Medicine, at least how it’s delivered in the U.S., has a lot of problems. COVID has put that system under the microscope. I like having a meaningful platform to institute change.
I believe in the mission of providing hospital-level care at home, which is the model promoted by Contessa. I became their corporate medical director at the end of March, just as COVID was escalating rapidly. The adoption of telemedicine has been historically slow. The pandemic pushed the fast-forward button. Primary care clinics were shuttering in-person visits, and their only medium for interacting with patients became telemedicine. Internationally, the concept of hospital care at home is not new, but it’s a newer model in the U.S. A mid-’90s trial proved that it can deliver similar, if not better, patient outcomes at a lower cost. But the model wasn’t scalable at the time.
Then COVID hits and people are afraid to go to hospitals; families are kissing their loved ones goodbye as they enter the ER. The benefits of home recovery care programs are: You get to be in your bed. You have your creature comforts. Your physician rounds remotely, by video chat through tablets, at least once a day. The nurse comes to your house two or three times a day.
The social determinants of health are not handled well by the health care system. The patient is often left to deal with any gaps in their care. Home recovery care programs say, “Let us help you out.” The nurses help get your appointments set up and make sure you’re getting your prescriptions filled.
Health care systems are adapting to use telemedicine to check in on patients with COVID, so they don’t go back to the ER that second or third time.
The silver lining is that this is accelerating changes in how we can deliver medicine. Once coronavirus goes away, patients are going to be left with completely different expectations. And health care is going to have to adapt to that.
Dr. Rob Moskowitz ’95, emergency room physician and corporate medical director, Contessa Health, Nashville, Tenn.