POST 236. February 22, 2021. MOUNT SINAI AT HOME – “We began thinking about how we could use hospital-at-home to meet the needs of our hospital system in our community, in terms of responding to the crisis of COVID-19…” 

NOTE: I been on the faculty of the Icahn School of Medicine at Mount Sinai for forty-five years. I am not involved in any Mount Sinai COVID initiatives.

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May 10, 2019

“Mount Sinai at Home is distinct from home health care, the more familiar and common offering, which most often describes a visiting nurse service that provides non-acute treatments like wound care and chronic care management. In our program, we treat acutely ill patients who would otherwise require hospitalization, providing them with a suite of integrated services that may include daily visits from nurses, doctors, and social workers; IV support; oxygen; X-rays; and physical therapy. Our research finds that patients who receive hospital-at-home care have fewer complications and readmissions; they also rate their health care experience more highly.

Our protocols allow us to provide home hospital care safely for a set of specific conditions, including community-acquired pneumonia, congestive heart failure, COPD, cellulitis, and dehydration. Patients are either referred to the program by their primary care physicians or are enrolled in it after visiting the emergency department. Once home, they receive a combination of in-person visits, video visits, and monitoring. One of the first steps is to have a nurse visit the patient at home and set up a tablet with a connected blood pressure monitor, which allows the patient to send a blood pressure reading while talking to the nurse remotely. But ongoing at-home management of acute-care patients requires making services available 24 hours a day. We have physicians on call around the clock, and we collaborate closely with community paramedics who we can dispatch to a patient’s home at any hour. Say it’s 2 am and a patient isn’t feeling well. We immediately send a paramedic who can set up a video link with a doctor that is compliant with patient privacy laws; then, in consultation with the physician, the paramedic provides treatment, or, if necessary, transports the patient to the hospital.”” (A)

April 7, 2020

“As health care experts eye the next two weeks as possible peaks for the nation’s COVID-19 hotspots, hospital systems continue to search for innovative ways to increase their capacity…

One such hospital-at-home program making inroads is Mount Sinai at Home, housed out of New York City-based Mount Sinai Health System.

Launched in 2014 as part of a three-year CMS Innovation Center grant, Mount Sinai at Home has been actively working to free up beds across Mount Sinai’s eight hospital campuses. It’s doing so by shifting certain vital services into the home for patients nearing the end of their in-patient stays.”  (B)

May 13, 2020

Mount Sinai Health System is launching a new Center for Post COVID Care to offer additional support for and gather crucial data from patients recovering from the virus as they transition from hospital to home.

Mounting evidence shows that the virus extends beyond respiratory symptoms to include multiple systemic complications that impact the brain, heart, kidneys and other regions of the body. There are also growing concerns over striking disparities in outcomes for different patient groups, officials said.

“COVID-19 will be with us for years to come, and this Center will ensure that all New Yorkers, regardless of their disease state or socioeconomic status, will be able to get the comprehensive, expert care they need for this complex disease,” said Kenneth Davis, M.D., president and CEO of the Mount Sinai Health System, in a statement.

Mount Sinai has treated more than 8,000 patients diagnosed with COVID-19. Located at Mount Sinai-Union Square, the center will serve as a destination for patients across the Mount Sinai Health System. It will provide comprehensive multispecialty care and systematic evaluation of the long-term impact of COVID-19, officials said.

The long-term complications of acute infection are still unknown.

The center will also have a COVID-19 registry in which participating patients will undergo a baseline survey to collect information regarding sociodemographics, behaviors, comorbidities, mental health conditions and medications. Researchers will gather baseline measures of pulmonary symptoms, cognition and other mental health measures along with physical indicators including biometrics, spirometry, EKG, bloodwork and antibody titers for SARS-CoV-2, the virus that causes COVID-19.

