February 5, 2026: Asim Malik, VP of Health System Partnerships at DispatchHealth, joins Sarah to explore how high-acuity care is moving beyond traditional hospital walls. From pneumonia to COPD exacerbations, discover why this isn't just about convenience; it's about solving capacity constraints, improving margins, and giving patients back control. Asim breaks down the technology infrastructure, command center requirements, and clinical buy-in needed to make these programs succeed at scale.

Key Points:

• 02:01 Challenges and Solutions in Home-Based Care
• 06:53 Technological and Operational Requirements
• 09:46 Overcoming Barriers and Misconceptions

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Flourish Sound Bytes: Healthcare at Home is Closer Than You Think with Asim Malik

Sarah Richardson: I'm Sarah Richardson, a principal here at this week Health where our mission is healthcare transformation, powered by community. This is Flourish Soundbites, unfiltered Conversations with healthcare leaders. Let's get real,

Welcome back to Flourish. I am Sarah Richardson. And today's soundbite explores a powerful shift happening across healthcare, high acuity care, moving beyond the four walls of the hospital.

My guest today is Asim Malik, a healthcare leader who has recently made the intentional move into the hospital at home and er at home space while he's now working with organizations enabling in-home acute care. Today's conversation isn't about a company, it's about a care model that's changing how we think about access, outcomes cost.

And the patient experience. We'll talk about why this matters, the barriers to making it real, and what health IT leaders and patients need to understand as care continues to move closer to home. Asim, welcome to the show.

Sarah Richardson: I am so glad you're here 'cause we got to know each other pretty well through the HCSP program where you are one of the coaching cohort.

Asim Malik: It was wonderful. It was really. Special program and the the cohort and I are still sort of in touch today.

Sarah Richardson: That's the whole point, isn't it? That we get to create community and continue to really solve for healthcare. So thank you for being here because you've made a move and your focus in hospital at home and er at home space. I wanna know, and I know our listeners wanna know, what drew you to this model at this point in your career?

Asim Malik: After years of working in healthcare strategy and business development, I saw health system repeatedly, repeatedly facing the same problem. Capital constraints and margin issues. I had a lot of experience in maternal child health, so I was watching more and more of that care come to the home, either in the prenatal or postpartum space.

Sarah Richardson: So when you dug a bit deeper, and also from your perspective, what problem is this model actually solving for health systems and for patients?

Asim Malik: There's interconnected problems between capacity, cost, and patient experience, and so in so many cases, health systems. Don't have the beds or they're having trouble assigning the beds to the right patients. Similarly, patients who are not, who may be at risk of falling or have other issues, wanna try to get care at home versus the hospital.

And then just the pinching costs. With CMS I've been quite a concern for the whole system. So this is, it's a really, a perfect storm, I think.

Sarah Richardson: We hear a lot of terms today. We've got hospital at home, we have ER at home, transitional care. How do you help leaders and patients understand the differences in where each one fits?

So hospital at home has infrastructure related to creating a virtual floor. Attached to the EMR. And then there's oftentimes a command center or state specific licensing that needs to be done. But beyond that, there's also er, alternative care and transitional care, which can be ways in which you, avoid admissions that don't need to happen or avoid ER visits saving those beds for higher acuity patients.

Sarah Richardson: What types of patients and conditions are best suited for high acuity care at home?

Asim Malik: I think the most common. Cases are, pneumonia, COPD, exacerbations, heart failure issues, cellulitis, UTIs, it's a pretty broad array of those issues. And then also there's all the post-surgical, post-procedural patients who can be, recovered at home.

The length of stake can happen outside of the traditional brick and mortar. So there's several different ways in which we can, free up those beds for other patients.

Sarah Richardson: And when this is done well, what do these models look like?

Oftentimes that length of stay can happen at home if the patient is medically stable, and that can reduce the brick and mortar cost for the health system, so their margins improve. We're seeing so many hospitals shutting down. Units across the country because they can't afford to keep the moment open.

And that's awful for not just rural health, but also urban health centers as well. So this is giving those hospitals more breathing room so they can build and grow rather than consolidate and shrink.

Sarah Richardson: Do the models require there to be a provider at home as well, or is this something that can get monitored? Heard even if a person doesn't have someone helping them with their care plan within their own home.

And then there's also a network of other folks. DMEs Pharmacy, courier services, ot, pt, all sorts of different vendor partners. We have both regionally, nationally, that can come and make different things available in the home uh, if the health system, needs that for their patient population.

Asim Malik: In some states they've, for example, the in-home clinician, that just depends. Some states require a nurse, some require a paramedic or an EMT, that sort. So we have that sort of mapped out and experience delivering those to health systems. So then as we're talking about that with the health system, we're also thinking about patient activation, which is the best way to identify the right patient who's a.

Candidate for this type of work, how to activate them, either through the hospitalist group or some other way. And then, beyond that model, what is the best way to help them pay for it? There has been some CMS waiver uncertainty lately, and we're ex excited for what we anticipate to be an extension that happens next week, fingers crossed.

But beyond that, there are Medicare Advantage, Medicaid, and even commercial patients that are, perfect candidates for this type of work because of not just reimbursement, but lowering total costs of care, lowering risk, and lowering other, key components of the health system contracting.

Asim Malik: Specifically for a hospital at home, there has to be, first and foremost the health system's. EHR has to have what's called a virtual floor built out, 'cause we're basically creating bed capacity in those patients' homes and living rooms. So they've gotta first build out that, and we can certainly advise there as well.

