Hospital at Home (H@H) is a revolutionary model for delivering hospital-level, patient-centric, individualized care for patients at home via remote patient monitoring. Although other nations, such as England, Israel, and Australia, have already used the model, the United States has yet to gain traction. Research has found that Hospital at Home has realised cost savings of almost one-third. Patients and family members showed higher levels of satisfaction and less stress while improving health outcomes. Research published in the Medical Journal of Australia reported that the meta analysis of Hospital at Home found a 24% reduction in readmissions and a 20% reduction in mortality (1).
At its most basic level, Hospital at Home is the concept of identifying people who are candidates for admission to the hospital and admitting them to their home where they receive the same level of quality and acute care. This high-level of care can take place in a variety of ways combining virtual check-ins with medical staff, remote monitoring of vital signs, video interactions, and in-home visits from nurses or other clinicians. This model can also make it possible to quickly expand bed capacity in situations such as surges.
COVID-19 has illustrated how quickly a hospital can reach capacity in some hotspot areas, the idea of providing hospital level care in the patient’s home is gaining traction. A recent study found that the cost of an acute care episode for Hospital at Home patients was 38% lower when compared to patients who received care in the hospital. Hospital at Home patients had far fewer lab tests, imaging studies, and consultations, and they also spent less time being sedentary in a bed. Moreover, fewer were readmitted to acute care after 30 days than hospitalized patients(3).
Rx.Health’s monitoring dashboards are fully customizable depending on the condition and facility specifications. During home monitoring, the patient may be prescribed a digital navigation program that will deliver reminders, alerts and messages that may assist with behavioural modification
For health care consumers, Hospital at Home results in higher patient satisfaction, lower infection rates, and better outcomes, per Bruce Leff, M.D., director of the Center for Transformative Geriatric Research at Johns Hopkins University School of Medicine, who launched and studied a Hospital at Home program in the 1990s. Hospitalization can mean being at higher risk for falls, delirium, and functional decline for many elderly patients. By eliminating the facility costs of a hospital room, the health care system can experience lower costs.
Hospital at Home program layers multiple capabilities
As we can predict, rather than building a new hospital wing, organizations can leverage hospital-at-home programs. While cost-effective, these are often complex programs requiring coordination of supplies, staff, and specialists.
- Workforce readiness: With advanced virtual offerings and support of aligned clinicians and staff with a focus on improving quality, patient experience, and cost effectiveness. Hospitals will likely need both a highly coordinated virtual team and in-person team.
- Clinical pathways and protocols: With training clinical staff to reorient the provision of clinical pathways and processes for care delivery is required to move patient care from a hospital to a home.
- Technology, infrastructure, and integration: Launch a scalable technology infrastructure to support the core of Hospital at Home. Integrate multiple systems, vendors, providers, and logistics. Ensure medical grade broadband connectivity to home that allows for the provision of virtual health tools for near real-time transmission of data and televideo capabilities.
- Supply chain: Make certain that each patient’s home has all the necessary medical equipment and supplies so that a nurse or family member can properly care for the patient. Often the most significant challenge is the need for a layered supply chain that supports initial supply drop for the diagnoses, specialty care, and emergencies.
- Hospital at Home command center: Enable on-demand staff 24/7, real-time condition monitoring and management, service coordination, and network technology health analytics and monitoring. A command center should receive input from all sources including patient monitoring, transport, supply chain, specialists, and virtualists. Along with being able to receive data, the command center should also be able to act upon it.
- Cognitive and analytics: Leverage innovative data-science techniques to generate meaningful insights on identification, stratification, intelligent routing, geospatial mapping, population health management, condition monitoring, and measuring outcomes.
- Governance: Engage and align leadership. Identify medical policy issues that should be addressed to help ensure the appropriateness of admissions and discharge.
The Centers for Medicare & Medicaid Services (CMS) has proposed extensive measures to improve the capacity of the health care systems to deliver care beyond the conventional hospital setting to the patients. Click here to learn more
- Hospital-Level Care at Home for Acutely Ill Adults: A Randomized Controlled Trial, Annals of Internal Medicine, January 21, 2020