Expert discusses feasibility of at-home inpatient urologic care

In this video, Timothy D. Lyon, MD, discusses the Urology Practice paper “Initial Experience With Inpatient Hospital Care at Home for Urologic Disease.” He was speaking at the 2025 Desai Sethi Urology Institute Urology on the Beach meeting. Lyon is an associate professor of urology and Urology Residency Program Director at Mayo Clinic in Jacksonville, Florida.

Transcription:

Please provide an overview of this study and its notable findings.

In this paper, we looked at urologic patients who were admitted to Mayo Clinic's Advanced Care at Home program. This is a hospital-at-home program where we provide care for hospitalized inpatients in their home. It's done with several services. We have a technology bundle that's brought to the patient's house that provides secure internet access, provides an iPad-like device where they can have daily video rounds with their physicians, as well as as-needed contact with their health care team. And we provide an array of services through home care nurses, things like phlebotomy, IV infusion therapy, skilled nursing, and we can do basic radiography, things like X rays and ultrasounds. To date, we've cared for more than 3000 patients in this program across our site since it started in 2020, but the majority of them have been people with medical diagnoses. So the objective of this paper was to look at, who have we treated with urological problems? What do they look like, and are there any opportunities to expand what we offer in the program in the future? So when we looked at our experience, we identified 54 patients in the Advanced Care at Home program with urological diagnoses. They ranged in age from late 40s all the way up to 92. The vast majority of patients, 95%, had GU infections, things like pyelonephritis, requiring IV antibiotics. The other 5% had other problems after urological surgery; for instance, diverticulitis, congestive heart failure, needing a few days of diuresis. Average length of stay in the program was 3 days. Overall, we saved 216 brick-and-mortar hospital days by caring for these patients at home, and the rate of readmission within 30 days was 16%, so we concluded that it appears very feasible to treat patients with genitourinary infections in this program. It's perfect for the patient that gets admitted with pyelonephritis, say, after cystectomy or a kidney stone procedure, doesn't need any surgical intervention in terms of a drain or stent and just otherwise would be in the hospital for 2 or 3 days on IV antibiotics, waiting for their cultures to result. So this allows them to go home in a place that they're more comfortable. But it really remains to be seen whether we can expand this to care for other types of urological inpatients. We do have the capability to offer nasogastric suction. And so our next step is to think about, are there other types of patients who we could identify who may be able to go home, say, a day or 2 early than they otherwise normally would, and continue to convalesce in the program before hospital discharge?

This transcription was AI generated and edited by human editors for clarity.