“The entire research and clinical community has raced to understand this virus and has swiftly moved treatment and testing innovations from the lab to the bedside,” said Barbara Murphy, M.D., chairwoman of the Department of Medicine at the Icahn School of Medicine at Mount Sinai, in a statement. “The Center continues that excellence by caring for a wide spectrum of patients—from those just diagnosed to those already discharged from the hospital and those who were never hospitalized but need help recovering.” “(C)

Aug. 20, 2020

“As hospitals care for people with COVID-19 and try to keep others from catching the virus, more patients are opting to be treated where they feel safest: at home.

Across the U.S., “hospital at home” programs are taking off amid the pandemic, thanks to communications technology, portable medical equipment and teams of doctors, nurses, X-ray techs and paramedics. That’s reducing strains on medical centers and easing patients’ fears.

The programs represent a small slice of the roughly 35 million U.S. hospitalizations each year, but they are growing fast with boosts from Medicare and private health insurers. Like telemedicine, the concept stands to become more popular with consumers hooked on home delivery and other Internet-connected conveniences.

Eligible patients typically are acutely ill with — but don’t need round-the-clock intensive care for — common conditions including chronic heart failure, respiratory ailments, diabetes complications, infections and even COVID-19.

They are linked to 24/7 command centers via video and monitoring devices that send their vital signs. They get several daily home visits from a dedicated medical team. Just like in a hospital, they can press an emergency button any time for instant help…

……the hospital-at-home model has been used on a small scale in the U.S. since the mid-1990s, but it was held back because traditional Medicare and some insurance plans either didn’t cover such treatment at all or didn’t reimburse for the full cost of care.

But when the pandemic struck, the Centers for Medicare and Medicaid Services temporarily let hospitals bill for care outside their walls, including in patients’ homes. Many private insurers also are covering in-home hospital care during the pandemic. Hospital groups and others want Congress to make those changes permanent, at the same rates as in-hospital care…

Raphael Rakowski, co-founder of 4-year-old Medically Home, said the number of patients treated this July is up tenfold from July 2019.

“Our business is exploding because of COVID,” he said.

It now treats patients for 10 hospitals and one physicians’ group in five states, including two that were set up soon after the pandemic hit: Boston’s Tufts Medical Center and Adventist Health’s West Coast hospitals. Two Mayo Clinic hospitals joined this summer. Medically Home should be operating in 12 states by early 2021, Rakowski predicts.

He says some patients are offered at-home care after being examined in an emergency room. In other cases, doctors arrange the care for patients getting cancer treatment, those with a sudden illness, some about to get surgery, or homebound patients with dangerous complications.

The Veterans Health Administration operates 12 hospital-at-home programs. Last year, they served 1,120 veterans…

While interest in the programs has skyrocketed, whether in-home hospital care blossoms after the pandemic largely depends on whether government and private insurers continue to cover it at profitable prices.

If they don’t, Johns Hopkins’ Leff said: “I think most hospitals will go back to normal.”” (C)

November 29, 2021.

The Icahn School of Medicine at Mount Sinai will serve as a hub site for two cohort studies contributing to a nationwide health consortium study by the National Institutes of Health (NIH) on the long-term effects of SARS-CoV-2, the virus that causes COVID-19.

The NIH Researching COVID to Enhance Recovery (RECOVER) Initiative will examine the long-term effects of the virus, which are known as post-acute sequelae of SARS-CoV-2 infection or “long COVID.” As part of the RECOVER Initiative, which is building a national study of diverse participant research and supporting large-scale studies on long COVID, Mount Sinai will be a hub site for one of the more than 30 research teams across the United States…

Mount Sinai researchers will lead recruitment of an adult cohort to identify, evaluate, and characterize the pace and extent of recovery after severe SARS-CoV-2 infection, the course of clinical care after a severe infection, and the risk factors associated with the severity of this condition. The study will also focus on the biological differences and social determinants that distinguish patients who recover quickly from those who develop long-term effects and symptoms, such as racial and ethnic disparities in risks and outcomes. The participant group will include people during various phases of SARS-CoV-2 infection including the acute and post-acute stages, as well as pregnant people…

