2020 saw three factors combine to define the future of “Hospital at Home” care in a way that will become a new care reality over the coming years.
Changing Patient Attitudes
Patients became more reluctant and concerned about going to hospitals. The fear of contracting illnesses such as Healthcare Acquired Infections (HAIs), like sepsis, is a real and legitimate concern. While the number of patients has been declining, around 100,000 people die each year in the US from contracting an HAI in the hospital setting. To top it all off, the risk of contracting an infection increases with the length of time spent in the hospital facility.
Medical Economics
Second, hospital finances became more precarious due to the backlog of cancelled or postponed operations. The basic economics stemming from this is clear: the fewer operations and procedures that hospitals perform, the weaker their financial situation. Just in the first four months of the COVID pandemic, in 2020, hospitals faced an estimated $202.6bn loss due to the sheer number of cancellations.
Hospitals looking to recover from the spiraling costs will need to significantly increase the number of procedures and operations performed and will aim to do so by moving patients through the system faster.
Growing Acceptance of Telemedicine by Patients
The third way in which the health landscape has been permanently changed over the last year is the positive acceptance of telemedicine, where the patient is in one location and the medical provider is in another, bridged by technology. In fact, patients have generally become more amenable to being treated remotely, further supporting the move to add telehealth tools to the patient care arsenal.
Increasing The Quality of Care at Home Without Adding to The Burden
As a result of these benefits, health providers are increasingly seeing Hospital at Home as a way of relieving the burden on hospital beds while meeting the patient’s wish of being discharged as soon as possible.
But here is the dilemma – recovery times for procedures have not reduced dramatically in the last few years. Therefore, the idea of patients being able to be discharged from treatment sooner becomes irrelevant, as they will still need the same level of treatment and monitoring. The obvious question here is how can we solve a seemingly impossible situation – how to release patients earlier from a hospital but maintain the same or improved levels of care at home?
You could be excused for thinking this would just replace one problem with another. By sending patients home earlier, aren’t we just transferring the burden of their care onto them, their loved ones, and community-based nurses?
There is some truth that patients can struggle if they must record their own vital data (temperature or blood pressure). Recovering patients usually demonstrate poor levels of adherence, as many people – already weakened by the operation and the medication – forget to enter their health data or struggle to read basic equipment, like a thermometer, correctly. And it is not fair to strictly rely on community-based nurses who may visit a recovering patient for a few minutes, possibly twice or three times a day.
So how can Hospital at Home be implemented to deliver benefits to both healthcare provider and health care receiver?
Bringing Hospital-grade Equipment to the Home
It is important that we see Hospital at Home technology not as a replacement for conventional hospitalization, but as an augmenter. Typically, a patient will spend up to five days post-operation in the hospital, and once they have regained enough strength, will then be discharged with a comprehensive care strategy to advance their recovery journey. To successfully transfer effective patient monitoring from the hospital to the home, we must incorporate the very same advanced medical technology being used in the hospital into the home. This is easier today than ever before, as non-invasive wearable patient monitors used in hospital settings can now wirelessly connect with patient management systems. In this way, these small wearable patient monitoring devices can continuously and automatically monitor and track vital patient health data for multiple days uninterrupted.
These devices can gather crucial patient data, including pulse rate, blood pressure, blood saturation levels, respiratory rate, skin temperature and other vital signs. Unlike certain hospitals and healthcare facilities where spot-checking practices are still in effect, these devices gather information continuously, not only when nurses make rounds. Additionally, these monitors can either be linked via a cellphone app or directly via wi-fi to the cloud, to ensure real-time transmission of the data back to the hospital. Alternatively, data can be downloaded and checked when the community nurse visits the patient at home.
With the more advanced systems, Artificial Intelligence (AI) and machine learning (ML) comes into play, providing real-time alerts to care teams, when abnormalities are discovered, ensuring that health staff provides the right care at the right time.
Helping Hospital at Home Succeed
To succeed, Hospital at Home will need to combine a few key elements. It will need patients to receive the correct length of hospitalization, as well as the technology to continuously monitor patient conditions from the home after they transfer out of the hospital setting. It will also require AI and ML-powered technologies to analyze the aggregated patient data and provide care staff with timely alerts to focus their attention and care, mainly on pre-symptomatic prevention. Lastly, it is imperative that patients receive regular visits by community nurses to ensure that all of these pieces are working in tandem.
Hospital at Home is already delivering on its intended triple-benefit – reducing risk, reducing cost by increasing the patient throughput and improving the patient experience. It is crucial that we recognize the move towards Hospital at Home as a future staple in healthcare provision and not a short-term solution to the issues revealed in 2020.
If we implement the right Hospital at Home technologies today, it could be a lifeline for an over-stretched healthcare sector, increasing the number of patients being treated – while reducing the backlog and the financial burdens. It can also improve the quality of data being gathered to keep patients safe and speed up recovery, which would also serve as databanks to be studied in the future.
About Arik Ben Ishay
Arik Ben Ishay is the CEO and co-founder of Biobeat, developer of wearable AI-powered remote patient monitoring solutions. Arik holds an LLB in Law, a BA in Accounting and is a volunteer Paramedic with MDA, Israel’s National Emergency Pre-Hospital Medical and Blood Services Organization.
