PERSPECTIVE

Health in Place: The New Care Delivery Paradigm

Theo Koury , MD

President of Vituity

Published August 29, 2022

Patient receiving care at home with Health in Place.

For decades, patients have traveled to hospitals for acute care. This delivery model made sense, given the equipment and personnel needed to manage serious illnesses. However, as medicine and technology have evolved, delivery models have remained static for decades. And as the coronavirus pandemic demonstrated, patients too often pay the price in terms of care delays and degraded quality of life.

At Vituity, we believe the time has come to reimagine acute care delivery. As an industry, we now have the tools to make acute care convenient, accessible, and aligned with patient preferences. We call this concept Health in Place, and it’s at the center of our mission, innovation, and commitment to healthcare’s future.

Reimagining Care Delivery Models

What exactly is Health in Place? At Vituity, we define it as a delivery ecosystem designed to meet patients when, where, and how they need care. This may be within the hospital setting, via virtual or hybrid models, at home, or any place a patient requires help.

Studies show that patient-centered approaches like Health in Place can improve both care quality and quality of life for patients. They also create a more satisfying experience for today’s consumers and their families, who expect options and convenience when receiving care. After all, we live in a world where the expectation is to access virtually all needs through the click of a button. Why should healthcare be different?

Health in Place solves some of the thorniest problems facing hospitals and health systems, such as:

Fragmented care delivery that doesn’t serve the needs of hospitals or patients.
Decreased patient engagement and loss of trust in the system.
Low clinician morale and high rates of burnout.

Bringing New Patient Care Ideas to Life

Of course, this patient-centric shift won’t come quickly or easily. Our system needs to change fundamentally to meet the vision of truly patient-centric care.

One of our first tasks must be to rethink care teams. Presently, care is inefficiently delivered through physician-centric, face-to-face, in-hospital/medical office models. However, it’s time to shift physicians to a team leader/head consultant role to mitigate rising costs and staffing shortages. The expansion of a highly coordinated team (nurses, advanced providers, social workers, navigators, home health caregivers, etc.) where members operate at their highest license significantly changes the calculus of healthcare.

We also need to help patients access and navigate their needed care. Patient navigation, which provides individualized guidance and support, is the gold standard. But when it comes to touch points, we must consider the role technology plays in managing patients. Appropriately used, it leverages the care team model and exponentially increases patient interaction, ensuring the right level of care at the right location is achieved.

Health in Place in Action

So how can Health in Place (HIP) improve healthcare access and experience? Successful HIP programs blend three key characteristics:

Patient-Centered Quality. In addition to government-mandated quality metrics, Health in Place emphasizes access, convenience, communication, and other factors impacting quality of care. An example is Vituity’s ED Revisit Reduction Program, which assigns care navigators to at-risk patients to help them access needed services after their discharge. Navigators meet with eligible patients before discharge to schedule follow-up appointments. They also provide referrals to community organizations that can help with housing, food, transportation, and other social needs. In addition, Navigators follow-up with patients within one to two days after discharge to ensure they reach their follow-up and complete the care plan developed in the ED. If the care plan requires modification, the Navigator addresses it.
Evolved Care Teams. Health in Place leverages expanded care teams and force-multiplying technologies to meet the needs of patients and providers. For example, to meet critical care needs across a health system region, Vituity rolled out a hub-and-spoke model. A centralized intensivist group works as a unified team, providing on-site and tele-ICU coverage across their one tertiary and four community hospitals. The program has greatly improved clinical outcomes for conditions like sepsis, saving the system an estimated 35% in critical care staffing costs.
Care without Boundaries. Health in Place seeks to end traditional barriers to care by extending services beyond hospital walls. For example, Vituity and San Joaquin County Clinics now operate an RV-based mobile health center. This clinic on wheels rotates through seven community sites on a weekly schedule—all adjacent to homeless encampments and other high-need populations. With the help of a Vituity Innovation Grant, the program recently hired several dedicated physician assistants to provide virtual care to these vulnerable populations.

It All Adds Up to Care Delivery with Health in Place

Health in Place represents both the apex of Vituity’s clinical integration evolution and a jumping-off point for the future. It’s about bringing healthcare to the patient, wherever they may be. We achieve this through a combination of technology and evolved care teams, such as our Virtual Health Navigation Team.

Our vision is to create a care delivery environment where everyone practices at their highest level and technology-enabled providers (not provider-enabled technology) deliver true patient-centric care—all while addressing provider wellness and burnout.

Partnering to improve patient lives

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