Mount Sinai will also be a hub site for a tissue pathology cohort that examines the molecular profiling of COVID-19 autopsies…. Under the leadership of the late Mary Fowkes, MD, PhD, Mount Sinai conducted one of the first COVID-19 autopsies in New York State in March 2020, which revealed how the virus spreads throughout the body and altered management of COVID-19 patients at Mount Sinai and globally. The tissue pathology cohort for the RECOVER Initiative will specifically evaluate the tissues and organs of long-term symptoms in people who succumbed to COVID-19 to elucidate pathophysiologic alterations—including changes in respiratory, neurological, neuropsychiatric, and inflammation-mediated multi-organ failure states. Mount Sinai researchers have committed to at least 50 autopsies per year with a capacity to increase cases…”  (D)

April 7, 2020

“As health care experts eye the next two weeks as possible peaks for the nation’s COVID-19 hotspots, hospital systems continue to search for innovative ways to increase their capacity…

One such hospital-at-home program making inroads is Mount Sinai at Home, housed out of New York City-based Mount Sinai Health System.

Launched in 2014 as part of a three-year CMS Innovation Center grant, Mount Sinai at Home has been actively working to free up beds across Mount Sinai’s eight hospital campuses. It’s doing so by shifting certain vital services into the home for patients nearing the end of their in-patient stays.

“We began thinking about how we could use hospital-at-home to meet the needs of our hospital system in our community, in terms of responding to the crisis of COVID-19 in the context of the [Gov. Andrew Cuomo’s] state of emergency,” Al Siu, director of Mount Sinai at Home, told HHCN in mid-March. “What we have done is made various [moves] to be able to take care of a number of subsets of patients. We believe doing that will help create some hospital capacity to take care of patients who truly need our hospital beds.”

In some cases, for example, that could mean continuing IV-antibiotic treatment at home instead of in the hospital. With patients that require general monitoring, it could mean shifting daily nursing services into the home, paired with physician monitoring and select laboratory testing.

“Rather than focusing on specific diagnoses, our focus has been on specific services that we’re able to render at home — and whether those are the services that are keeping the patient in the hospital,” Siu said.”” (E)

April 4, 2021

“New Jersey-based RWJBarnabas Health Medical Group said it’s seen positive outcomes among 120 COVID-19 patients treated through its integrated care program and has expanded its effort into other facilities and younger cases…

Through a groundbreaking combination of data, technology, services and scale, PINC AITM is designed to accelerate ingenuity in healthcare.

To this end, RWJBarnabas Health launched an integrated, multidisciplinary program focused on treating persistent COVID-19 symptoms at its flagship Saint Barnabas Medical Center (SBMC) in October…

The Post-COVID CARE (Comprehensive Assessment, Recovery and Evaluation) program incorporates 17 different specialties supported by the health system, ranging from infectious diseases to neurology to behavioral health. It’s recommended for patients who are still experiencing lingering symptoms four weeks after a COVID-19 diagnosis and does not require a referral to participate.

Those enrolled in the program are guided by the process by a designated nurse navigator, who connects them to the appropriate specialist, schedules their care and corresponds with the patient and their primary care physician.

“Unlike other diseases, Post-Acute Sequelae of COVID-19 (PASC) impacts each patient differently resulting in a very individualized treatment plan,” Trespalacios, who serves as director of the program, said. “On average, each patient may have three to four specialty referrals in addition to diagnostic testing. The nurse navigator is critical to facilitating patient appointments in order to minimize treatment delays.”

Trespalacios said adopting this personalized, adaptive approach has helped the organization better tackle the wide range of issues that follow a COVID-19 infection. Among the 120 patients treated through the program to date, outcomes have varied from an improvement in symptoms or daily function to “a complete resolution of symptoms,” she said.

Also of note, she said the medical center has been logging relevant data points over time to flesh out its COVID-19 care pathways and inform future efforts. 

While RWJBarnabas Health initially took a “measured” approach to ensure it had the capacity to treat those who were enrolled, in late 2020 it decided to move forward with a pediatric version of the program that hosts the same full range of specialty services, which officially launched in February. (F)

February 11, 2022

“When we face a serious health issue that demands attention, we typically access that care beyond the confines of our home, traveling to a healthcare facility like a doctor’s office, urgent care clinic or — in especially serious situations — the hospital. 

