking to someone (you can see). You're not just talking on the phone. And they're extremely prompt in answering. So there really isn't, in my opinion, a lot of technology involved. Thank heavens,” Anderson gladly reports.

There is a minimum of two visits from a nurse each day. Patients receive three meals a day and individuals can live alone or with family members. Costs are the same as for a hospital stay.

Meier says OSF OnCall Digital Hospital helps both the health system and the patient.

Research also shows patients in digital hospital programs recover faster, fewer are re-admitted to the hospital and they avoid hospital-acquired infections.

OSF is currently recruiting and training nurses for the digital hospital program in Rockford with special curriculum developed by OSF Innovation. It includes simulation for real-life scenarios, so nurses are prepared for any challenges. Dahnert says most nurses enjoy this new way of caring for patients that harkens back to the days of house calls.

“It takes us back to being able to provide that really good care; getting to know someone even though we're only caring for them for two or three days and making their health relevant to them. And it gives us time to breathe. So it's an amazing opportunity for both the patient and the provider.”

For patients concerned about their care and safety at home, the first-ever digital hospital patient for OSF, Jim Stickelmaier, says being at home was the best medicine.

“I would say definitely try it. I think they’ll find out that it was a lot easier and a lot nicer to be at home than in the hospital.” 

OSF OnCall has cared for nearly 370 patients in the Peoria area since launching its digital hospital program in August of 2022. The first digital hospital patient at OSF Saint Anthony Medical Center could be admitted after the program launches for Rockford area patients on February 27.

Melissa Meier and Courtney Dahnert

OSF OnCall Digital Hospital Peoria-area patients Pam Anderson and Jim Stickelmaier

B-roll OSF OnCall Digital Hospital