Advancing digitally enabled hospital-at-home services
Virtual care adoption accelerated dramatically in Australia in the wake of COVID-19. This was driven by the need to minimise the risk of the virus spreading, free up bed capacity for acutely unwell patients, and preserve personal protective equipment (PPE).
One area that has seen substantial growth is hospital-at-home models of care. While Australia has had well-established hospital-at-home services for many years, the pandemic has fuelled further interest in this model and is accelerating the development of new models of hospital-at-home care. Many of the traditional barriers, such as clinician understanding of the relevance of the model and patient concerns about being cared for at home, no longer exist.
Gartner predicts that 40% of healthcare providers will shift 20% of hospital beds to the patient’s home by 2025, by offering digitally enabled hospital-at-home services, improving patient experience and outcomes, and reducing costs.
Advances in hospital-at-home technologies
Hospital-at-home services consist of acute-level health care that is enabled by multidisciplinary teams, digital technologies and ancillary services. It is delivered in the homes of patients who would otherwise require admission to an inpatient facility. Advances in virtual care technology are enabling higher acuity patients to be cared for at home and delivery of hospital-at-home models of care at scale.
For healthcare providers, establishing hospital-at-home services requires the development of new capabilities across clinical (such as home infusions and diagnostic testing) and logistics (such as delivery of medical supplies) domains.
Healthcare providers must decide whether to build these capabilities internally or to partner with a third party to supplement their existing capabilities. Calvary Health’s partnership with Medibank Private is one such example, delivering the new My Home Hospital program across metropolitan and outer suburbs of Adelaide in South Australia.
Irrespective of how services are organised, the flow of clinical information across service lines is a must for minimising clinical risk associated with transitions in care, as is the ability to access this information on any device for this highly mobile clinical workforce. Therefore, the underlying technology platform supporting the program must enable seamless integration of information across the entire value chain.
Technology advances, particularly in the area of remote patient monitoring, are dramatically changing the capacity to care for patients in their homes. Medical-grade wearable biosensors are enabling the continuous collection and monitoring of a patient’s physiological parameters.
Applying analytics, artificial intelligence and machine learning to this data, combined with subjective information collected from the patient and data contained within the electronic health record (EHR), drives scale through clinical decision support, eg, through the alerting of clinicians to patients with early warning signs of deterioration and those who require urgent attention.
How to advance hospital-at-home
In establishing or scaling hospital-at-home services it is incumbent upon healthcare providers to ensure virtual care technologies meet the clinical needs of hospital-at-home patients. Do this by working with clinical leaders to understand the digital capabilities required to support the acuity level for target patient cohorts.
Healthcare providers must also focus on building an underlying digital architecture that delivers a seamless clinician user experience by partnering with clinical informatics colleagues and third-party partners to map core clinical workflows and identify key information and integration requirements.
In addition, include evaluation of the digital solution architecture in terms of connectivity, data requirements and interoperability, and the ease of which target patient populations can engage with and use the technology across procurement processes.
To facilitate communication across the distributed multidisciplinary care team and operational support staff, deploy care team collaboration technologies that enable communication and collaboration on patient care in real time. Ensure these technologies also include capabilities to include the patient, their caregivers and family in their treatment and care.
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