The problems facing health systems have persisted over the past three years, continuing to shift perspectives on how to achieve optimal care delivery. Pandemic-related changes brought increased attention on telemedicine, health equity, and bringing patient care into the home. These continue to be top-of-mind strategies for healthcare leaders.
Organizations are prioritizing more sustainable, efficient, and patient-centered approaches to care delivery. Specifically, many are finding that remote care at home programs allow for proactive patient management, across the care continuum. These programs are beneficial not only for patients moving from the acute setting to post-acute care, but also for the chronically ill.
Evidence that care in the home is the future of healthcare
According to the American Journal of Nursing, hospital at home programs can be safe, effective, and less expensive than inpatient care. Another study by the Annals of Internal Medicine showed a hospital at home program enabled a 70% reduction in readmissions and decreased the cost of acute care episodes by an average of 38%.1
Caring for patients in the comfort of their home is not a new concept, but there is a rapidly growing trend among health systems to establish hospital at home programs. Hospitals adopting this new model of care have successfully improved patient satisfaction and overall health outcomes, while achieving much-needed operational efficiencies.
Additional evidence is offered in a pandemic-era study conducted by Kaiser Permanente. The study found 94% of patients treated with remote care at home reported being satisfied with the quality of care and would recommend the program to others.2 Additionally, remote care offers the potential to expand patient access to care, bringing more in-home services such as nursing, phlebotomy and nutrition to a wider population.
For health systems, delays in inpatient discharges can result in increased costs and may lead to an increased risk of hospital-acquired patient complications (e.g. falls, pressure ulcers, healthcare-associated infections). Another advantage of investing in hospital at home programs is reduced length of stay (LOS). Reductions in a facility’s average LOS frees up capacity for other patients with more critical conditions.
Considerations for establishing a successful hospital at home program
The coordination of technology plays a crucial role in enabling innovations in care and ensuring the success of a remote care program. To name just a few, a well-designed platform should include: integrations with a broad suite of patient monitoring devices, disease-specific care pathways, evidence-based clinical decision support, and FDA-cleared algorithms. And because patient engagement is essential, a solution should allow simple, secure, HIPAA-compliant communication between the patient and clinical team.
A remote care at home platform should not just monitor a patient’s vitals but be capable of delivering actionable, up-to-date clinical insights. These data-driven insights can support treatment decisions during in-home visits or remote interventions. Ultimately, this is helping the provider gain a clearer picture of a patient's health status, while allowing for the patient to remain in the comfort of their own home.
The right platform should deliver improved care coordination through an ecosystem of clinicians and service providers. By utilizing a single dashboard to order, track and manage a patient’s needs, hospital staff can use their time more efficiently. Effectively leveraging existing staff will continue to be important as the 10-year demand for home health and personal care aides is expected to grow at 25%, year over year – significantly faster than average job growth.3
Adapting to better serve patients — and ensure long-term organizational success
In the pursuit of improved clinical outcomes, providers have always embraced innovation and new approaches to care delivery. When compared to acute care, remote care at home programs have already demonstrated the ability to improve the patient experience with lower costs and similar outcomes. And since the start of the pandemic, more and more health systems are deploying these programs to solve existing challenges.
“Over the next decade, hospital at home will become part of our mainstream care as a delivery option for patients,” said Dr. Tahir Haque, Senior Medical Director at Biofourmis. “If you are a health system considering a remote care at home program, there will be some growing pains initially to overcome. But it will be well worth it – both clinically and financially. If you are a clinician, please consider practicing in a care at home model if appropriate for your specialty – it will be one of the most rewarding things you do in your career.”
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Footnotes
1. Levine DM, Ouchi K, Blanchfield B, Saenz A, Burke K, Paz M, Diamond K, Pu CT, Schnipper JL. Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial. Ann Intern Med. 2020 Jan 21;172(2):77-85. doi: 10.7326/M19-0600. Epub 2019 Dec 17. PMID: 31842232. https://pubmed.ncbi.nlm.nih.gov/31842232/
2. Dan Ngoc Huynh , MD , Alyssa Millan , MPH , Earl Quijada , MD , Deborah John , Shariq Khan , and Tadashi Funahashi , MD. Description and Early Results of the Kaiser Permanente Southern California COVID-19 Home Monitoring Program. The Permanente Journal Sept 21; https://doi.org/10.7812/TPP/20.281
3. U.S. Bureau of Labor Statistics. (n.d.). Occupational outlook handbook: Home health aides and personal care aides - Job outlook. https://www.bls.gov/ooh/healthcare/home-health-aides-and-personal-care-aides.htm#TB_inline?height=325&width=325&inlineId=qf-outlook