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ChristianaCare Celebrates Milestone of More Than 1,000 Patient Admissions in Innovative Hospital Care at Home Program

Mar 28, 2024

4 min

The ChristianaCare Hospital Care at Home program, a national leader in providing acute care in a place most familiar to patients – their own homes – has reached a new milestone with more than 1,000 admissions since opening in December 2021.


ChristianaCare’s innovative program enables patients with common chronic conditions, such as congestive heart failure and diabetes complications, as well as infections like pneumonia, to receive hospital-level care at home through virtual and in-person care provided by a team of physicians, nurse practitioners, paramedics and others. Technology kits deployed to patient homes ensure round-the-clock access to a health care professional, along with twice daily visits from caregivers, medication deliveries and mobile laboratory services.



“This program is a wonderful example of how ChristianaCare is building a better health care system and meeting people’s health care needs through innovation, collaboration and an unwavering commitment to providing the very best care for the people we serve,” said Janice E. Nevin, M.D., president and CEO of ChristianaCare.


“We are proud to be at the forefront of hospital care at home nationally, through the collaboration with leaders like Sen. Tom Carper of Delaware, who has championed this new model of care at the federal level; Medically Home, which partnered with ChristianaCare to help us design a program that best meets the needs of the communities we serve; and our own health professionals – we call them caregivers – whose expert care and coordination make this all possible. Together, we are creating health so that people can flourish.”


‘Just amazing’ for patients

Patients are evaluated for the hospital care at home program when they come to Wilmington or Christiana hospital emergency departments. Those who can be treated at home receive a technology kit that connects them to the command center, powered by the ChristianaCare Center for Virtual Health. With a touch of a button, they can access an expert team of ChristianaCare doctors and nurses. But hospital care at home isn’t just virtual care—the technology supports an entire care team that works inside the patient’s home and remotely to provide optimal support at all times—just like in a hospital.


Patients connect with their health care team with just the touch of a button. 


Carol Bieber, whose 98-year-old father, Bill, has been a hospital care at home patient, sees the difference it makes for him to wake up in his own bed, sit in his own living room and still get the care he needs to get better.


"The whole hospital care at home experience is really calm and easy and familiar to him," said Bieber, who lives in Newark. “My dad is a people person, so to be able to connect with everybody who comes in to see him or talk to him on the screen is just amazing.”


Innovative solutions for in-home care

ChristianaCare’s Hospital Care at Home program was developed in 2021 after the Centers for Medicaid & Medicare Services (CMS) began the Acute Hospital Care at Home waiver program to allow Medicare beneficiaries to receive acute-level health care services in their home.


U.S. Sen. Tom Carper, who represents Delaware, worked to pass the bipartisan Hospital Inpatient Services Modernization Act in 2023 that extended this program. Last month. Sen. Carper introduced the bipartisan At Home Observation and Medical Evaluation (HOME) Services Act that would expand this lifesaving and cost-saving program.


“Hospital at Home – which grew out of the COVID pandemic – was an opportunity for us to meet seniors where they are,” Sen. Carper said. “It has delivered positive outcomes, higher patient satisfaction, and saves money. That is why when this program was about to go away with the end of the COVID public health emergency, I joined my colleagues across the aisle to extend the program for two more years. Today, especially as we celebrate the success of the program in Delaware with ChristianaCare, I’m encouraged that we can further extend that program!”


Sarah E. Schenck, M.D., FACP, executive director of the ChristianaCare Center for Virtual Health, said the hospital care at home program has yielded lower readmission rates than brick-and-mortar hospitals. In addition, patient experience scores are about three times higher than the national average for a traditional hospital experience.


Options like Hospital Care at Home give patients the care they need in the space they want, said Dr. Sarah Schenck, executive director of ChristianaCare's Center for Virtual Health. 


“We’ve been conditioned to believe that care only happens within the four walls of a hospital. For our patients who have loved ones at home or their pets, a favorite chair or favorite food, they’re now able to have all of that as they heal,” Schenck said.


“Once our patients have experienced this, what we hear from them is that they are truly grateful.”


Promoting healing – at home

Helping patients recover in their homes also has been transformational for caregivers who get to see a different side of their patients and better understand what they need to successfully recover.


“I can’t express how much I enjoy the patients and their families,” said Heather Orkis, a paramedic with the hospital care at home program.


