advanced care at home podcast episode

Podcast: Creating a better patient experience with advanced care at home


Vivian Reyes, MD, and Margaret Paulson, DO, share how home-based acute-level care programs can improve patient outcomes


Emerging from the COVID-19 pandemic, advanced care-at-home programs have evolved into a promising option for bringing acute-level care directly to patients’ homes — with the potential to be more cost-effective if scaled appropriately. Key to the success of in-home care programs is matching, or even improving on, the quality of care patients receive in hospital settings.

In 2021, Kaiser Permanente and Mayo Clinic jointly invested in a Boston-based medical device company to provide some of the technology that makes care at home possible. The organizations also co-founded the Advanced Care at Home Coalition to support advancement of these programs with regulators, policymakers, and throughout the industry.

This episode of the Permanente Medicine Podcast brings together 2 physicians experts on advanced care at home from Kaiser Permanente and Mayo Clinic to speak with host Chris Grant, chief operating officer of The Permanente Federation, about how these programs are growing and what the future has in store.

  • Vivian Reyes, MD, is regional medical director of Strategic Hospital Initiatives for The Permanente Medical Group in Northern California. Dr. Reyes also serves as the national physician leader for the Kaiser Permanente Care at Home program, which strives to bring acute-level care services to the patient’s home.
  • Margaret Paulson, DO, serves as medical director for Advanced Care at Home and Home Health with Mayo Clinic. She is also a rural hospitalist and teaches as an assistant professor of medicine at the Mayo Clinic School of Medicine.

We face the same mandate to prevent death from firearm violence that we face to prevent death from cancer or heart disease. If it kills people, it’s a health problem.

— Vivian Reyes, MD

We’re in their homes, we’re at their bedsides, we’re getting this glimpse into their lives that as a hospitalist in a traditional hospital, I wouldn’t ordinarily receive.

— Margaret Paulson, DO

Drs. Reyes and Paulson share what advanced care looks like in practice and how it has evolved since the start of the COVID-19 pandemic. They also discuss bridging disparities in health care and how remote care and home visits can help address social determinants of health. Innovation in advanced care at home provides care teams a glimpse into the lives of patients and treat individuals more holistically.

Related story: “Stephen Parodi, MD, shares lessons on building advanced care at home programs

In this episode

2:35 Evolution of advanced care at home and current work in the space

4:24 What advanced care at home looks like for Kaiser Permanente members

6:47 The Mayo Clinic story for advanced care at home

9:19 Mission of Advanced Care at Home Coalition and advocacy efforts

11:36 Building quality framework and testing new programs for advanced care

12:58 Advancing health equity and bridging disparities in health care

15:48 Improving access to care for rural communities

16:47 Key learnings from Mayo Clinic’s hospital at home experience

18:55 How advanced care transformed during the COVID-19 pandemic

23:21 The future of advanced care at home

24:22 Using AI to create efficiencies for advanced care-at-home programs

26:10 Offering more robust advanced care-at-home services

Connect with Chris Grant on Twitter at @cmgrant, Dr. Reyes at @VivanMReyes, and Dr. Paulson at @DrMPaulson.

Program notes

Follow us: Subscribe to the Permanente Medicine Podcast on your favorite streaming platform.