It hasn’t always been that way. Healthcare — from birth through death — once happened in the home. Now, with a boost from technology, we may find that home once again provides more and more of our healthcare solutions.

How did we get to this place? In the Middle Ages, barbers, skilled in wielding sharp instruments like razors and scissors, diversified into a range of procedures aimed at restorative health. They practiced bloodletting and tooth-pulling, as well as surgical procedures such as bladder-stone removal and limb amputation.

Many barber-surgeons worked from shops or storefronts with red, white and blue poles. Meanwhile, “flying barbers” took their services from town to town either in the home or on the battlefield. They were the predecessor of house-call doctors or Mobile Army Surgical Hospital (MASH) units.

War is a scourge, but it’s also a profound change accelerant — especially with respect to medicine and healthcare. During the U.S. Civil War, thousands of wounded and sick soldiers prompted a proportionate medical response. Armies needed beds, bandages and surgeries at scale. The response became a giant leap forward for medical practice. Public expectations shifted, and new practices migrated from the military to the civilian sphere. Hospitals evolved and soon became a fixture in our national and global healthcare system.

Hospitals Interrupted

How permanent is the hospital’s position in modern life? In an interview with the New York Times, George Halvorson, the former CEO of Kaiser Permanente, challenged us to look beyond hospitals for better solutions to healthcare problems by “[moving] care farther and farther from the hospital setting — and even out of doctors’ offices.”

The data support this shift.

1. Hospital admissions were trending downward across all age cohorts. The length of hospital stays is shrinking for procedures like childbirth, joint replacement and cardiac surgery. 

2. In-patient services at hospitals are expensive, straining the budgets of households, employers and national economies. The average daily charge for a hospital bed is several thousand dollars. Patients can get treatments and procedures in doctors’ offices and ambulatory surgical centers for much less.

3. Hospital stays can be risky. Hospital-acquired infections and medical errors are two preventable causes of death in hospitals. While precise estimates have been subject to considerable debate, estimates of preventable hospital deaths range from as many as 100,000 to well over two times that number. While the debate continues, there is risk involved.

4. Better and cheaper alternatives to hospital care exist. A “continuum of care” supports those who need medical attention. That continuum moves from home care to residential care to acute care. Each has its role, but home healthcare typically combines the lowest cost of care with the highest quality of life.

Smart Home Equals Smart Healthcare

The pendulum is swinging back home. Whereas technology once pulled many breakthrough innovations beyond the home, it’s now enabling a virtual homecoming for those same activities. Home offices, remote classrooms and home gyms are commonplace. Hardware and software advances have been combined with ingenious design and artificial intelligence to inspire its own category: the smart home.

Many smart devices have home-healthcare applications. Amazon recently announced a new service called “Alexa Together” that targets families with aging family members who live independently and may require extra monitoring, support and emergency services. Smartwatches can detect falls and summon quick assistance.

Of course, the smartphone can monitor an impressive range of human activity, access relevant data, find information and tap expertise. Phones can also administer care through meditation apps, weight-loss programs and behavioral nudges. In an NPR interview, Dr. Eric Topol reports that a UCLA startup may even coax our smartphones to take X-rays — the ultimate selfie.

More technological advancements are coming. Advances in virtual reality platforms could allow virtual doctor visits and consultations. Plus, they may enable experiences that mimic travel, entertainment and social interaction to reduce social isolation and boost mental health.

How Will The Healthcare Establishment Respond?

The prospect of more healthcare delivered in a home setting represents a big shift in the industry. Control and power are shifting away from the medical establishment and toward the consumer of healthcare — a seismic change in the established paradigm. The patient increasingly will call the shots. How will the traditional healthcare establishments and professionals respond?

The stakes are high. Not only do patients expect better treatment and outcomes — at costs that are both transparent and affordable — but the size and inefficiencies of our healthcare system encourage competition from outside the system. Newcomers and tech firms that have demonstrated the potential of data-driven service models can apply their business models and platforms to get a piece of a multitrillion-dollar healthcare market that looks ripe for disruption.

