In 2005, a study in Annals of Internal Medicine Proof of Digital Home Hospital, or home hospital, the solution offers better clinical outcomes, shorter average length of stay, higher patient and family satisfaction, fewer complications and significant cost savings compared to traditional inpatient care.Thereafter, other Research Similar findings have been shown, including a 70% reduction in readmission rates, a 40% reduction in costs, and improved patient mobility for managing patients at home.
Despite these measurable benefits, adoption of the home hospital model has been limited. Recently, however, several factors have focused on the implementation of home hospitals.
The innovative home hospital model pioneered by Johns Hopkins University in 1995 provides hospital-grade care in the patient’s home and, in some cases, is a better alternative to acute hospital care.
The current digital home hospital care model often requires the identification of eligible patients in emergency rooms or outpatient care settings. Once a patient is admitted or accepted into the program, clinicians have daily visits to all of the necessary care infrastructure — from infusion services to drug delivery devices to remote monitoring — all set up at home.
Why now?
Deloitte Health Solutions Center Several key reasons why hospitals seek to transform their business models are identified, including reducing costs, maximizing technology, better engaging consumers, improving clinician satisfaction, and a desire to compete with healthcare disruptors from Walmart to Amazon.
The digital home hospital concept offers the potential to address all of these challenges, especially given that healthcare systems, physicians and patients are embracing virtual care and digital technologies with renewed enthusiasm during the pandemic. Managing patient care can actually allow patients who are afraid of exposure to Covid-19 to be treated at home as much as possible. At the same time, due to the wave after wave of Covid-19 patients, hospitals are overcapacity, and with limited resources, hospitals are able to provide more beds for more critically ill patients.
In addition to the pandemic’s expanded acceptance of telehealth, it has also removed a major barrier to adoption of digital home hospitals by spurring CMS and other payers to begin covering care provided outside the hospital, including in patients’ homes .
McKinsey & Company estimates that at most $265 Billion in Nursing Services By 2025, some Medicare beneficiaries may move from medical facilities to families without loss of quality or access. This major change in reimbursement policy enables healthcare providers to cost-effectively expand care for more patients while eliminating the need for substantial investment in building or acquiring more inpatient facilities.
Consumer expectations for an improved care experience have also accelerated interest in the home hospital model. Although hospitals are the gold standard for treating acute illnesses in the United States, They can be expensive and uncomfortableespecially in older patients with frequent delirium, hospital-associated infections, or functional decline.
Digital technology advantage
However, the strongest drivers of digital home hospital adoption are advances in telemedicine, remote monitoring, and emerging digital technologies that facilitate high-quality, cost-effective care outside the hospital.
First, continuous remote patient monitoring (cRPM) sensors continue to improve in quality and data collection, while also becoming smaller, easier to wear, and more affordable. Second, the pervasive use of smartphones and mobile applications enables clinicians and patients to stay connected and share important health information. Third, large amounts of data can be stored in the cloud and accessed in near real-time. These solutions are designed not only to simulate the care a patient receives in a hospital, but to enhance it. Finally, FDA-approved artificial intelligence (AI) algorithms can be used to analyze multivariate patient data and support the delivery of personalized insights that can transform care. In fact, the Deloitte Center for Health Solutions identified artificial intelligence and machine learning as important game changers in healthcare over the next 10 years.
patient-centred care
The digital home hospital model offers hospitals an excellent opportunity to provide patient-centred care, encouraging active collaboration and shared decision making Designed and managed among patients, families and clinicians custom made and a comprehensive care plan.
For example, many inpatients receive regular checkups by clinicians in their rooms to spot-check their vital signs, whereas digital home hospital patients can be monitored conveniently, continuously, and often passively. In this way, clinicians can closely track key health indicators, receive alerts of early signs of potential deterioration, and connect with patients via mobile app, text or video call. This allows the right care to be delivered to the right patient at the right time – while focusing on the patient’s physical comfort and emotional well-being.
In the digital home hospital model, patients—especially those with chronic conditions such as heart failure or chronic obstructive pulmonary disease—feel more confident and comfortable that they are being continuously monitored, as do their families and others involved in decision-making and communication in this way. their care. Clinicians can now access patient-reported outcomes and hard data to make informed care decisions, such as whether to continue monitoring and treating patients at home or hospitalize them. The pervasive use of EMR in health systems also helps ensure that digital home hospital care services can enter patient records to keep all care providers up to date.
A digital home hospital environment can also support improved medication adherence, which is critical to patient outcomes. For example, adding a layer of cRPM on top of multiple clinician visits as part of a holistic digital home hospital model provides an opportunity to monitor changes in patients’ vital signs that could indicate side effects or non-adherence.
Home hospital in action
Let us consider a hypothetical scenario to illustrate the benefits of the digital home hospital model. A 70-year-old woman with NYHA class II heart failure and atrial fibrillation (afib) presented with palpitations, anxiety, and shortness of breath.
The ED doctor determined that she had poor heart rate control for atrial fibrillation and changed her medication dose. After consulting with a resident, she was admitted to a home hospital program (instead of an inpatient bed) and trained on cRPM solutions, which included a chest patch and mobile smartphone app.
The app links her to a clear explanation of her new medication regimen and information about her condition to share with her family. Her home health care team sent a message reminding her to respond to the daily registry survey.
A few days later, when the patient is overworked, the app immediately asks her to answer a few questions and share the results with her care team. A nurse reached out to further assess her status, advising to take breaks and re-educate her about when to take her medication — avoiding unnecessary ER visits. Going forward, the home health team will continue to monitor her activity, vital signs and progress as she performs rehab exercises on the app.
optimistic outlook
All indications are that the hospital business model of the future will be very different from today’s version. Digital home hospital solutions will be key to improving the patient experience. With the right technology, clinicians can deliver hospital-grade care to more patients in the right place—for many, in the comfort and familiarity of their own home.
Photo: Willowpix, Getty Images
