TDP 137: Advocate's Strategy Advisor, Colleen Hole: Deep Dive on Hospital at Home: Navigating Regulatory Challenges, Dealing with Misaligned Incentives, and Improving Patient, Caregiver, and Clinician Wellbeing

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On this episode of The Digital Patient, Dr. Joshua Liu, Co-founder & CEO of SeamlessMD, and marketing colleague, Alan Sardana, chat with Colleen Hole, Strategy Advisor for Innovation and Commercialization at Advocate Health, about "Hospital at Home: Navigating Regulatory Challenges, Dealing with
Misaligned Incentives, Improving Patient, Caregiver, and Clinician Wellbeing, and more..." Click the play button to listen or read the show notes below.
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Audio:

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Video:

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Guest(s):

• Colleen Hole, Strategy Advisor for Innovation and Commercialization at Advocate Health
• Dr. Joshua Liu (@joshuapliu), Co-founder & CEO at SeamlessMD

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‍Episode 137 - Show Notes:

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[00:00:22] Introduction to Ms. Colleen Hole, Strategy Advisor for Innovation and Commercialization at Advocate Health, discussing her impactful career centered on patient care, quality, and healthcare policy;

[00:00:47] Ms. Hole's unexpected journey into nursing influenced by a desire to be in a helping profession, sparked by an episode of General Hospital;

[00:02:09] Early disillusionment with the task-oriented nature of nursing and the evolution into leadership roles where she could influence holistic patient care;

[00:03:22] Transition into population health, embracing value-based care and the triple/quadruple aim to improve healthcare outcomes and cost-efficiency;

[00:04:35] Leadership in advanced care planning and patient autonomy at Atrium Health, focusing on empowering patients and shifting away from a paternalistic healthcare system;

[00:07:15] The evolution of technology in nursing from manual practices to sophisticated systems enhancing patient safety and care visibility;

[00:08:40] Reflections on the shift from institutionalized to more personalized, home-based care, integrating technology with patient-centered approaches;

[00:09:27] Discussion on the changing perception of clinical professions and the importance of maintaining a connection to the passion for helping others despite systemic challenges;

[00:11:11] Implementation and challenges of the Hospital at Home program at Atrium Health, expanding care delivery beyond traditional hospital settings;

[00:13:03] Addressing workforce challenges and the evolution of healthcare roles, enhancing the capacity to deliver care amidst growing demand;

[00:15:19] The potential for Hospital at Home to scale and transform how acute care is delivered, reducing hospital dependency and addressing capacity issues;

[00:19:07] Future aspirations for Hospital at Home, including potential expansion and integration into broader healthcare delivery models;

[00:20:32] Various entry points to the Hospital at Home program, from emergency department direct admissions to transitions from inpatient care;

[00:22:29] Discussion on the evolving payment models and the need for alignment with comprehensive, patient-centered home care services;

[00:24:27] The role of community partnerships in supporting home-based care and addressing social determinants of health effectively;

[00:29:06] The struggle with securing sustainable funding for innovative care models and advocating for governmental payer coverage;

[00:31:32] The internal challenges within hospitals, including misaligned incentives for transferring stable patients to home care settings;

[00:33:06] Navigating regulatory and compliance uncertainties in home-based care, especially around defining care standards and patient eligibility;

[00:34:19] How the Hospital at Home model impacts hospital readmission rates and quality metrics, providing benefits to traditional hospital settings;

[00:35:40] Emphasizing the need for continuous engagement and advocacy to integrate Hospital at Home into standard care practices;

[00:38:25] Ms. Hole highlights the significant impact of Hospital at Home on patient and family well-being, especially in terms of reducing caregiver burden and improving the patient experience in familiar environments;

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Fast 5 Lightning Round:‍

1. Favorite Book: "Seven Habits of Highly Effective People" by Stephen Covey — a transformative read that shaped her views on living well.
2. Person to Meet: A 13-generations-back ancestor who migrated from Wales in the 1600s — curious about his motivations and experiences.
3. Preferred Superpower: Super strength, encompassing physical, mental, emotional, and spiritual resilience.
4. Healthcare Belief: The profound impact of human caring on health outcomes, emphasizing the importance of personal connection in healthcare.
5. Time Travel Wish: To 1939, to witness her grandmother’s resilience during the home birth of her father in rural West Virginia, inspiring her commitment to home-based care.