The man’s face was pasty, his eyes closed as he lay back in bed waiting for a wave of nausea to pass. Dr. Elizabeth Ward bent over him after checking his temperature, blood pressure, and oxygen levels and finding that all were normal.
“Would you rather stay home or go to the hospital?” she asked Frank Blondin, 52, who suffers from severe rheumatoid arthritis and heart disease, and had a nasty diarrhea-inducing bacterial infection.
“Home,” Blondin responded, without hesitation.
Soon, the doctor was managing a “hospital at home” admission for Blondin — an arrangement allowing him to receive intensive care and medical monitoring in the quiet of his own bedroom. Medical supplies and medications would be delivered as soon as possible, she told Blondin’s wife, Pamela. A nurse would come within the hour, take laboratory samples, and return later that afternoon and in the days to come. Ward would check in by phone, visit daily, and help would be available 24/7 if required.
“Hospital at home” programs fundamentally refashion care for chronically ill patients who have acute medical problems — testing traditional notions of how services should be delivered when people become seriously ill. Only a handful of such initiatives exist, including the Albuquerque program, run by Presbyterian Healthcare Services, and programs in Portland, Ore., Honolulu, Boise, Idaho, and New Orleans offered through the Veterans Health Administration.