TAYLORSVILLE — Imagine coping with a new cancer diagnosis, and then a pandemic hits.
That’s what Kym Gallegos confronted early this year after she learned in January she has a rare form of ovarian cancer and then underwent surgery and chemotherapy.
The Magna mother of three then faced a long recovery even as COVID-19 continued spreading throughout Utah, posing the most danger to those with underlying conditions.
“And it’s doing better, but it’s really hard on family. It’s very hard on me,” Gallegos said of her condition.
While she’s healing physically, she said, the recovery time spent inside has taken a mental toll.
But Gallegos says she hasn’t been without help.
When Huntsman Cancer Institute providers launched a trial program in 2018 to deliver clinical-level care to patients’ homes, they couldn’t have guessed just how vital the program would become for patients in 2020.
Ever since the COVID-19 outbreak hit the U.S., “everybody’s scrambling, switching to telehealth, trying to keep cancer patients out of the emergency department. They’re frail, they’re immunosuppressed,” explained Kathi Mooney, interim senior director of population sciences at the institute and distinguished professor of nursing at the University of Utah.
“Or even coming into the cancer hospital — the more that we can keep patients at home at this time, the better for them. And so to have a program like this that in fact can decrease the need for emergency department visits or hospitalizations . . . to have this extra layer of support for patients is perfect for this particular time, and particularly for cancer patients who are vulnerable.”
The Huntsman at Home program is available to those who live within a 20-mile radius of the institute. The first of its kind specifically for cancer patients in the U.S., the institute started the program to test whether the most ill patients — some recovering from chemotherapy, and others needing hospice care — could avoid emergency room visits and unplanned hospital stays.
Often, patients with cancer become extremely ill and are left to decide if and when to visit the emergency department and end up waiting for their symptoms get “out of control” before going in, Mooney said. For example, it’s common for those recovering from chemotherapy to become dehydrated and require IVs. Many times, they need hospitalization because there isn’t adequate care in their communities for them.
Through the Huntsman at Home program, nurse practitioners and registered nurses with palliative care and oncology expertise regularly make home visits to patients to monitor their symptoms and help them manage their illnesses.
“If you can stay up on top of things, cancer patients at home have a lot of fluctuating symptoms. They can be doing well and then they have problems that they become quite ill,” Mooney said.
“If there’s sort of a support for them at home, and we keep the symptoms at a minimal level and we’re checking on them to make sure that they’re continuing to do OK . . . then it doesn’t get to the point that they’ve been vomiting, they’re dehydrated,” Mooney said.
Most insurance companies reimburse for a very limited number of home visits, according to Mooney. Visits through Huntsman at Care program have been covered by the institute in hopes of demonstrating to insurance companies that such programs can save them money by preventing prolonged hospital stays.
During the first 30 days of enrollment, those receiving care from Huntsman at Home providers were 58% less likely to be admitted into a hospital for an unplanned stay, while those who did need to be admitted required shorter stays, according to researchers. Emergency room visits were cut by 48% for Huntsman at Home patients compared to those who lived outside the program area and didn’t receive at-home care.
Gallegos said when she returned home after having surgery, she was told a nurse would visit her the next day.
“Which there was. And the services that were rendered to me were excellent,” she said.
Since then, she says the providers who visit her have helped her through the healing process.
“They’re patient, they answer your questions thoroughly, they’re not in a hurry to rush you off. The physical therapist is great and the occupational therapist has been great. She’s helped me with making a schedule so that I could work, do something for a little bit and lay down, then do something for another project, and then lay down for another hour. So as far as that, they have really worked with me really well,” Gallegos said.
“I don’t think that I could go out with the surgery that I had, so I think it’s really necessary that there are these home health care agencies that come out to help you, because it’s a long process of healing.”
Mooney described the push to get creative in care delivery caused by the pandemic “a small silver lining” that will potentially change the way health care is delivered in the long term.