Patients aren't the only ones who enjoy the experience of Hospital Care at Home - so do the health care professionals who care for them. 

“To be able to enjoy the family and see these people get better in their own homes, with their families, their grandkids, their dogs, their cats – it’s just a completely different kind of medicine.”


For Bill Bieber’s family, hospital care at home is more than health care.


“It’s just the best thing ever,” Carol Bieber said.


Families appreciate the frequent interactions with members of the Hospital Care at Home team. 
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New Study Finds Most Patients Can Safely Continue Weight Loss and Diabetes Drugs Before Gynecologic Surgery

Most patients taking popular weight loss and diabetes medications such as Ozempic and Wegovy can safely continue them before gynecologic surgery, according to a new journal article from ChristianaCare published in Obstetrics & Gynecology. The review found that serious anesthesia risks linked to these drugs are uncommon for most patients and can usually be managed through individualized planning rather than stopping the medication. The paper is the first to take a focused look at glucagon-like peptide-1 receptor agonists, commonly called GLP-1 drugs, in gynecologic surgery. These medications were first approved to treat diabetes and are now widely used to support weight loss and metabolic health, which refers to how the body processes sugar and energy. “Our study shows that the evidence does not support routinely stopping these medications before surgery and that the actual risk is low for most patients,” said Michelle Pacis, M.D., MPH, senior author of the study and a minimally invasive gynecologic surgeon at ChristianaCare. Why these medications raised concerns GLP-1 drugs work in part by slowing how quickly the stomach empties. This helps patients feel full longer, but it also raises concerns for surgery. Doctors worry that food remaining in the stomach could increase the risk of aspiration, when stomach contents enter the lungs during anesthesia. Because of this, early recommendations often advised stopping GLP-1 medications before surgery. The ChristianaCare review found that this approach was largely based on caution rather than strong evidence. The authors reviewed data from multiple studies, including large patient groups, that examined outcomes in people taking GLP-1 drugs during procedures. While some studies showed higher amounts of stomach contents, aspiration events were rare and occurred at rates similar to patients who were not taking the medications. New guidance reflects a change in thinking Recent national guidance from several medical societies now recommends a more tailored approach. Most patients can continue GLP-1 medications before surgery. For patients with higher risk factors, such as significant stomach symptoms or known delayed digestion, simple precautions can reduce risk. These precautions may include a clear liquid diet for 24 hours before surgery or closer monitoring during anesthesia. A clear liquid diet includes fluids like water, broth and clear juices. “This shift recognizes both the benefits of these medications and the importance of patient-specific decision making,” Pacis said. Why this matters for gynecologic surgery Many gynecologic surgeries require patients to be positioned in ways that can affect breathing and circulation. At the same time, many patients needing these procedures also have obesity or diabetes, which can increase surgical risk. GLP-1 medications can improve blood sugar control and support weight loss, helping patients enter surgery in better overall health and enhance recovery. Stopping these drugs without a clear reason may work against those benefits. Practical steps to support patient safety The study outlines several strategies care teams can use when patients remain on GLP-1 medications. These include thoughtful anesthesia planning, careful monitoring of heart and lung function, and, in select cases, the use of ultrasound to check stomach contents before surgery. “The goal is not to ignore risk, but to manage it wisely,” Pacis said. “For many patients, continuing these medications supports safer surgery and better recovery.” The authors note that more research is needed, particularly studies focused specifically on gynecologic surgery. Still, the findings offer clarity for patients and clinicians navigating a rapidly changing area of care. “This review helps bring evidence and balance to an issue that has caused a lot of confusion,” Pacis said. “It supports keeping patients on therapies that benefit their health whenever it is safe to do so.”