But then beyond that, we integrate with a platform called Sasha, which really takes hospital order orders and turn them into home orders and that. Capability makes it easier to coordinate and schedule and orchestrate care at the home with various different actors. It's not just one person come to the room to take labs, it's several people coming to deliver the lab, do the lab work and then have the lab taken care of outside of the home.

Have this this almost like air traffic control set up to decide where do our cars dispatch to how do we organize that through a busy city, you'd say Atlanta or Chicago markets to make the most efficient sort of trips.

Sarah Richardson: If you're the CIO or the CMIO, one of the leaders who can evaluate this from that digital perspective, what should you be asking early before you jump into this type of model?

Asim Malik: I think the real world struggles these folks have is understanding how is that health systems physicians, how will they be? Looped in and kept as part of the process. So the physicians wanna know are these still my patients? How do I know about what's happening with their care?

And so that's where our chief medical officer and our other like clinical leaders come in to evaluate what they have today, show them best practices from our other 30 or 40 different partner health systems, and really help them settle on what the best flow is. So that once you have the flow in mind, we can then build the technology around that to make that flow as seamless as possible.

One example is during the admission process, having that referral be very seamless and make it, in some cases health systems decide upon a patient being, coming into the hospital saying the er. Is this patient a candidate to go home, which seems rather counterintuitive, but if they know this is one of those many conditions we can treat at home, it immediately frees up a bed.

But that's a big culture shift that requires technology and personnel as well.

Asim Malik: It's not the technology architecture, it's not the financial model. 'cause they spend a lot of time on that. It really is making sure that their clinicians are bought into it. They understand what this is about because, some health systems do work with external groups.

They like a radiology group or some other one, and the culture has already welcomed that. But for other ones who don't and who really do own. Their relationships with the community and the patient community. This can be a bit of a leap at first, so early on, talking to the clinical team, showing them how patients are not just activated, but how these workflows are designed.

That's really key, I think, because. You can set up the most ideal system from a technological techno technology standpoint, but if those patients are not being referred into the program's gonna fail. And so it's really by getting to a certain number of admissions per month so they can be a sustainable, profitable program.

And even one that improves the finances of the health system, not just as a standalone program.

Asim Malik: I think we're moving from care happening within the four walls of the health system to care happening wherever it's clinically appropriate. And so that's oftentimes. Beyond just a brick and mortar, the health system. So we have not just this hospital at home model, but uh, er at home and even in some cases a joint venture, which is skilled nursing facility at home type of work.

And so that can happen at home in a kitchen, in the living room, in a bedroom. That can happen in an apartment, that can happen in a extended care nursing type of facility. That can happen in a variety of different places. And so that's, I think what makes it different and what. It's very counterintuitive , having our teams come in with all their gear to do administer care there oftentimes feels like a huge departure, but it oftentimes delivers better care in the right, meeting the patient in the right place at the right time so that it is, delivered before it's too late.

What makes in-home acute care feel safe and trustworthy for a patient?

Asim Malik: I think the most. Important aspects of trust are like clarity as in like clarity of communication. And then, having the experience, the competence to do this type of work. And then like just the team that's done it multiple times, we've, been able to do it in such a wide variety of markets that I think we've been able to see.

You know what the safety net, issues are in different markets and how we can either leverage those or fill in the gaps where they are. So oftentimes, we wanna make sure the patient has confidence and that confidence is never lost. 'cause building that confidence back is a real concern.

Sarah Richardson: do we ensure that these models don't become another example of innovation that only works for a subset of the population?

Sarah Richardson: You know what's interesting about that evaluation though, is it does. Reveal where patients may have either housing or food insecurities. And then you can step in and help with other programs that are offered throughout the system and solve for more than just the ability to free up beds and to have that complexity eliminated for some of the patients.

And so I'm always grateful when innovation solves other problems versus the one that's necessarily on the table. Okay. Are you ready for speed round?

Asim Malik: Sure, let's do it.

Asim Malik: That it's only for low acuity patients. No. The evidence shows that we can safely treat pneumonia, COPD exacerbations UTI issues and whatnot at home, and that acuity levels keep rising as we get better at this.

The misconception that it's just for low acuity limits, the adoption. You know, Physicians assume it's only for the easy patients uh, that qualify when it's actually the selection criteria is much broader than they think.

Sarah Richardson: what's the capability that health systems must get right before scaling a program like this?

Asim Malik: It is the command center. And so you can have the best home care teams in the world, but without 24 7 like virtual oversight and coordination, the model breaks down. The command center is the air traffic control of home-based acute care. It's where triage happens, where ex escalations are managed or families call when they're scared at 2:00 AM.

Get that right and everything else gets easier, get it wrong and nothing else matters.

Asim Malik: Patients should feel empowered, you know, empowered to heal in their own environment, empowered to have their families involved. Empowered to maintain dignity and comfort while getting hospital grade medical care at home. When patients feel empowered, outcomes improve, and um, you know, when they feel like they've got lost control, outcomes suffer.

So home-based care done right, gives patients back that sense of control,

Sarah Richardson: At a time when they likely feel like they don't have that much of it, which

is such a win when it comes to the healing process for sure. Asim this conversation highlights a fundamental shift in healthcare. One where care isn't defined by buildings, but by capacity, safety, and trust. Hospital at home and ER at home aren't just new programs.

There's signals of how care delivery is evolving. Thank you for sharing your perspective and helping us think differently about what's possible.

Asim Malik: Thank you so much. Wonderful to be here.

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