Hospital at Home-hot topic

Hi Kim,  my site went live in April 2024 with the H@H program, went live with POC testing for it in December.  We were also blind sided by its inception and rushed to get it compliant ASAP.   I will answer the best I can speaking to my experience:

Feel free to message me with any other additional questions.  It is not an easy thing to bring POC testing into the patient's home!  These types of hospital from home programs do not seem to understand the rules and regulations all this testing requires from a laboratory perspective.  However, we did not allow the program to start using any POC testing until we deemed it ready.  The program was operating for 8 months before we allowed POC testing to go live.  

Thanks Christina. Looks like they will be under the main lab CLIA, and have asked for iSTAT Chem 8 and CG4, but we only have lactic acid active on that cartridge.  I think it is a great program for the patient, just trying to figure out how to manage with CAP regs!!  Temp control seems to be one of the biggest issues people face, was there another product you liked better than the GoVee?

We have this program and we added the location for our hospital main lab CLIA. Originally, they had Nova Glucometer, Coaguchek INR, ISTAT Chem 8 and ISTAT CG4.  Due to low or no usage at all, we have since removed Coaguchek and ISTAT CG4 from their testing abilities.  Nova and ISTAT are interfaced and they upload results when docked at their hospital location.  Their lab supplies are stored within our lab.  We take the temperature every day in the lab area and working on potentially implementing a temp process for when out on calls, but struggling with when it is appropriate to take.  Going to investigate the GoVee that Christina mentions above!

Miranda - how do you deal with the interfacing of the results from Nova and ISTAT if it can only upload to patient chart once back in the hospital setting?  We needed to turn off auto upload and require results to be manually entered while out in the field so that the physicians are aware of the values and can make decisions in real-time. 

Kim- I did not research any other temperature devices other than GoVee at this point in time.  We were very limited with the time we had prior to go-live.  GoVee was already in use for our trauma flight team so that is why were able to purchase them quickly.  I would have rather preferred a web-based software that can be accessed anywhere and uploaded whenever connected to a hotspot, rather than an app-based software.

Our push is to be up by end of May, we will start with waived testing only with enter/edit into Epic.  We have encountered the question about iSTAT,  They want to manually enter chem 8 results and not then have results chart again at the end of the day. Results would hold in RALS and we would have to do audits to check manual enter/edit into Epic--not ideal.  How is everyone else managing results?

Our Hospital At Home team is fine with the results uploading to Epic when they come back to the home base and dock them.  They have never asked for manual result entry and I don't think we would ever approve that anyway due to clerical error, applying the right CLIA, reference/age/gender ranges in Enter/Edit.  That function is a total nightmare and not user friendly at least for us.