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Michael J. Maniaci, M.D., Chief Clinical Officer, Hospital Internal Medicine, Physician Lead, Advanced Care at Home, Mayo Clinic in Florida: Mr. Jolly is a gentleman with acute kidney injury. Monitoring is very important with these patients. Usually hospital stays on this or at least three to five days sometimes longer depending on the kidney function. He was 48 hours into his hospital stay and he was feeling quite fine. He asked is there any other way to do this. We said guess what we have a way. We have our Advanced Care at Home program opening up. Advanced Care at Home is taking what we do in the inpatient setting and transforming that and bringing the care to the patient in their home. We're able to transport with Mayo Clinic transport the patient out of the hospital setting into their home environment. We meet them with an APP and a tech pack. The tech pack contains everything we need to take care of that patient over the acute phase of care that includes connected, secure, HIPPA-compliant wi-fi monitoring for blood pressure, pulse ox, a scale, any other medical supplies they need along with the tablet that provides the virtual connection to us as well as a daily schedule so the patient knows exactly what's happening from time to time. We set that all up in the house and connect it. We test it. Our hands on the ground, EMS or APP staff, does a physical exam. Make sure the transfer was safe. I connect in. Talk to the patient to make sure that he's doing well and that's what we did for Mr. Jolly.

Background discussion: Dr. Maniaci to Mr. Jolly: Keeping your fluids up as you're doing is important and if the number gets a little worse that just means we need to give you more fluid that way.

Mr. John Jolly, patient: You're monitored as if you're in a hospital. For example they actually see you take the medicine and they can verify it. I think the best part of it is during the day, they've taught me how to do my blood pressure and oxygen in the blood and stuff like that so I get my own vitals and send it to them. But also if it's important enough where I know that with the thing is 24 hours a day. All I have to do is push a button and there's a picture of a nice young lady and I can start asking her questions at two o'clock in the morning or three o'clock in the morning.

Letty Jolly: Plus your mobility is much better too.

Mr. Jolly: Yeah, I think that was the worst thing about being in a hospital, I could not get up out of the bed and take a walk. I just love the idea that I can read and then I can get out and look at my marsh view. It's just so much better to be home.

Dr. Maniaci: We have the resources now to treat our patients better. To give them equal if not better care. To provide better satisfaction in their home environment and reduce costs to our patient and ourselves. It's the next evolution of medicine and we should all be part of this and striving for this, and what's after this.

Mr. Jolly: I think the big thing about this is the word, I would say, is it gives me a patient freedom.

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