More patients prefer to recover and receive care at home than at a medical facility. COVID-19 accelerated the demand as visits to facilities were restricted. Implementing care-at-home services is surprisingly challenging and is much more than people + technology. Key success factors include involving clinicians and understanding actual patient demand.
Care-at-Home Trend
The Home Health/care-at-home market is one of the fastest growing sectors in healthcare. According to Grand View Research, the global home healthcare market was valued at USD 281.8 billion in 2019 and is expected to grow at a compound annual growth rate (CAGR) of 7.9% to 2027.
A recent survey of health plan executives revealed that 97% believed that more care at home would be better for both their organizations and their members. That survey included a very interesting statement: “COVID accelerated acceptance of care-at-home and the adoption of the technology, staffing and processes necessary to make it happen.”
The statement highlights that it takes more than just technology to care for patients in their homes. As much as Remote Patient Monitoring (RPM) technology has taken off, it alone cannot provide the level of care that patients need.
“It’s not something you can just pick up and say ‘hey, we’re going to move care outside of the four walls of the hospital today’,” explained Lisa Esch, SVP, Chief Innovation Officer, Healthcare Provider at NTT DATA Services who sat down recently with Healthcare IT Today.
Getting Started
Esch recommends that healthcare organizations start by looking at the economic and demand fundamentals before diving into a care-at-home strategy:
- Look at what your capabilities are
- Get an accurate read on the demand in your local market
- Understand your patient’s expectations and how they prefer to engage
- Determine the willingness to support and level of confidence that clinicians have for your care-at-home offering
Esch also suggests beginning with a single use-case (ie: cardiology cases or ortho) rather than trying to tackle all possible care-at-home situations. Working through a single use-case not only helps the organization to focus, it can also identify issues that when resolved, will help make expansion of the care-at-home program easier.
Involving Clinicians
“It is critical that you work alongside clinicians to make care-at-home happen,” stated Michael C Petersen, MD – Chief Clinical Innovation Officer at NTT DATA Services. “You can’t work in isolation of clinicians. They not only have to be on-board but they also should have a hand in designing the workflows and processes that will be part of the care-at-home strategy.”
Petersen points to something as simple as alert escalation as an example of a process that needs clinician input. Most remote patient monitoring devices are designed to send out an alert when it detects something abnormal. Where should that alert go?
Involving clinicians in the design means that alerts will be routed to the appropriate staff when the care-at-home rolls out and more importantly, there will be buy-in that the alerts are going to the right place.
Petersen warned healthcare organizations not to underestimate the impact of the volume of data that will be generated from patients receiving care at home. “A single patient, being monitored at home by a single clinician is simple,” said Petersen. “But multiply that by a thousand or tens of thousands and you can see how daunting that becomes. You’re going to need someone who can consume that data, integrate it into your systems and provide the right alerts to the right people.”
Not NASA
When we think of care-at-home, the vision most of us get in our heads is a bunch of doctors and nurses sitting in a darkened room staring at a wall of huge monitors like they do at NASA’s Mission Control Center. Both Esch and Petersen were quick to point out that is far from the reality.
When implemented properly, doctors, nurses, and other staff will have access to dashboards designed specifically for the patients they are caring for at home. There will be a dashboard for cardiology patients used by the cardiology team, a dashboard for patients in rehab, etc. There may even be a dashboard for the CMIO that is vastly different than the one for case workers.
Esch also pointed out that the person using the dashboard is not likely to be in the basement of the building, but rather in their office, conducting rounds, or even at home.
Right Partner
“You can try to build a care-at-home program yourself and take years, or you can bring in a partner who can accelerate your thinking and the implementation,” said Petersen. “Healthcare in the hospital is complicated. Bringing that experience to the home and ensure it is seamlessly operating with the hospital’s systems is even more challenging.”
Esch and Petersen pointed to the increasing number of conversations they are having with their clients on this exact topic as evidence of the growing recognition by healthcare organizations that they need to partner with experts.
“It takes planning and an understanding of the local healthcare community,” said Esch. “Healthcare organizations need to partner with someone if they want to implement it quickly, and effectively.“
Bright Future
The future is bright for care-at-home as more and more organizations embrace the concept. Some organizations are even taking things to the next level by creating facilities without any beds – ingraining home recovery and care into their entire operation. UPMC in Pittsburg PA and Women’s College Hospital in Toronto ON are just two examples.
“The future will be ICU-straight to home,” said Petersen. “We’ll have all the services pre-positioned, all the dashboards already in place at the hospital, all the devices will be ready to be deployed to the patient’s home. Everything is seamlessly integrated.”
Let’s hope that future arrive quickly.
Watch the full interview with Lisa Esch and Michael C. Petersen, MD and learn:
- Why it is important to understand what patients want from a care-at-home program
- How AI is critical to the future of care-at-home
- Why mental health services and detecting falls have Esch and Petersen excited
To learn more about NTT DATA Services, visit their website https://us.nttdata.com/en/
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