Mount Sinai is leading a revolution in health care. Instead of looking to fill beds, we are looking for ways to take care of patients in their homes. And in order to create and optimize these new models of care, data is key. Our mission at the Institute for Care Innovations at Home is to provide learning about all the facets of home-based care:
- How can we provide the best possible care in a home environment?
- Who is best served by this new model of care?
- How can we support families and caregivers?
- What segments of the population are underserved?
- How can we provide better care more cost-effectively?
Data is the Key to Change
In order for these new models of care to exist, they need to be supported by legal, regulatory, and insurance frameworks. And for that to happen, data is needed to provide justification for change. How can home care, paramedical care, and other models improve quality of care, quality of life, and patient satisfaction—as well as create financial and medical efficiencies?
In conjunction with our clinical partner, Mount Sinai at Home, we are answering these questions. Mount Sinai at Home provides in-home services including:
- Hospitalization at Home, for patients with an acute condition such as pneumonia, cancer, or heart disease
- Mount Sinai Visiting Doctors who provide primary care for homebound patients, who are usually frail and elderly
- Rehabilitation at Home, which enables patients to recover at home instead of an inpatient rehabilitation center
- Pediatric Visiting Doctors and Complex Care Program, which cares for children with chronic illnesses or infants who have just left neonatal intensive care
Access to the Broad Spectrum of Mount Sinai Patients
Our research team has a unique advantage in that we have access to data on the wide variety of Mount Sinai patients. We are able to compare hospitalized patients to patients who are cared for in their home. We are able to compare outcomes and document whether patients are receiving better care at home. Are readmissions lower? Is patient satisfaction higher? And are costs lower? These statistics are critical as we evolve our programs. And one of the exciting things about our work is that we are able to see our insights implemented and affecting change immediately.
Insights Not Just for New York, But for the Health Care System as a Whole
The changes we are implementing at Mount Sinai don’t just benefit our Health System alone. We see these insights as being able to be used nationwide. Why shouldn’t the rural elderly be able to receive care at home, instead of driving 150 miles to a facility? Or a child who has cancer be able to stay at home in the suburbs instead of being hospitalized? Or a mom from a small town who has a broken leg be able to rehabilitate at home instead of at a facility two counties away—enabling her to be there for her children?
Finding the Hidden Populations Who Need Care
Another important question health systems need to ask is, “Who are we not serving?” Today, it is estimated that there are more homebound older adults with health issues than there are in nursing homes. How do we identify and care for these “hidden” populations? We are addressing this question in two ways: through our involvement in national studies which follow subjects over an extended period of time, and our deep involvement in the communities of New York that we serve. Mount Sinai has a long legacy of community-based services, and we are able to tap into that rich involvement to understand population dynamics.
The Family as a Support Network
We are also continually asking ourselves, “How are we serving the families of our patients?” Our gauge of success needs to be broad enough to encompass family caregivers. So measuring attitudes and examining needs of patient support networks are critical to the overall success of our programs. In this country, our system of long-term services and support relies heavily on family—yet attitudes surrounding responsibility vary greatly. It is important for us to understand the involvement of family, and the stresses and challenges they face.
It is an exciting time to be conducting research about home-based care. Today, we are in the forefront of a movement that has the power to transform the way we approach health care in general. And together with Mount Sinai at Home, we are seeing our insights improve the experience of patients and their families every day.