Hospital at Home-hot topic

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We are starting a HaH program, I know that several sites were starting this program last year and wanted to see how it was going for everyone. We are expected to go live end of May and I have only known about it for 2 weeks! Here are my questions, would love to hear from those who have HaH at your system.

Did you get a new CLIA or add to your hospital CLIA-?-test menu is for moderate and waived POC
What is your POC test menu?
Did you interface your devices and have them download at the end of the day or manually enter results into EMR? (glucose/iSTAT)
What is the best cooler/temp monitoring system? What do you do if out of range?
Do your HaH staff come to the hospital to get supplies or do they work out of another site where they keep insturments/reagents
Anyone in NC willing to share info/experience with others at our hospital--pharmacy/IT

Thanks
Kim

2 Replies

Christina Schleich

Mon Mar 03, 2025 at 11:37AM

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:

Did you get a new CLIA or add to your hospital CLIA-?-test menu is for moderate and waived POC - The test menu is falling under the main lab CLIA, we were unaware that it would have been possible for them to get their own CLIA (I highly recommend this option for you)

What is your POC test menu? We offer Rapid Strep A Antigen, Rapid Flu A/B, Rapid Covid Antigen, INR, glucometer, urine HCG, and ePOC Chemistry with H/H (no blood gas and lactate allowed)

Did you interface your devices and have them download at the end of the day or manually enter results into EMR? (glucose/iSTAT) Everything is manually entered via a third party Command Center

What is the best cooler/temp monitoring system? What do you do if out of range? This topic has been the biggest challenge yet. We decided to use GoVee wireless temp/humidity monitors but it is not an ideal setup. We also got specially made room temperature phase material gel packs to be used inside Igloo soft sided coolers. We did a bunch of validation studies to prove this system would work if utilized correctly. We have the GoVee app loaded to all the RN's cell phones (and mine as well) which will alarm them when the temperature of the bag they are using starts to drop out of range. If temp falls out of range, they are required to cease all POC testing until QC can be performed on all the platforms and devices in their bag. It has happened about 6 times since the new year. If testing is needed before we determine the reagents in the bag are ok to be used, they are to draw blood/urine to be sent to the main hospital lab for testing. Every night at midnight, the temp logs for each device are emailed to me for my review. At the end of each month, I compile all those temperatures into a spreadsheet and document any corrective action that was done, QC that was performed, etc.

Do your HaH staff come to the hospital to get supplies or do they work out of another site where they keep insturments/reagents - All the supplies and devices come from the hospital. The program has its own office area inside the hospital where the RNs are dispatched from.

Anyone in NC willing to share info/experience with others at our hospital--pharmacy/IT

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.

Kim Ballister

Mon Mar 03, 2025 at 3:49PM

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?

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