It’s hard to ignore anything that becomes a “movement” in the way [email protected] models have. And it’s no wonder: with the ability to provide acute, hospital-grade care in the patient’s home instead of a (probably) expensive and (potentially) dangerous trip to the hospital, why wouldn’t it be deserving of its own hashtag?
In addition, experts repeatedly cite its clinical results success – with global popularity. According to Home Healthcare News, “hospital-at-home care has been shown to achieve shorter average lengths of stay compared to traditional in-patient care, at 3.2 days compared to 5.5 days, respectively. Additionally, hospital-at-home models have also been found to have substantially lower rates of hospital readmissions and lower rates of emergency department visits.”
And as the pandemic continues to remain with us, many of the original roadblocks (from reimbursement structures to technology support) that existed between a solid embrace of [email protected] and its implementation have faded into collective memory.
In a recent episode of the Vital Insights podcast series, we delved into the implementation of virtual care models like [email protected] with Karen Thomas, RN, to identify roadblocks that have been addressed – and the ones that remain. Through her work with both healthcare provider clients and remote patient monitoring companies, she identified a few of those: 1) demonstrable ROI, 2) addressing staff shortages, and 3) quality of data provided.
And as Karen suggested in her interview, it’s helpful to begin with ROI – or as she calls it, “following the money.”
ROI of Value-based Care
A roadblock to almost any proposed change to in infrastructure typically has to pass muster in terms of a perceived reduction in overall costs – which in the healthcare industry ties tightly to the capability for reimbursement.
“If we ‘follow the money’ surrounding [email protected], there are a couple critical elements that have been addressed recently,” said Karen. “One of those is that CMS [Centers for Medicare and Medicaid] has come around to the idea of long-term care in the home through support such as provider waivers, new accounting methodology for home health, and new reimbursement codes for virtual care. Anytime CMS has enough data that they’re willing to pay, we know we’ve turned a corner – and are headed in the right direction.”
Alleviating the Staffing Burden
The ability to address the shortage of healthcare staff has been the subject of debate for decades – even prior to the pandemic, which only exacerbated the issue. If technology solutions intended to streamline workflows instead do the opposite and add to staff workloads (even if only temporarily), it can represent a major roadblock in the successful implementation of virtual care models.
“Our personnel – nurses and physicians – are valuable assets to an organization, and time is money,” observed Karen. “If technology solutions can build time back into their day – maybe by taking away the hours they previously spent driving to see patients in their homes – and give them more time to spend with patients or even see more patients, then we’ve alleviated that staffing burden, while increasing the quality of care we’re providing to our patients.”
Quality of the Data
In her podcast, Karen discusses the quality of data as being more than the sum of its parts. And where we sometimes tend to focus only on the measurable aspects of quality (i.e. how well the devices adhere to the gold standards in terms of measurement validity). While that component is absolutely critical, it doesn’t represent the whole picture.
“If we look at how the data can be used, and even more, how different streams of data can be pulled together so that we’re seeing a more complete picture of patient health, that also represents an aspect of quality,” said Karen. “For example, if we’re monitoring a post-operative patient overnight with an EarlySense device, and notice increase movements and respiratory rates in the early hours of the morning, followed by a higher-than-normal blood pressure reading for that patient, we would be able to discern the pain medication they are on at night isn’t a high enough or frequent enough dosage, and pain is breaking through. The more you understand the trend data, the more opportunities you have to intervene.”
As president of Cardeum, Karen focuses on reducing hospital readmissions, improving patient outcomes, and reducing health care costs through the use of transformative technologies and best clinical practices. Tune in to her podcast to find out how.