Hospital-Level Care in the Comfort of the Patient's Home

Following an extremely intense calisthenics workout, Mike noticed discoloration in his urine. Two days later, he went to an urgent care clinic. Tests showed his creatine phosphokinase (CPK) levels were very high, a sign of stress or injury to the heart or other muscles.

Mike went straight to the Massachusetts General Hospital Emergency Department, where he was diagnosed with rhabdomyolysis. Although a potentially dangerous condition, rhabdomyolysis is relatively easy to treat. To start, Mike was given an IV to flush out his kidneys and lower his CPK levels.

Since Mass General's beds were mostly filled, Mike was transferred to Newton-Wellesley Hospital for continued care. After Mike stayed two days for observation, hospitalist Abraham Cherukara, MD, brought up the possibility of completing his treatment at home.

"Not every patient is a candidate for Home Hospital," explained Gregory Goodman, MD, an internist and associate physician with the program. "If you require significant specialty care, lots of imaging, frequent labs, or frequent dosing of certain medications, it may be challenging."

Mike, however, was an ideal candidate. He could receive ongoing fluid management at home, and his care team could draw blood work daily and closely monitor his CPK levels, liver function, and kidney function.

Home Hospital is voluntary. If the patient prefers not to go home, they can choose to remain in the hospital for care until they are discharged. But for Mike, it was an easy decision to opt in.

"The home hospital model was something I knew about through my work in venture capital. I welcomed the opportunity to experience it for myself," he said. "Given my age and overall health, I didn't need to be taking up a hospital bed when I could be relaxing in my own space at home."

At least two at-home visits a day

Home Hospital patients enjoy hospital-level care at home. The patient receives two visits from Mass General Brigham clinicians every day, usually a nurse and/or a paramedic. At the home visit, the clinical team gives the patient all necessary care, such as checking vital signs, drawing blood, or administering medications.

During all visits, a Mass General Brigham doctor is available for consultation via video call. In Mike's case, Dr. Goodman served this role.

"We had great conversations, educating him on what was happening, following the lab results together, and discussing the treatment plan and next step with him," Dr. Goodman said.

"My wife and I were thoroughly impressed with the nursing staff. They had excellent bedside manner and made me feel confident in the quality of care provided," Mike added. "Whenever I needed to speak with Dr. Goodman, the nurse would patch him in via the tablet. He clearly knew the details of my case. It felt like a luxury experience because the care was so personalized."

Even when no one from Home Hospital was at Mike's home, the team was monitoring his health remotely. One time, his iPad rang while he was in the middle of a shower.

"They were just calling to let me know my heart rate was a bit out of range and wanted to make sure everything was okay," he said.