Introduction—Medicine’s future: Helping patients stay healthy at home

Home-based care will undoubtedly play an increasingly important role in the health care system as the United States seeks ways to provide cost-effective and compassionate care to a growing population of older adults with chronic illness. “Home health care,” a term that refers more specifically to visiting nurses, therapists, and related services, is currently the prominent home care model in this country.

Home health services were developed around the start of the 20th century to address the unmet health and social needs of vulnerable populations living in the shadows. Today, there are more than 10,000 home health agencies and visiting nurse organizations across the country that care for millions of homebound patients each year. With the onset of health reform and the increasing focus on value and “accountability,” there are many opportunities and challenges for home health providers and the physicians, hospitals, and facilities they work with to try to find the best ways to keep patients healthy at home and drive value for society.

There is a paucity of medical and health services literature to guide providers and policymakers’ decisions about the right types and approaches to care at home. Maybe this is because academic centers and American medicine became so focused on acute institutional care in the past half century that the home has been overlooked. However, that pendulum is likely swinging back as almost every sober analysis of our current health care environment suggests a need for better care for the chronically ill at home and in the community. It is important that research and academic enterprises emphasize scholarly efforts to understand and improve home and community care so that the anticipated shift in care to home is informed by the best possible evidence, ultimately ensuring that patients get the best possible care.

The articles in this online, CME-certified Cleveland Clinic Journal of Medicine supplement address contemporary topics in home health and other home-based care concepts. The authors have diverse backgrounds and discuss issues related to technology, palliative care, care transitions, heart failure, knee replacement, primary care, and health reform. Several articles share concepts and outcomes from innovative approaches being developed throughout the country to help patients succeed at home, especially when returning home from a hospitalization.

The articles should improve readers’ understanding of a wide range of initiatives and ideas for how home health and home care might look in the future delivery system. The authors also raise numerous yet-unanswered questions and opportunities for future study. The needs for further home care research from clinical, public health, and policy perspectives are evident. Health care is going home, and this transformation will be enhanced and possibly accelerated by thoughtful research and synthesis.

I am incredibly thankful to my fellow authors, and hope that we have produced a useful supplement that will help readers in their efforts to assist the most vulnerable patients and families in their efforts to remain independent at home.

Home-based care will undoubtedly play an increasingly important role in the health care system as the United States seeks ways to provide cost-effective and compassionate care to a growing population of older adults with chronic illness. “Home health care,” a term that refers more specifically to visiting nurses, therapists, and related services, is currently the prominent home care model in this country.

Home health services were developed around the start of the 20th century to address the unmet health and social needs of vulnerable populations living in the shadows. Today, there are more than 10,000 home health agencies and visiting nurse organizations across the country that care for millions of homebound patients each year. With the onset of health reform and the increasing focus on value and “accountability,” there are many opportunities and challenges for home health providers and the physicians, hospitals, and facilities they work with to try to find the best ways to keep patients healthy at home and drive value for society.

There is a paucity of medical and health services literature to guide providers and policymakers’ decisions about the right types and approaches to care at home. Maybe this is because academic centers and American medicine became so focused on acute institutional care in the past half century that the home has been overlooked. However, that pendulum is likely swinging back as almost every sober analysis of our current health care environment suggests a need for better care for the chronically ill at home and in the community. It is important that research and academic enterprises emphasize scholarly efforts to understand and improve home and community care so that the anticipated shift in care to home is informed by the best possible evidence, ultimately ensuring that patients get the best possible care.

The articles in this online, CME-certified Cleveland Clinic Journal of Medicine supplement address contemporary topics in home health and other home-based care concepts. The authors have diverse backgrounds and discuss issues related to technology, palliative care, care transitions, heart failure, knee replacement, primary care, and health reform. Several articles share concepts and outcomes from innovative approaches being developed throughout the country to help patients succeed at home, especially when returning home from a hospitalization.

The articles should improve readers’ understanding of a wide range of initiatives and ideas for how home health and home care might look in the future delivery system. The authors also raise numerous yet-unanswered questions and opportunities for future study. The needs for further home care research from clinical, public health, and policy perspectives are evident. Health care is going home, and this transformation will be enhanced and possibly accelerated by thoughtful research and synthesis.

I am incredibly thankful to my fellow authors, and hope that we have produced a useful supplement that will help readers in their efforts to assist the most vulnerable patients and families in their efforts to remain independent at home.

Home-based care will undoubtedly play an increasingly important role in the health care system as the United States seeks ways to provide cost-effective and compassionate care to a growing population of older adults with chronic illness. “Home health care,” a term that refers more specifically to visiting nurses, therapists, and related services, is currently the prominent home care model in this country.

Home health services were developed around the start of the 20th century to address the unmet health and social needs of vulnerable populations living in the shadows. Today, there are more than 10,000 home health agencies and visiting nurse organizations across the country that care for millions of homebound patients each year. With the onset of health reform and the increasing focus on value and “accountability,” there are many opportunities and challenges for home health providers and the physicians, hospitals, and facilities they work with to try to find the best ways to keep patients healthy at home and drive value for society.

There is a paucity of medical and health services literature to guide providers and policymakers’ decisions about the right types and approaches to care at home. Maybe this is because academic centers and American medicine became so focused on acute institutional care in the past half century that the home has been overlooked. However, that pendulum is likely swinging back as almost every sober analysis of our current health care environment suggests a need for better care for the chronically ill at home and in the community. It is important that research and academic enterprises emphasize scholarly efforts to understand and improve home and community care so that the anticipated shift in care to home is informed by the best possible evidence, ultimately ensuring that patients get the best possible care.

The articles in this online, CME-certified Cleveland Clinic Journal of Medicine supplement address contemporary topics in home health and other home-based care concepts. The authors have diverse backgrounds and discuss issues related to technology, palliative care, care transitions, heart failure, knee replacement, primary care, and health reform. Several articles share concepts and outcomes from innovative approaches being developed throughout the country to help patients succeed at home, especially when returning home from a hospitalization.

The articles should improve readers’ understanding of a wide range of initiatives and ideas for how home health and home care might look in the future delivery system. The authors also raise numerous yet-unanswered questions and opportunities for future study. The needs for further home care research from clinical, public health, and policy perspectives are evident. Health care is going home, and this transformation will be enhanced and possibly accelerated by thoughtful research and synthesis.

I am incredibly thankful to my fellow authors, and hope that we have produced a useful supplement that will help readers in their efforts to assist the most vulnerable patients and families in their efforts to remain independent at home.