The battle lines are forming. The winners will break through in these areas.

1. Utilization of personal health data. With the spread of activity monitors and the continuous capture of information about sleep, heart rate, blood sugar and more, the scale and scope of personal health data has jumped ahead of healthcare providers’ capacity to manage, analyze and use it. Electronic health records (EHRs) have now arrived, but patients have yet to see all the expected and promised benefits.

2. Better patient experience. For too long, dealing with the healthcare establishment has been a frustratingly slow and complex experience for patients. While other industries have harnessed digital services to streamline shopping, payment, delivery and consumption, traditional healthcare providers continue to lag.

3. Home sweet home. The continuum of care is shifting from institutional settings — the hospital in particular — to more convenient locations for patients. Home care puts less of a cost burden on resource-constrained consumers. Meanwhile, patients can enjoy the therapeutic comforts of their familiar surroundings. Who will be the first to hang out the “Welcome Home” sign?” (E)

February 3, 2022

Hackensack Meridian Health, New Jersey’s largest and most integrated health network, is pleased to announce the launch of Hospital At Home at JFK University Medical Center in Edison, a program that delivers high-quality acute care in the home of a Medicare patient and may ultimately be scalable to the larger patient population.

“Healthcare continues to expand beyond the walls of the hospital and this new program will help us advance strategies to improve outcomes and patient satisfaction while making care more affordable,” said Robert C. Garrett, FACHE, chief executive officer of Hackensack Meridian Health.

The program is created through a Medicare waiver, which permits hospitals to provide acute care at home to Medicare patients. The network will select patients based on factors that include diagnoses that often result in frequent and costly readmissions to hospitals: uncomplicated Congestive Heart Failure (CHF), pneumonia, Chronic Obstructive Pulmonary Disease (COPD) and cellulitis.

Initially the program will admit a few patients a week and provide the following services delivered in the home: two nursing visits daily; medications delivered to the home including infusions; rehab visits as needed; remote patient monitoring which includes pulse ox, blood pressure, heart rate, weight and temperature. Nutritious meals and home health support can be provided as needed.

The program was created during the COVID-19 pandemic to help hospitals struggling with bed capacity. In November 2020, the Centers for Medicare & Medicaid Services (CMS) released a waiver called the Acute Hospital Care at Home Waiver allowing for hospitals to bill for acute care services that patients receive at home.

“We are proud to offer this innovative program to our community, a new approach that is showing great promise for improving outcomes, meeting the needs of our patients and continuing our efforts to transform care,” said Amie Thornton, chief hospital executive at JFK University Medical Center.

Research shows that these programs are at least as safe as inpatient care and result in improved clinical outcomes, higher rates of patient satisfaction and reduced healthcare costs. Patients have indicated that they want to receive care at home, especially during the pandemic. According to a recent survey, 85 percent of adults say it should be a high priority for the government to expand Medicare coverage for at-home health care.

Ultimately the network plans to expand the program to other hospitals once the pilot is proven successful. Additionally, Hackensack Meridian Health believes Hospital-at-Home can be scaled significantly to include patients who are not covered by Medicare.

“This program can also provide an excellent opportunity to expand care in underserved communities where transportation may be an issue,” Mr. Garrett said. “A major strategic priority of the network is to help reduce inequality in care delivery.”” (F)

February 17, 2022

“At MGB, patients who come to the Emergency Department or who are already hospitalized with an acute illness may be offered the option of receiving hospital-level care at home if they meet certain criteria. The core HaH team for each patient includes a physician who sees the patient once a day, either by video or in the home, plus a nurse and specially trained paramedic who visit the patient at least twice a day at home to deliver the care they would receive in the hospital, such as IV medications and advanced respiratory therapies.

The authors discuss the technologies that have enhanced MGB’s hospital-level care at home and that are critical to scaling the model to accommodate a growing number of patients. The key technology domains are telemedicine, remote patient monitoring, clinical team coordination, and supply chain management.

