During the COVID-19 pandemic, many people with cancer—and their doctors—discovered the potential of telemedicine. But what if more intensive cancer treatment could take place in the comfort of your own home as well?
That’s the “hospital at home” model. Consider chemotherapy infusions. “In the infusion suite, dozens of potentially immunocompromised patients are collocated with a variety of health care providers who may be vectors for SARS-CoV-2 [the virus that causes COVID-19],” write three oncologists in “The Home is the New Cancer Center,” an article in the Journal of the National Comprehensive Cancer Network (NCCN). As an alternative, they describe Christie at Home, a program of The Christie, a large cancer center in Manchester, England. A trained nurse visits people needing certain cancer treatments in their homes; 100% of these patients rated their care as “excellent.” Cancer Care at Home, a more limited program at Penn Medicine in Philadelphia, has nurses administer 13 cancer drugs that are usually delivered in an outpatient setting to patients in their homes.
Even more intensive acute care can sometimes be delivered at home. Huntsman at Home, a program of the Huntsman Cancer Institute at the University of Utah, provides such care for cancer patients who live within 20 miles of the institute. Nurse practitioners and registered nurses visit patients at home, sometimes more than once a day. They monitor symptoms, check heart health, manage oxygen therapy and administer medications, including intravenously. In a study of the program published in the Journal of Clinical Oncology, researchers evaluated 367 patients who qualified for home care. Half were cared for at home, the other half in the hospital. For the at-home group, unplanned hospital stays fell by 55%, visits to the ER fell by 45% and health care costs dropped by 47% over 30 days.
While the COVID-19 pandemic has been a catalyst for home care, write the NCCN authors, there is great potential for post-pandemic times as well: “We should leverage this momentum to transform care for our patients.”