Hospital at home tech: The ‘quiet revolution’ improving outcomes, cutting costs and building relationships

At CES 2019, experts from around the healthcare industry highlight the human benefits of home care technologies.
By Dave Muoio
03:08 pm

Left to right: Medically Home Group's Richard Rakowski, Stand Up To Cancer's Sung Poblete, LHC Group's Bruce Greenstein and panel moderator Glenna Crooks.

Healthcare is no longer solely housed within the walls of the doctor’s office. Thanks to the numerous remote monitoring, telecommunication and care delivery technologies developed in recent years, patients are spending less time recovering in a hospital bed while caretakers are more equipped than ever to watch over the health of their loved ones.

As these innovations become cheaper and easier to scale with each passing year, leaders from various corners of the healthcare industry are looking to how a tech-driven “hospital at home” healthcare model could reduce costs and improve satisfaction across medicine.

“We’re just getting to the point where [home care] technology makes sense. It’s scalable, it’s not super expensive — it’s not cheap, but it’s affordable, and it’s certainly [more so] in the context of providing care in the home rather than in the hospital,” Bruce Greenstein, formerly the CTO of HHS, now the EVP and chief strategy and innovation officer at LHC Group, said during the opening session of CES 2019’s Digital Health Summit.

“Now you have to take the next step: is it safe enough? What’s the level of complexity of patients that you’ll take in? How do you choose to go there instead of going home? … We’re in the midst of a very quiet revolution, [and] the better we are at articulating exactly what these programs mean and how it works, the better we are in terms of making it more widely available.”

The benefits of home care technologies aren’t just limited to reduced costs, continued Dr. Bruce Leff, a professor of medicine at Johns Hopkins University School of Medicine and a longtime proponent of remote care technologies. Patients are, understandably, much happier recovering from a recent surgical procedure in the comfort of their own home, and shielded from the risk of developing one of several hospital-associated conditions that can often complicate recoveries.

“Hospital at home is actually one of the best delivery models out there. If you look into the core literature, there are dozens of randomized controlled trials [that] show patients actually do better at home than in the hospital,” Leff said during the session. “If hospital at home was a pill or a medical device, none of us would be sitting up on stage — we’d be on a beach in the Caymans counting millions of dollars in profit because it’s such a powerful intervention. But disseminating health delivery is more difficult, and certainly worthy of the effort.”

A vital component of home care technologies are their capacity to link the patient with other stakeholders and, subsequently, improve communication. While this functionality primarily serves to help caregivers modify therapy, it also can help patients and their family members alike become more involved in the care experience.

“One of the under appreciated aspects of this technology is the ability to integrate family 24-7, on demand,” Richard Rakowski, CEO and founder of Medically Home Group, said during the session. “It’s usually a family member that struggles … and they want to access a physician to ask a question or get the status of a family member. The beauty of [these technologies] is now every family member [can] ask questions, have them answered on demand, in real time, and changes the level of emotional response that a family member has, which then drives patient behavior.”

Greenstein took this point one step further, stressing that tech-driven, on-demand communications with providers can keep anxious family members from pushing for unnecessary healthcare utilization.

“We don’t talk about it very often, but [guilt is] an amazing driver. If you’re feeling guilty and you’re feeling without a lot of power and control because you live in another town and your parents are in Del Boca Vista … it’s definitely a driver that makes people make what they see as the most cautious and using the most resources decision, but is rarely the right decision to make. So when you think about intersecting technology in the model, it gives the ability to have distant and remote adult children of the parents — or a spouse or anyone in the family — have access to the clinician and information, being part of the care decision remotely. Being part of a care team, even remotely, makes those healthcare decisions … far more efficient, far more accurate.”

Even if in-home care means that physicians won’t be seeing their charges in person, Rakowski argued that the hospital at home care model also could be an opportunity for physicians to refocus on their relationships with patients and their families. Specifically, he harkened back to the healthcare model of years past, where a single physician or care team could stick with a patient throughout the entire course of their care, respond to their feedback and find professional satisfaction in their recovery.

“[SInce then], we industrialized medicine and started to do piecework with one physician doing part of the care and another doing another piece of the care, and most clinicians never get to see the end of this course of care, whether the patient did well or not,” Rakowski said. “With [hospital-at-home tech approaches], if you do have significantly lower cost … a single care team can stay with the patient from beginning to end with no handoffs, no transitions and no loss of satisfaction by the clinician actually seeing what happened to the patient. I cannot overstate how important that is for clinicians because that’s why they went into medicine — to heal patients.”


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