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Andrew Burt
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CLINICAL-GRADE TECHNOLOGY DRIVES THE HOSPITAL AT HOME REVOLUTION
Imagine receiving medical care—excluding ICU-level interventions—in the comfort of your home. No more hassles of trudging to a doctor’s office for routine care, dealing with parking, long wait times to be seen, etc.
This Hospital at Home (HaH) model—a relatively recent innovation in healthcare delivery—is one of the most evidence-based health service delivery options in years. In fact, HaH is supported by a growing body of research showing its effectiveness in helping improve all components of the value equation—patient outcomes, patient experience, and reduced cost.1
HaH offers similar care services as a brick-and-mortar hospital, but the remote monitoring devices used in HaH must be of clinical-grade quality—meeting regulatory, scientific, and operational standards—and bolstered by advanced measurement instruments, sensors, and AI.
WHAT IS HOSPITAL AT HOME?Hospital at Home takes staff, equipment, technologies, medication, and skills usually provided in hospitals and delivers that care to patients in their homes. A multidisciplinary team provides essential treatments, including vital signs monitoring (VSM), heart failure monitoring, point of care testing (POCT), and more. HaH is ideal for patients with chronic conditions with acute exacerbations, not needing constant monitoring or intensive interventions. NOTE: Not all patients are suitable candidates for HaH care. Every HaH program has its own inclusion/exclusion criteria to treat patients at home. Some diseases treated in HaH are COPD, CHF, pneumonia, UTI, cellulitis, and asthma.2 |
“HaH is one of the future healthcare services that ADI is supporting with its product development. But its success will be centered around cloud-based algorithms and advanced, clinical-grade sensing technologies which operate at the Intelligent Edge.”Andrew Burt
Director, Product Line Management, Digital Healthcare Business Unit | Analog Devices
The Case for Hospital at Home is Growing
RESEARCH CONFIRMS: HOSPITAL AT HOME WORKS
Numerous studies have confirmed HaH’s effectiveness. One such study published in JAMA Network Open showed that compared to their in-hospital counterparts, HaH patients had similar mortality risk, a 26% lower readmission risk, and a lower risk for admission into a long-term care facility. Researchers concluded HaH was a viable alternative for in-hospital stays.7
In 2018, the Medicare & Medicaid Innovation Center conducted a HaH study at Mount Sinai Hospital in New York City, published in JAMA Internal Medicine. The study, set in a fee-for-service model, showed HaH reduced acute stay lengths, halved readmissions, and decreased emergency visits and care costs over 30 days. Additionally, HaH patients experienced better care and fewer discharges to skilled nursing facilities.8
Further proof that HaH is not a fringe healthcare model is at Mass General Brigham Hospital (MGH Brigham) in Boston. Here, HaH has become one of the largest, most established programs in the country, and what MGH Brigham terms “home hospital” care is one of their strategic priorities moving forward.9
EVERYONE BENEFITS FROM HaH: PATIENTS, PROVIDERS, PAYORS
- Enhanced comfort, convenience, familiarity
- More personalized, proactive care
- Reduced risk of infection outside hospital setting
- Greater satisfaction without the hassles of doctor/hospital visit (travel, parking, time consumption, etc.)
- Greater resource efficiency, reduced need for hospital beds
- Free up healthcare workers’ time for critical care patients
- Enhanced patient monitoring
- Help prevent/treat potential issues earlier
- Lower operating costs with reduced overhead
- Cost savings by avoiding expensive hospital admissions
- Reduced length of hospital stays, saving costs
- Identify health problems early, avoiding higher cost claims
AI IS AT THE HEART OF HOSPITAL AT HOME
AI is revolutionizing society, and perhaps no more so than in healthcare and in particular, HaH. AI is enabling key technologies in HaH that help deliver:
- Real-time, predictive data analytics and early warning signs (EWS): Informing clinical decisions from comprehensive patient data.
- Telemedicine: Enabling virtual consults with providers and virtual assistants for instant access and guidance on treatments.
- Optimized resources: AI algorithms can help optimize the allocation of resources by predicting patient needs and coordinating the deployment of nurses, equipment, and medications.10
- Enhanced patient engagement: Leveraging AI-powered apps and tools may help patients access educational materials, communication info, tracking, etc.
- Medication management: Reminders can be sent to patients to take medications on time, in proper amounts, and include interactions, and side effects.
IF IT’S NOT CLINICAL-GRADE, IT’S NOT HaH-WORTHY
For HaH to truly be effective, it requires regulated, clinical-grade, remote patient monitoring devices. Fortunately, these high-quality devices are increasingly common, affordable, and accessible to both patients and providers.
Key Technologies Driving Hospital at Home Care
Continuous glucose monitoring (CGM)
Pulse Oximeter
Attached to finger to measure blood oxygen levels
Vital Signs Monitor
Pressure monitors, wearables, cuffs
Telehealth Platforms
Point of Care Testing
(POCT)
While HaH technologies are beneficial, researchers found risks like alarm fatigue and accuracy issues with false positives/negatives.11 These challenges can overwhelm providers with excessive alerts or misinterpret patient conditions.
Advanced semiconductor technologies and precision-driven algorithms can enhance accuracy by filtering noncritical data, ensuring only essential information reaches healthcare professionals. This helps reduce alarm fatigue and improve patient monitoring reliability.
HOSPITAL AT HOME: TRANSFORMING HEALTHCARE DELIVERY
The American population aged 50 and over with one chronic condition is expected to double to +142 million by 2050.12 HaH offers a viable solution to improve care across the healthcare spectrum for these patients, caregivers, and insurers. What’s more, HaH can also improve services for underserved communities, rural areas, and those who are homebound.
To be clear, while HaH is gaining in popularity, it does not eliminate traditional doctor-patient interactions, rather it enhances them through improved communication. Ultimately, the success of HaH is contingent upon the use of precise, clinical-grade technologies that leverage data to provide actionable insights.
References
1 Hospital at Home: An Evolving Model for Comprehensive Healthcare. NIH/National Library of Medicine, 2021.
2 "Hospital at Home.” John Hopkins Medicine; “An Introduction to Hospital-at-Home, and How RPM Enables It.” CareSimple.
3 Association of Primary Care Visit Length with Potentially Inappropriate Prescribing. AMA Health Forum, 2023.
4 Consideration for Patient Panel Size. NIH/National Library of Medicine, 2022.
5 Is Your Living Room the Future of Hospital Care? KFF Health News, 2021.
6 Healthier at Home: Creating Value for All in the Shift from Hospital to Home. PA Consulting, 2023.
7 Hospital-at-Home Interventions vs. In-Hospital Stay for Patients with Chronic Disease Who Present to the Emergency Department: A Systemic Review and Meta-analysis. JAMA Network Open, 2021.
8 Association of a Bundled Hospital-at-Home and 30-Day Postacute Transitional Care Program with Clinical Outcomes and Patient Experiences. NIH, National Library of Medicine, 2018.
9 Mass General Brigham to Expand Home Hospital to 3 Community Sites. Mass General Brigham, 2023.
10 Kuo, A.M.H., et al. “Artificial Intelligence–Based Systems for Managing Patient Flow in Emergency Departments: A Review”. Journal of Medical Internet Research, 2020.
11 The Role of Digital Technology in Surgical Home Hospital Programs. NIH, 2023.
12 Projecting the Chronic Disease Burden Among the Adult Population in the United States Using a Multi-state Population Model. NIH, 2023.
