In the ever-evolving landscape of healthcare services, the integration of technology is reshaping patient care. Nowhere is this more evident than in the innovative concept of Hospital at Home (HaH) settings.
Driven by the need for more efficient resource utilization, enhanced patient outcomes and a response to the changes underway, HaH programs represent a paradigm shift that introduces a host of tech-enabled tools. These technologies not only bridge the gap between traditional hospital care and home-based solutions but also empower patients and their caregivers to better manage chronic conditions.
Tech Integration in Hospital at Home: A Seamless Transition
The technologies utilized in HaH mirror that of traditional hospital environments, encompassing essential devices, such as IV pumps for patients requiring infusion therapies. Initially catering to low acuity patients, like those with chronic conditions such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD) and others, HaH programs leverage these cutting-edge technologies to ensure effective communication and care delivery services that are specifically performed by caregivers in the home setting.
For example, a caregiver may be responsible for helping with daily living activities, such as such as bathing, eating or dressing, as well as managing medications, scheduling appointments, talking to care providers, transporting patients to doctor’s offices and more.
Smart devices, like iPads and tablets, play a crucial role in facilitating and streamlining all these activities, including video/telehealth communications between patients and providers that create a virtual bridge for medical consultations. These devices empower patients to seek assistance promptly, offering a lifeline akin to the traditional hospital call light.
Additionally, wearables, such as smart watches, are integrated into HaH programs, providing real-time monitoring of vital signs and activity levels. These devices offer healthcare providers valuable insights into patients’ health status, allowing for proactive interventions and personalized care plans tailored to individual needs.
Even non-digital, low-tech aids, such as bedside commodes, floor mats and grab bars, find a place in the tech-enhanced home care environment, supporting caregivers in managing patients more effectively.
Beyond Hospital Discharge: A Continuum of Tech-Enabled Care
One of the unique aspects of HaH is the potential for tech-enabled tools to extend beyond the patient’s admission period. While certain devices, like IV pumps, are recovered as durable medical equipment, numerous technologies can be left with the patient or easily obtained post-discharge. This tech-enabled principle allows patients, particularly those managing chronic diseases, to continue caring for themselves more effectively.
Key among these technologies are wireless scales integrated with remote patient monitoring. Managing patients’ weight becomes critical in conditions like congestive heart failure, where fluid balance is paramount. Additionally, respiratory devices like CPAP machines can wirelessly transmit crucial data, ensuring seamless monitoring of patients’ respiratory health.
The integration of tech-enabled tools into HaH settings signifies a transformative approach to patient care. From facilitating virtual consultations to empowering patients in managing their health post-discharge, these technologies are shaping a new era of healthcare. HD Nursing’s role in maintaining care standards ensures that the innovative HaH model continues to thrive, offering a more efficient, patient-centric and tech-driven approach to healthcare delivery.
Bridging the Gap for Rural Health Challenges
As HaH programs expand, challenges related to social determinants of health (SDoH), particularly the rurality of patients’ locations, come to the forefront. Patients lacking adequate wireless or broadband access face barriers to qualifying for HaH programs. Overcoming these challenges requires a concerted effort to minimize the impact of SDoH on patients’ ability to participate in such programs.
Shaping the Care Team Mosaic
The composition of care teams in HaH settings diverges from the traditional hospital model. Leveraging community resources, providers enlist the help of paramedics and EMTs to install and manage durable medical equipment. Partnerships with external entities, such as Best Buy Health – Geek Squad and Logistics Management, bring in technicians to educate patients on using digital devices for communication and other technologies introduced into their homes.
In addition to nurses and other licensed professionals performing daily visits, additional personnel and family caregivers may be involved in carrying out basic activities of daily living, highlighting the dynamic nature of the care team.
This shift reflects a more diverse and flexible care team, catering to the unique needs of patients in a home-based care environment. HD Nursing plays a crucial role in this scenario, ensuring that the inpatient standard of care is met. By focusing on falls and pressure injury prevention, HD Nursing helps HaH providers avoid deficiencies in regulatory requirements and provide seamless care transitions between traditional hospitals and home environments.
Future Outlook: A Growing Area of Innovation
The exponential growth potential of HaH programs not only indicates a significant shift in healthcare delivery but also offers a sustainable solution for evolving healthcare systems. One example includes a large East Coast HaH vendor with the goal of expanding from a 30-patient census to 300 by the end of a year, underscoring the appeal and viability of this care model. This ambitious growth strategy optimizes resource utilization and also presents a compelling business case. The experiences of patients learning to self-manage in a home environment contribute to the success of HaH programs, fostering patient retention and satisfaction with care within healthcare systems.
By avoiding the need for additional brick-and-mortar facilities and the associated overhead costs, healthcare systems can redirect resources toward enhancing patient care. The financial implications of managing a “whole hospital worth of patients” in a home-based care model are significant. This innovative approach successfully addresses capacity challenges and positions healthcare providers to deliver high-quality care in a more cost-effective manner.
The appeal of HaH extends beyond operational efficiencies. Patients are drawn to the concept and experience a transformative shift in their healthcare journey. The ability to learn and adapt to self-care in the comfort of their homes fosters a sense of empowerment and independence. This positive patient experience becomes a critical factor for retaining patients within the healthcare system and establishes long-term relationships between patients and providers.
As HaH programs continue to refine their models and integrate the latest technologies, the future of healthcare delivery appears more patient-centric, flexible and accessible. The success of these programs lies not only in their immediate benefits but also in their potential to reshape the entire healthcare ecosystem. By embracing innovation and leveraging technology, healthcare systems can create sustainable practices that prioritize patient well-being while optimizing resource allocation for years to come.
Amy Hester
Amy has 25 years of nursing experience including over a decade of med/surge and neuro nursing followed by unit management and hospital administration. In 2015, she earned a Doctor of Philosophy in Nursing Science and has since published and spoken extensively on the subject of falls and injury prediction and prevention. She retired from UAMS in 2018 after 26 years of service to dedicate her time fully to HD Nursing. She is adjunct faculty at UAMS College of Nursing. As an entrepreneur, she mentors others to help them with their own endeavors. Amy also serves as the Chair of the HD Nursing Board of Directors.
