Episode #59 – ‘Hospital at Home’ with David M. Levine MD

The topic we’re going to cover in this podcast episode may be one of the most disruptive changes in hospital care to come along in over a century.  It’s the movement of ‘hospital at home’ – literally shifting hospital-based care to people’s homes. It might sound a bit futuristic, but it’s already an established practice in other countries; and it’s rapidly gaining traction here in the US.

Our guest today is a leading medical director and researcher in this area.  David Levine, MD MPH MA, is a practicing general internist and clinician-investigator at Brigham Health and Harvard Medical School.  His research is focused on digital health technology, measuring the quality & experience of outpatient care, and optimizing healthcare at home.  As assistant medical director of “alternative care pathways” for the Brigham and Women’s Physician Organization, Dr. Levine works to bring acute, hospital-level care to patients’ homes as a substitute to traditional hospitalization.  

In this interview, Dr. Levine discusses:

• How ‘hospital at home’ actually works and the specific conditions that can be treated in the home instead of in hospitals.

• Some of the critical problems that ‘hospital at home’ addresses and solves.

• Why and how, when appropriately implemented, ‘hospital at home’ can be a superior substitute for hospital-based care.

• Why and how ‘hospital at home’ is more customized and personalized care.

• Some of the positive outcomes that have been demonstrated in research studies with the ‘hospital at home’ approach.

This ‘hospital at home’ movement is one of those elegant ideas that makes you wonder, “why didn’t someone think of doing this sooner?”  And more importantly, “why aren’t we doing more of this, right now?” It addresses some major issues, including access to hospital care, and the rising and uncontrollable costs of healthcare, as well as safety and quality of care.   

It was a privilege speaking with Dr. Levine. He brings a deep sense of humanity to his work.  It’s clear that his primary goal is not just the advancement of technology, but the advancement of health for patients.  He also brings a researcher’s diligence – not wanting to overstate where we are and what we’ve demonstrated to date.

It is incredible to think that nearly 25% of all hospital admissions could safely – perhaps even more safely – be deployed to patient’s homes.  And that, at some point in the very near future, that number could be as high as 50%, or more, of all hospital admissions. In addition to being a safer option, ‘hospital at home’ is more personalized and customer-oriented care as well – for the patient and their family.  It’s more accessible, more convenient and more comfortable. It’s not only better medical care; it’s better patient care.

This is one of those single point innovations that could potentially change the face of healthcare delivery forever.  And, it’s not a future discussion. It’s an immediately important issue for senior leaders across the country who are, right now, grappling with billion dollar, long-range decisions on how to invest in the infrastructure of healthcare delivery.

As always, I hope you’ve benefited from this interview as much as I have.

Until next time, be well.

Zeev Neuwirth, MD