Literature Review

Mass General Brigham tests drones for 'hospital at home': 6 things to know Becker's Health IT; by Giles Bruce; 10/15/24 Somerville, Mass.-based Mass General Brigham has tested out drone delivery for its hospital-at-home program. Here are six things to know:

How Mass General Brigham built the largest 'hospital at home'Becker's Health IT; by Giles Bruce; 10/1/24Somerville, Mass.-based Mass General Brigham has built the biggest hospital-at-home program in the country by getting buy-in from leadership and clinicians and through tech partnerships, executives said at a recent conference. The health system now has a capacity for acute hospital care at home of 70 patients, and is currently treating about 50 to 60 a day. The goal is to move to 10% of Mass General Brigham's overall capacity, or about 200 to 300 patients.Publisher's note: How might this be an opportunity for hospice? How might it be a threat?

Survey: Older adults unsatisfied with current healthcare system McKnights Long-Term Care News; by Kristen Fischer; 9/17/24 Older adults aren’t too happy with the healthcare system and many think it doesn’t meet their needs and preferences, according to a new survey. The results of the survey, conducted by The Harris Poll, were published Tuesday, and were released by Age Wave and The John A. Hartford Foundation.  Four in five adults aged 65 and older said that the system isn’t prepared to handle the changing needs of Americans in their age group. In total, only 11% said the US healthcare system deserved a grade of “A.” Results show that older adults want solutions such as affordable care interventions, developments to prevent or reduce cognitive decline, and healthcare professionals who understand what matters to them when they discuss care options.

Palliative care is a viable option for frail elderly patients with neurocognitive disorders admitted for hip fractures BMC Musculoskeletal Disorders; by Justine Boulet, Etienne L Belzile, Norbert Dion, Chantal Morency, Mélanie Bérubé, Alexandra Tremblay, Stéphane Pelet; 8/10/24 Most patients presenting with a hip fracture regardless of their comorbidities are surgically treated. A growing body of research states that a certain type of elderly patient could benefit more from a palliative approach. ... The presence of [a nuerocognitive disorder] NCD and diminished prefracture autonomy strongly support counseling for palliative care. The high rate of complications when surgery is proposed for frail patients with multiple comorbidities suggests that the concept of palliative surgery needs to be revisited. 

‘Good’ death different for everyone Altoona Mirror, Altoona, PA; 7/26/24 The social and economic inequities patients suffer in life often shapes their death” was a key point of a July 13-14 article in the Review section of the Wall Street Journal. ... In the article, which was written by Dr. Sunita Puri, a palliative care physician and the author of “That Good Night: Life and Medicine in the Eleventh Hour,” Puri focuses on the conundrum many families face when dealing with the question of where to spend the final days of life. ... “New research classifies the rise in home deaths as progress,” the message immediately under the article’s headline begins, “but we need to look more closely at what these deaths look like.” ... Puri, now 10 years into her physician career, says it is now clear to her that there is much more to a “good” death than where it occurs. “Presuming a home death is a success obscures important questions about the process,” she wrote. “Did this person die comfortably? Did their caregivers have the resources and guidance they needed? Was dying at home a choice or simply the only option?” 

Advance care questions to ask your loved one Parkview Health; 7/27/24 ... To ease into a conversation about decisions and scenarios, we can start with questions that are easier to answer, like: What does a good day look like? If you got to spend the day with your favorite people doing your favorite things, what would you be doing? With whom? ... From there, we can talk about more specifics related to healthcare decisions, such as: If your heart and breathing stop suddenly, would you want to have CPR (cardiopulmonary resuscitation), which can include pushing on your chest, breathing support, medications, and electrical shocks? ... If you knew that death was likely to happen in a brief period of time, would you want to be in the hospital, in a nursing care facility or at home? ... Editor's Note: The wording, sequencing, and open-ended format of these questions gently open the door for the person to reflect on and describe one's wishes, in contrast to some advance care planning questions that focus on filling out a form. Yes, Advance Directives forms are crucial. However, the forms are a tool for now and for needs ahead. The focus is the person, while building a context of relationship and trust.

Why CommonSpirit Health is investing in the home Becker's Helath IT; by Giles Bruce; 7/18/24 Chicago-based CommonSpirit Health has grown into the country’s largest Catholic provider of care at home. ... Becker's recently sat down with Trisha Crissman, interim executive director of CommonSpirit Health at Home, to discuss the metamorphosis of at-home care. ... [In 2010] ... we established hospice as another service line for the organization. ... And that brings us to where we find ourselves today — as the largest Catholic care-at-home provider in the country, with 84 locations and soon to be about 15 states, serving about 15,000 patients daily, with skilled home healthcare, hospice, palliative care, home infusion. We have many solution models, including "hospital at home," SNF [skilled nursing facility] at home, and ED [emergency department] diversion solutions.

