Hopkins/Dome on line for growth in home care

ONE on one

September 17, 1990

One on One is a weekly feature offering excerpts of interviews D conducted by The Evening Sun with newsworthy business 6 leaders. Irwin P. Bloom is the President and Chief Executive = Officer of the Dome Management Services Inc, a subsidiary of = the Dome Corp., a for-profit company owned by The Johns 8 Hopkins University and Health System.

& Q. In your new role as president and chief executive of Dome Management Services, Inc., you will be coordinating the new agencies called Johns Hopkins Home Care Inc. and Johns Hopkins Home Care Alternatives. What are the roles of these agencies?

A. In this coordination, there is actually a third company called MedCare Health Resources. And what we've decided to do is to develop this integrated network of Home Health Services. Hopkins Home Care and Hopkins Home Care Alternatives are the two companies in which we provide professional hands-on care, predominantly with registered nurses. We have some LPNs [licensed practical nurses] and some homemakers, but that is predominantly the hands-on care professionals. MedCare is what is known as an infusion therapy company, meaning that they provide products, the medication, the equipment that is used as a vehicle to administer the medications. And therefore we have the nurses from Hopkins Home Care going into the home and setting the patient up on the equipment, educating the patient and administering medications as necessary. ... Now, MedCare is a subsidiary of Dome and the two health agencies are subsidiaries of the health system. Our attitudes at this point in time are that we want the health care system to provide the hands-on care; MedCare will provide the other products and the equipment and other services, such as respiratory therapy, wherein you're going in and providing certain patients with oxygen. Those kinds of services.

Q.Is this a formalization of services that had already been offered by Johns Hopkins or is this a completely new endeavor for the hospital and Dome Corp.?

A.Actually, it's not a new endeavor. Johns Hopkins Hospital has had a home care department for a number of years and because of the growing demand for home care services, the home care department within the hospital was experiencing tremendous increases in volume. We've gone from approximately 5,000 visits a year when the home care was a department in Hopkins to approximately 40,000 a year now, as two subsidiaries of the health system. Those are visits per year. Now in 1987, the Dome Corp. formed the joint venture with a subsidiary of Baxter Corp. which goes by the name of CareMark. CareMark is what is known as an infusion therapy company. And in the first couple of years that was a joint venture in which MedCare represented CareMark in the Maryland area. We have since broken off that joint venture and MedCare is operating solely on its own. Therefore we had an infusion therapy company up and running and we've had a home care agency-type department within the hospital and because of where home care is headed in the future, we thought the best thing to do was to take the home care out of the hospital as a subsidiary of the health system, take the MedCare subsidiary of Dome and create this new network in which we are completely full service home health care organization.

Q.Now my understanding of home care is that actual sophisticated hospital equipment is brought into the home setting in a lot of instances and they are given the type of care which had been in the past given in hospitals. Could you tell me if this is an accurate description of home care and also can you tell me why are more people getting this type of care now rather than getting the care in the hospital?

A.Yes, I think that you've characterized this development correctly and as a matter of fact, I would think that in five to 10 years we'll find certain types of care being provided to the patient in the home setting that we today think it's impossible to do unless you're in a hospital. We are using sophisticated equipment in the home. These are patients in which the attending physicians feel will benefit from this type of care in the home setting. I think it's a natural pressure to want to discharge the patient from the hospital because of the cost of care in a hospital compared to the home setting. Therefore, I think that's been part of the pressure to develop the whole industry in home care and bring new technology into providing care in the home. As well as, I think there is a certain quality of living ... if I were ill, I'd rather be at home if I could be, taken care of at home.

Q.How great is the cost pressure for home care vs. the psychological desirability of being at home?

A.I think the cost pressure is the major force behind efforts to discharge the patient earlier and earlier during their stay at the hospital. There are other types of arenas, such as a nursing home, extended care facilities, chronic care.

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