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Safer@Home is a new virtual, acute care model developed at the Los Angeles General Medical Center. In this virtual care model, patients who are acutely ill and would normally be hospitalized are instead sent home with remote vital sign monitoring and daily virtual check-ins with a hospital-based care team.

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​​​​​​This model was developed initially for COVID, and enabled us to care for more than 4,000 patients with COVID pneumonia who required oxygen at home instead of in hospital.

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We subsequently expanded the model to a variety of other acute illnesses.

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We have demonstrated that patients cared for in Safer@Home spent an average of 4 fewer days in hospital per patient, with no out-of-hospital deaths, and no significant change in 30 day hospital readmissions, but fewer 30 day Emergency Department revisits.

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Safer@Home derives from advances in medical care:

1. We now know that oral antibiotics are as effective as IV antibiotics as long as the patient is hemodynamically stable and the intestine is likely to absorb the antibiotic;

2. Remote vital sign monitoring is now possible with advances in durable medical equipment (DME).

3. We have also shown that acutely required nasal canula oxygen can be safely delivered at home rather than in hospital, and there is no evidence that IV diuresis is more effective than oral diuresis for heart failure at measurable clinical endpoints.

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The peer review publications (including the supplemental content) provide detailed descriptions of program implementation, including patient selection criteria, medication/treatment protocols, daily nurse and physician scripts, durable medical equipment use, and follow-up criteria.

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The economics of the program have been studied and that work is in development for publication (coming soon!).

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We have had considerable interest from health systems in learning more about how to implement the program. Contact us for more information; bspellberg@dhs.lacounty.gov.