More than half of the patients enrolled in HaH are over the age of 65 and have limited technology literacy. “It was very important to create technology systems that broke down the barriers to patients using individual technologies,” says Levine. Patients don’t need to have Internet access in their homes or own any electronic devices to enroll in HaH; the care team supplies everything the patient needs for remote visits. For example, patients receive a dedicated tablet installed with specialized software so they need only touch an icon of the physician’s face to initiate a video visit or to communicate with the home hospital team. Other technologies make it easy for patients with visual or hearing impairments to communicate with their healthcare team.

Eligible patients wear sensors that provide continuous hospital-level monitoring of their vital signs, such as a chest patch that records the heart’s activity. In the near future, sensors will be able to measure even more advanced parameters completely touchless, says Levine. And research is underway to use artificial intelligence to analyze the massive amounts of data generated from sensors. “Humans may benefit from machine algorithms to put all the information together to make predictions about the course of a patient’s illness based on physiologic measurements,” says Levine. “We believe that we are just beginning to realize the potential for technology to assist acute care at home.”” (G)

February 17, 2022

Healthcare is increasingly provided in a patient’s home, with potential cost savings and clinical improvements. But the hospital-at-home also raises unique liability issues not only for physicians and hospitals but also for caregivers and patients.

The COVID-19 pandemic has spurred hospitals to increasingly implement remote care models that replace in-patient care — from checkups to diagnosis to treatment — with services delivered in the patient’s home, known as the ‘hospital-at-home’ (HaH) (Box 1). Such patients typically move through the HaH in the same way that a patient moves through a traditional hospital: admission, monitoring, intervention, and discharge. But there are differences. Care occurs in the patient’s home, rather than in the hospital, which requires that the HaH providers use physicians, nurses, technicians, and caregivers in different ways from their use in the traditional hospital setting, such as telehealth or house visits. The HaH has potentially substantial economic and health benefits and has been associated with reduced risk of infections, increased mobility for patients, cost savings, and improved clinical outcomes1,2. Despite these potential benefits, the HaH poses several pressing legal and ethical challenges, including legal liability, that must be resolved for its safe, ethical, and effective implementation.

An HaH is defined as a care-delivery paradigm characterized by the following:

A pre-specified geographic catchment area for eligible patients that is delineated largely by travel time

An acuity and intensity of medical care needs that would otherwise warrant admission to an inpatient facility

An inability of community-based home health services to appropriately coordinate and deliver the services needed to sufficiently address the severity of illness…

A clinical vignette (Fig. 1) can be used to demonstrate and map the unique and complex liability issues likely to arise in the HaH setting, including liability for physicians, hospitals, and third-party service providers3. Some potential liability, such as liability for admission decisions or delayed response times, exists in the hospital setting but applies to the HaH in a unique way. Other potential liability, such as liability arising from dangerous conditions at the patient’s home, is unique to the HaH setting (Table 1).

The patient is a 61-year-old male, otherwise healthy, who recently initiated outpatient-based chemotherapy for a locally advanced renal cancer. The patient developed a non-productive cough and shortness of breath after a walk. The patient’s wife and primary caregiver immediately took the patient to the nearest emergency department, where the patient began to develop a fever. IV, intravenous; ICU, intensive care unit.

Under US tort law, when caring for patients, physicians must provide a certain standard of care: they must, depending on the state in which they practice, act either according to the “generally recognized and accepted practices in their profession” or as a “reasonable physician under similar circumstances” would act4,5,6. Although standards of care apply equally to HaH care (physicians and hospitals have duties to exercise reasonable care in admitting, monitoring, and treating patients), courts may apply them differently in the HaH context.

