MetroHealth System patients with sickle cell disease are now able to receive treatment at home.
The home treatment program's first sickle cell patient, 26-year-old Cleveland resident Mahogany Hogan, started at-home care last month. She said this approach makes a real difference in her life.
"It's from the comfort of your home," she said. "I don't think anything can be better than that. Most people don't like hospitals. I, for one, don't like hospitals at all and I've been in the hospital my entire life. The fact that I could do it at home makes it better treatment-wise."
The sickle cell program follows other home treatment programs begun after the onset of the COVID-19 pandemic, in an effort to treat those infected without the additional risk of bringing them to the hospital, said Jasmine Showell, a MetroHealth nurse manager. Previous home treatment programs focused on less serious or urgent conditions, such as chronic obstructive pulmonary disease, or COPD.
Under this program, patients receive daily virtual visits from their doctor and the virtual care nursing team, and two in-person visits from a registered nurse.
Patients are chosen for the program based on three criteria: their medical diagnosis, location and housing status, said Dr. Parth Saraiya, medical director for Hospital at Home. He added MetroHealth wants to ensure a patient's condition can be properly managed at home, that they are located within Cuyahoga County and that they have stable, safe housing for doctors and nurses to visit.
He said the program is meant to ease the trauma of the pain associated with the disease.
"Having dealt with a lot of patients who are in the hospital for very lengthy periods of times, to deal with sickle cell crisis, it can both be individually, medically traumatic, having the condition itself, but also socially traumatic," Saraiya said, adding at-home care "really does impact the kind of quality of life, well-being aspect of their care."
At-home care also allows care providers to head off any problems related to pain, he said.
"We prevent a lot of complications that we might see in the hospital from things like delirium or additional infections," Saraiya said.
Treating patients at home also allows doctors and nurses to observe any other potential health problems, Showell noted.
"If there are any social determinants of health, factors that we see in the home, we're able to intervene, make the appropriate interventions, connect them with the appropriate resources, so it's really the definition of holistic care," she said.
She added that there are no additional costs to patients for at-home care than regular in-patient treatment.
Sickle cell disease is a group of inherited red blood cell disorders that affect hemoglobin, the protein that carries oxygen through the body. In sickle cell disease, red blood cells become crescent, or “sickle”-shaped, due to a genetic mutation.
These sickled red blood cells do not bend or move easily and can block blood flow to the rest of the body. The blocked blood flow can lead to serious problems, including stroke, eye problems, infections and episodes of pain called pain crises.
According to the National Heart, Lung and Blood Institute, sickle cell affects more than 100,000 people in the United States, many of whom are of African ancestry or identify themselves as Black. MetroHealth treats approximately 600 cases of adult and pediatric sickle cell disease and those patients are among the most frequent visitors to the hospital's emergency department, mainly for pain management.