Provider of in-home imaging services and 24/7 radiologist access raises $200M Radiology Business; by Marty Stempniak; 7/9/24 HarmonyCares, a provider of in-home X-ray services that spans 15 states, has raised $200 million in new capital, leaders announced Monday. Based in Nashville, Tennessee, the company is focused on physician-led care for vulnerable patients who cannot travel to a traditional healthcare facility. HarmonyCare Diagnostics brings the latest digital X-ray technology to patients’ homes or long-term care facilities, offering rapid results with board certified radiologists “available 24/7.”

Grief care efforts should include settings outside of hospice, provider group say McKnights Senior Living; by Kimberly Bonvissuto; 7/3/24 If standards are developed for high-quality bereavement and grief care, they must apply to settings outside of traditional hospice care, such as affordable senior housing, where there is a “critical lack” of mental health services. That’s according to LeadingAge, which submitted comments last week to the Agency for Healthcare Research and Quality on a draft report from a research project that will inform an independent panel that will develop standards for high-quality bereavement and grief care. Katy Barnett, LeadingAge director of home care and hospice operations and policy, highlighted the need for cross-continuum grief and bereavement assessments, interventions and resources, including in settings outside of traditional hospice care, such as affordable senior housing.

HHS to impose penalties on providers that block patients’ health information McKnights Home Care; by Adam Healy; 6/24/24In a bid to promote easier access and exchange of patients’ health records, the Department of Health and Human Services published a final rule Monday outlining penalties for providers that block access to electronic health information. ... Fragmented and inaccessible patient data can prevent long-term and post-acute care providers from seeing the full picture of a patients’ health. Hospitals, for example, are not required to share updates about a patient’s health with the patient’s post-acute care provider. As a result, home health and home care agencies frequently cannot access patients’ electronic health records to help assess and treat patients. Three disincentives: ... First, hospitals that commit information blocking can be subject to a reduction of three quarters of an annual market basket update. Second, clinicians eligible for the Merit-based Incentive Payment System will receive a zero score in the “promoting interoperability performance” MIPS category, which can be equivalent to roughly a quarter of the clinician’s MIPS score in a given year. Lastly, providers that participate in information blocking can have their Medicare Shared Savings Program or Accountable Care Organization eligibility revoked for at least one year. ...Editor's Note: Almost any solution raises additional challenges. How does HIPAA interface with this? How might a cyberattack at a hospital (or other healthcare agency) affect the patients' other agencies, putting them at risk as well?

48 health systems with strong finances Becker's Hospital CFO Report; by Andrew Cass; 6/20/24 Here are 48 health systems with strong operational metrics and solid financial positions, according to reports from credit rating agencies Fitch Ratings and Moody's Investors Service released in 2024. Note: This is not an exhaustive list. Health systems were compiled from credit rating reports. [Click on the title's link for the list.] Editor's Note: This list is from larger "health systems," and does not reflect stand-alone hospice and palliative organizations.

Acting now to sustain and improve America’s healthcare system: Advice from innovative physicians and health system leadersSheppardMullin Healthcare Law Blog; by Kathleen O'Neill, John Golembesky, Jeralin Cardoso, Chi Huynh & Carolyn Young; 6/6/24 At [the recent] America’s Physician Groups Spring conference in San Diego, California, we listened as physicians and health system leaders described the ways in which they are responding to short and long term challenges to the sustainability of America’s healthcare system in its current form. It now stands at a critical juncture, facing challenges such as provider shortages and burnout, increasing concerns around access and cost for pharmaceutical products and other supplies, the increasing burden of managing chronic diseases, rising demand for services across the spectrum from an aging population, and balancing the transition to value-based care models in a predominantly fee-for-service environment. ... Here, we outline the key areas of focus described by leaders at the conference: ... 

Transformative peer connections: Early experiences from the ASCO Palliative Care Community of Practice American Society of Clinical Oncology; by Mazie Tsang, Cristiane Bergerot, Natasha Dhawan, Rushil Patel, Darcy Burbage, Tingting Zhang, Jafar Al-Mondhiry, Joseph McCollom, Ramy Sedhom; 5/22/24 online ahead of print in June 2024  ... there are barriers to implementing palliative oncology at many institutions for myriad reasons. ... In this article, we discuss an innovative strategy that ASCO implemented called the Communities of Practice (CoP). We share our experiences as the Palliative Care CoP and how our group seeks to develop processes and structures to collectively promote systemic change and enhance palliative care delivery for people with cancer. Our Palliative Care CoP engages with senior leaders, administrators, and those in power to achieve a shared vision of delivering holistic health care for people with serious illness. ... [We address] eight main domains: