Phyllis Petruzzelli spent the week before Christmas struggling to breathe. When she went to the emergency department on Dec. 26, the doctor at Brigham and Women's Faulkner Hospital near her home in Boston's Jamaica Plain neighborhood said she had pneumonia and needed hospitalization. Then the doctor proposed something that made Petruzzelli nervous. Instead of being admitted to the hospital, she could go back home and let the hospital come to her.
As a "hospital-at-home" patient, Petruzzelli, 71, learned doctors and nurses would come to her home twice a day and perform any needed tests or bloodwork.
A wireless patch a little bigger than her index finger would be affixed to her skin to track her vital signs and send a steady stream of data to the hospital. If she had any questions, she could talk face-to-face via video chat anytime with a nurse or doctor at the hospital.
Hospitals are germy and noisy places, putting acutely ill, frail patients at risk for infection, sleeplessness and delirium, among other problems. "Your resistance is low," the doctor told her. "If you come to the hospital, you don't know what might happen. You're a perfect candidate for this."
So Petruzzelli agreed. That afternoon, she arrived home in a hospital vehicle. A doctor and nurse were waiting at the front door. She settled on the couch in the living room, with her husband, Augie, and dog, Max, nearby. The doctor and nurse checked her IV, attached the monitoring patch to her chest and left.
When Dr. David Levine arrived the next morning, he asked why she'd been walking around during the night. Far from feeling uncomfortable that her nocturnal trips to the bathroom were being monitored, "I felt very safe and secure," Petruzzelli said. "What if I fell while my husband was out getting me food? They'd know."
After three uneventful days, she was "discharged" from her home hospital stay, and the equipment removed from her home. "I'd do it again in a heartbeat," Petruzzelli said.
Brigham Health in Boston is one of a slowly growing number of health systems that encourage selected acutely ill emergency department patients who are stable and don't need intensive, round-the-clock care to opt for hospital-level care at home.
In the couple of years since Brigham and Women's Hospital started testing this type of care, hospital staff who were initially skeptical have generally embraced it, said Levine.
"They very quickly realize that this is really what patients want, and it's really good care," he said.