Covid-19 has broken down the traditional walls of healthcare and turned our idea of what it means to visit a doctor’s office or hospital upside down. It accelerated a nascent trend in displacing care delivery from traditional outpatient and inpatient facility settings to virtual care and hospital-at-home care.
With care now being delivered across so many settings — from hospitals to long-term care facilities to the home — we have to consider our path forward and what infrastructure, technology, and data are needed to holistically support patient care in every location.
The state of care today
The displaced care model is here to stay, and it’s moving from ad-hoc to a codified set of regulatory and business practices across the globe. In the United States, the Centers for Medicare & Medicaid Services (CMS) have been approving hospitals to treat patients from inside the home with new regulatory and reimbursement flexibility under its rapidly growing hospital-at-home initiative. The Biden administration is looking to further cement and support this trend, and originally proposed $400 billion to give the elderly more care at home.
Despite displaced care emerging somewhat out of necessity during Covid-19, hospital-at-home care can be beneficial to patient recovery. One study showed that patients increased mobility — a factor vital to recovery — by nearly three times relative to the facility-based cohort. At-home care boosted patient sleep time, produced fewer readmissions, and reduced mortality rates, all while significantly cutting costs. Especially for patients vulnerable to hospital-acquired infections and other inpatient care complications, at-home care can be a safe and effective solution.
For further advancements to happen, we need the right technology to help providers maintain accuracy and efficiency. Data is at the center of powering solutions that enable patient recovery at home, along with other tools that can scale current at-home patient care systems and offer more care to more people in more places across the world.
Advancing displaced care with better technology
With all of these changes, technology investment is critical to ensure safe and effective at-home care, starting with a modern data platform that can support unstructured data and real-time analytics.
Quality data is essential to successful care, and it’s never been more important for providers to have timely access to patient data. The effective use of data platforms will enable the collection, curation, analytics, and reporting of patient data, and ensure that quality standards are met from home. Timely data and reporting must provide a level of transparency that is commensurate with the traditional oversight in facility settings. This Harvard Business Review article shares an example of a health system, Piedmont Healthcare, that used a cloud-based platform to help deliver, engage, and personalize at scale. The Piedmont Healthcare team now has a complete view of patient medical history, and in-home providers can access patient profiles easily to flag gaps in healthy food access or transportation.
A modern data platform must enable advanced analytics for more targeted care, starting with identifying what patients and conditions are most appropriate for each care setting. Machine learning already is being used more frequently to predict deterioration — it’s considered by many to be the gold standard for such analyses in the ICU. And artificial intelligence tools can augment care outside of facility settings; this research paper shares how AI tools can help healthcare professionals conduct remote monitoring and manage telehealth visits. One consumer AI tool, Binah.ai, features a validated tool that can scan someone’s face and report heart rate (HR), oxygen saturation, and respiration. In the case of telehealth visits, the same research indicates that electronic interactions with patients can be “materially enhanced by AI,” which helps reduce response time for medical attention and alleviate provider administrative burden.
Streaming data and real-time monitoring, including wearables, is also at the forefront of enabling at-home patient management and rehabilitation. A company called Innsightful, for example, is developing wearable biosignal monitoring paired with artificial intelligence for virus detection. They also offer another wearable that picks up emotional stress — symptoms are assessed by a digital “agent” that can promptly put the wearer in touch with a therapist.
Audio data and sentiment analysis is another essential capability to help healthcare organizations bridge the communication gap between providers and patients. Sentiment analysis can enable companies in the healthcare industry to classify patient comments into component parts and then assign specific scores to categories based on comments. This technology enables healthcare providers to better assess patient well being and make at-home care achievable.
To advance care, healthcare leaders need to embrace a modern platform that accommodates unstructured data like video and audio, enables streaming data for real-time analytics, offers data governance and quality assurance, and supports both reporting and predictive analytics from a single source of truth. Organizations that do so will be able to meet patients where they are, improve the quality and consistency of care, and deliver a better experience for patients and providers alike.
Over the next 12 months, we can expect to see regulatory enablement of home health services, more private equity investment and consolidation in the home health market, and health insurers both building home healthcare capabilities as well as partnering with independent companies to drive care management programs. We’ll also see home health companies investing in technology capabilities outside of the EMR. Data will continue to lead the way on the Covid-19 front as the industry tracks progress of patients in their homes, arranges for urgent medical care remotely and navigates new variants and other challenges the pandemic might bring.
Covid-19 has both triggered displaced care and reimagined care more generally — this Bloomberg City Lab piece discusses how digital health is poised to continue to “break things,” as tech has done with other aspects of life. We’ve already broken down the traditional walls of healthcare, and if we invest in the right tools, we can continue shifting to a more streamlined, efficient, and patient-first care model.
Photo: elenabs, Getty Images