1 min

Two Research Scientists at the Cawley Center for Translational Cancer Research Earn Top Honors at UD Biology Research Day

Two rising cancer researchers from ChristianaCare’s Cawley Center for Translational Cancer Research were recognized for outstanding scientific contributions at the University of Delaware’s Annual Biology Research Day Conference on January 30, 2026. The awards highlight the strength and impact of colorectal cancer research underway at the Cawley Center. Anh Nguyen, a third year Ph.D. student, received the conference’s first place poster award for his project, “FGF19/FGFR4 Axis: A Key Driver in Tumor Growth and Treatment Resistance in Colorectal Cancer.” His research explores a signaling pathway that may lead to new strategies for targeting treatment resistant disease. Molly Lausten, a fifth year Ph.D. student, earned third place for her presentation, “Investigating the role of miR 27a 3p in the WNT signaling pathway and chemoresistance in colorectal cancer stem cells.” Her work examines a key microRNA that may influence resistance to therapy, a major challenge in treating aggressive tumors. “These awards reflect far more than individual excellence,” said Bruce M. Boman, M.D., Ph.D., MSPH, FACP, senior scientist and director of Cancer Genetics at the Cawley Center. “They show the power of rigorous, curiosity driven science to move the field forward. Molly and Anh are tackling some of the hardest questions in colorectal cancer, and their success speaks to the innovative environment we are building at ChristianaCare. I could not be more proud of their achievement and their commitment to improving outcomes for patients.”

3 min

Gene Editing Breakthrough Offers New Hope for Head and Neck Cancer Patients

Researchers at the ChristianaCare Gene Editing Institute have made an important advance in treating head and neck cancers. By using CRISPR gene editing, the team found a way to restore how well chemotherapy works in tumors that have stopped responding to treatment. Their results, now published in Molecular Therapy Oncology, could change how doctors treat these aggressive cancers and give new hope to many patients who face limited options. Head and neck cancer is the seventh most common cancer worldwide, and cases are expected to rise by 30 percent every year by 2030. Even with progress in surgery, chemotherapy and immunotherapy, many patients still reach a point where treatment no longer works. The ChristianaCare team aimed to solve this challenge at its source. Targeting the Heart of Drug Resistance The researchers focused on a gene called NRF2. This gene acts like a master switch that helps cancer cells survive stress and resist chemotherapy. Because NRF2 plays such a central role in tumor growth, the team chose to develop a genetic therapy that disables the gene itself rather than targeting a single protein, which is common in traditional drug development. Since NRF2 is a transcription factor, shutting it down in a lasting way is more likely to succeed through CRISPR gene editing. Their major advance was showing that CRISPR can successfully disrupt NRF2 in head and neck cancer cells and in esophageal cancer cells. This work builds on earlier studies in lung cancer, where blocking NRF2 made tumors more sensitive to chemotherapy and improved survival in animal models. “Our goal was to break through the wall of drug resistance that so many patients face,” said Natalia Rivera Torres, Ph.D., the study’s lead author. “By precisely editing the NRF2 gene, we can make cancer cells vulnerable again to standard treatments. This could improve outcomes and quality of life.” Precision Matters: The Power of Target Choice The study also showed that the location of the CRISPR cut within the NRF2 gene makes a big difference. The strongest results came from targeting exon 4, a part of the gene that controls a key section of the NRF2 protein. Editing this region reduced NRF2 levels by 90 percent and made cancer cells much more sensitive to chemotherapy. In comparison, editing exon 2 was less effective even though it still caused high levels of gene disruption. The team also found that a process called exon skipping, where sections of genetic code are rearranged, can affect the outcome of gene editing. This discovery highlights how important careful design and testing are when building gene editing therapies. A Platform for Broader Impact ChristianaCare researchers saw the same results in both head and neck cancer cells and esophageal cancer cells. This suggests the strategy could help treat many solid tumors that have high levels of NRF2 and are known for strong drug resistance. “This is more than just a single experiment,” said Eric Kmiec, Ph.D., director of the Gene Editing Institute and senior author of the study. “We are building a platform that can be adapted to different cancers. Our earlier work in lung cancer showed the promise of this approach, and now we see it working in other hard to treat tumors. It is an exciting step toward making gene editing a meaningful part of cancer treatment.” Looking Ahead: Toward Clinical Application With these strong results, the team is now focused on finding the safest and most effective way to deliver the gene editing tools directly to tumors. Their goal is to reduce how much standard treatment a patient needs in order to get the best result with fewer side effects. “Drug resistance is one of the biggest challenges in cancer care,” Rivera Torres said. “If we can overcome it with gene editing, we could give patients more time, better quality of life and a renewed sense of hope.” Kmiec added, “We are committed to moving this technology forward quickly while always keeping the patient in mind. The future of cancer treatment is personal, precise and, we believe, within reach.”

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