Caring for Patients at Home During a Public Health Crisis

To make room in the hospital for patients with COVID-19 and send patients home sooner, UNC Health Care launched an enhanced home health program. A nurse conducts in-home check-ins using Haiku, Epic’s mobile app, and facilitates MyChart virtual visits with providers at the hospital.

“Having the nurse in a patient’s home for virtual visits brings down a lot of barriers,” said Melissa Mahaney, UNC Health Care’s home care director. “The average age of our home health population is 78, and many of these patients don’t have their own devices or haven’t used telehealth before. The nurse can provide support for them.”

When a patient arrives in the ED with heart failure, COPD, pneumonia, a UTI, wound care, or a mild case of COVID-19 and is stable enough to be cared for at home, the ED physician orders a referral in Epic for the enhanced home health program. The entire care team can easily see in the chart that a patient is enrolled.

Shortly after the ED visit, a home health nurse visits the patient at home. This nurse is a consistent point of contact for the patient throughout the program. The nurse later visits again to facilitate a virtual visit with a provider who uses Haiku to do a visual assessment of the patient. Enrolled patients have 5-7 home visits in the first two weeks, depending on the level of care required. UNC Health Care uses reports in Epic to track patients’ progress.

“The feedback from patients and providers has been very positive all around,” Mahaney said. “Patients want to limit their exposure to COVID-19, and this program gives them the care they need right at home.”

UNC Health Care plans to expand the program to include more diagnoses in the near future. Epic community members can learn more about how to replicate the program on the UserWeb.