Published in Health Care

Uber, but for medical care: Spectrum Health service offers on-demand home visits from a nurse

BY Sunday, March 18, 2018 04:36pm

GRAND RAPIDS — An on-demand home health service Spectrum Health debuted a month ago aims to aid not only patients but also the people who care for them.

In an initiative that’s testing a different way to deliver care, Carol Health allows people caring for an elderly parent or loved one to sign up for a visit from a registered nurse should they need help. When a caregiver puts in a request on the Carol Health website or mobile app, the service locates a nearby RN to respond to the home in as little as an hour.

RNs can sign up with Carol Health — which is short for “care for all” — to provide the home care, similar to how drivers register with ride-sharing services such as Uber or Lyft. Responding RNs also provide the person seeking assistance with updates on when they’ll arrive.

“We have a network of registered nurses that go on the platform and they pick up those jobs and we connect the person that’s seeking care with the nurse,” said Anthony Lazzaro, the business leader for Carol Health. “The nurse travels to the home giving notifications on the way to the person who requested care or the person receiving care.”

Spectrum Health launched the service on a pilot basis in Kent County for people caring for someone who’s aging. Through Carol Health, Spectrum Health seeks to provide caregivers with support and relief.

“What that looks like for us specifically is people who are in the ‘sandwich generation,’ meaning they are caring for an aging parent and they also are caring for their families. It creates a lot of stress and problems with them and conflict because they get pulled in a million different directions,” Lazzaro said. “We hope to solve those issues for them.”

Carol Health could extend services to parents of newborns, people undergoing physical therapy or recovering from serious injuries, or individuals with chronic medical conditions such as COPD or congestive heart failure, he said.

The service costs $65 per hour, which is not covered by health insurers. Talks are ongoing with the Spectrum-owned Priority Health and other insurers about covering the cost.

Carol Health wants to get 300 to 350 users signed up for the pilot by the end of June, then assess the service and roll it out on a broader basis.

A Carol Health RN can provide respite care, change the dressing on a wound, check vital signs, do a basic health assessment, make sure someone is taking their medication properly, or help with discharge instructions for someone who was recently hospitalized. Most of what an RN does on a home visit takes less than an hour, Lazzaro said.

Spectrum Heath pilots the service as the local population gets older on average, which is driving up medical expenditures because people who are older than 65 generally require more care.

In West Michigan, people 65 and older account for the largest growth rate since 2000 of any age category, according to Grand Valley State University’s 2018 HealthCheck report. The 65 and older age group as of 2016 accounted for a little more than 20 percent of the population, up from about 12 percent a decade earlier.

As the population steadily ages, Carol Health creates a new contact point to help people who are caring for an aging parent, for example.

“(It’s) an innovative way to provide that care connection,” said Spectrum Health COO Christina Freese-Decker. “We want to keep people home and we want to keep people healthy, and this is another way to do that. We’re also trying to do it in an innovative way with Carol that maybe can take off and can grow from there.”


Often times, the RN visit to a home is simply to offer reassurance to a caregiver, said Mike Czechowskyj, Carol Health’s clinical leader.

Czechowskyj cites one example in which a patient was discharged from the hospital after a bout with the flu. Two days later, her husband requested a visit from an RN to check on how well she was recovering.

“He wanted us to come check on her just to say, ‘Is she recovering nicely? Am I missing anything?’ and just make sure she’s healing (so he could) know that she’s OK,” Czechowskyj said.

Spectrum Health sees the service as alleviating the need for a doctor visit. It could also possibly prevent unnecessary and costly trips to an ER or urgent care center. There’s also the potential to reduce hospital readmission rates.

After a home visit, the RN writes a report and files it in a user’s personal health record. Carol Health is working with Great Lakes Health Connect, a Grand Rapids-based statewide health information exchange, to store the records so they are readily accessible by a patient’s primary care physician.

Spectrum Health is offering Carol Health on a limited basis for now so it can test the service to ensure it works as promised and determine if any adjustments are needed before broad deployment.

“Right now, our focus for this limited release is to really understand the value we’re providing to users and people throughout the community,” Lazzaro said. “We’re really focused on making sure we do all of the little things right, paying attention, listening to what they need, listening to what they want and what they desire, and seeing how we can build those tools not only for them but also for the nurses, and how we work effectively with the various health systems and throughout the community and the physician offices.”


The idea for Carol Health originated with Czechowskyj. The service was informed by his experience of watching his father caring for his aging grandfather, who did not qualify for homebound care covered by health insurance. That experience gave Czechowskyj an understanding of the frustration and stress that caring for an elderly parent or loved one can generate for a caregiver.

“There just wasn’t a good option out there, so that was one of the drivers to create this,” Czechowskyj said.

Through his own experience, Czechwoskyj began thinking about a solution to aid caregivers. He came up with the service that became Carol Health.

Spectrum Health vetted the idea through its innovations unit, Spectrum Health Innovations, which provides a platform for staff to bring an idea forward for consideration.

The health system has been marketing Carol Health directly to consumers and physician offices that can refer patients and caregivers, as well as to employers who may have employees struggling to balance their jobs with daily care for someone at home.

“We found that’s a really big problem in the workplace. Caring for a loved one doesn’t have a set schedule. It’s very sporadic and comes up at any time. That takes away from the workplace,” Lazzaro said. “It takes away (by people) showing up late, leaving early, or having to leave in the middle of the day.”

Carol Health wants to work with employers to offer the service as a benefit and a special rate, he said. 

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