Consider a physician’s decision to admit a patient. In the traditional setting, the physician evaluates the patient’s symptoms, the capacities of the hospital, and level of care required. In the HaH context, because the care setting is at home, the physician must also account for the readiness of the home environment, caregiver availability, and other social determinants of health or factors not relevant to the hospital setting…

Device-manufacturer liability…

Intentional and unintentional harms…

Risk of discrimination…

Guidelines and training…

HaH programs hold great promise but also present novel liability concerns. Decisions about admission to the HaH invite a unique set of considerations that go beyond the appropriateness of hospital-level acuity to include home safety, logistics, technological limitations, and cultural considerations, as well as potential liability for caregivers and for patients themselves. Professional societies and hospital associations should proactively establish practice guidelines and training curricula for the HaH to enhance its implementation and scalability, and to reduce liability risks.” (H)

Undated

“MOUNT SINAI Center for Post-COVID Care

It was initially thought that patients with COVID-19 fell into two groups: those who experience severe symptoms and require hospitalization; and those who have mild flu-like symptoms and recover within a couple of weeks. We now know that there is an important third group: people who begin to recover from COVID-19 but continue to experience heart issues, shortness of breath, fatigue, or cognitive difficulties—often for weeks or months…

Recovering from COVID-19 is Different for Every Patient

COVID-19 affects every patient differently, so your treatment needs to be personalized to you. While the long-term effects of the virus are not clear yet, we do know that it can affect many different systems within the body, from the lungs to the heart to the kidneys. That is why we offer our patients coordinated care from a broad range of medical specialties and support services. We understand that the road to recovery may be concerning, and may require multiple specialists, appointments, and procedures. We are here for you, and you are not alone in this journey. We will take care of scheduling and work with you to develop an individualized treatment plan including experts in: Primary care; Pulmonary medicine; Cardiology; Infectious diseases; Nephrology; Psychiatry; Physical and occupational therapy; Radiology; Neurology; Neuropsychiatry; Behavioral health; Social work; Pharmacy.” (I)

(A)Inside Mount Sinai’s Hospital-at-Home Program, by Albert Siu and Linda V. DeCherrie, https://hbr.org/2019/05/inside-mount-sinais-hospital-at-home-program

(B) Mount Sinai at Home, Other Hospital-at-Home Models Proving Value Amid National Emergency, By Robert Holly, https://homehealthcarenews.com/2020/04/mount-sinai-at-home-other-hospital-at-home-models-proving-value-amid-national-emergency/

(C)Mount Sinai launches post-COVID-19 care center for ongoing treatments, research, By Tina Reed, https://www.fiercehealthcare.com/hospitals-health-systems/mount-sinai-launches-post-covid-care-center-for-ongoing-treatments

(D) Mount Sinai Named a Lead Site for Enrollment in Nationwide Study on the Long-Term Effects of COVID-19, https://www.mountsinai.org/about/newsroom/2021/mount-sinai-named-a-lead-site-for-enrollment-in-nationwide-study-on-the-long-term-effects-of-covid-19

(D) Cross-specialty care program helps RWJBarnabas Health treat lingering COVID-19 symptoms, By Dave Muoio, https://www.fiercehealthcare.com/hospitals/cross-specialty-care-program-helps-rwjbarnabas-health-treat-lingering-covid-19-symptoms

(E) Pandemic pushes expansion of ‘hospital-at-home’ treatment, By LINDA A. JOHNSON, https://www.seattletimes.com/business/pandemic-pushes-expansion-of-hospital-at-home-treatment/

(F)Pilot program offers acute care treatment at home for Medicare patients, https://www.prnewswire.com/news-releases/hackensack-meridian-health-launches-hospital-at-home-at-jfk-university-medical-center-one-of-first-programs-in-nj-301475258.html

(G) For successful hospital-at-home programs, crucial technologies are within reach,by Massachusetts General Hospital, https://medicalxpress.com/news/2022-02-successful-hospital-at-home-crucial-technologies.html

(H) The hospital-at-home presents novel liabilities for physicians, hospitals, caregivers, and patients, David A. Simon, I. Glenn Cohen, Celynne Balatbat & Anaeze C. Offodile II,  https://www.nature.com/articles/s41591-022-01697-3

(I) Center for Post-COVID Care, https://www.mountsinai.org/about/covid19/information-resources/center-post-covid-care