It’s all good.
Home Healthcare is Growing at an Astronomic Rate and Costs are Lower
The mean cost of care provided to patients in the home instead of at the hospital was 38% less, according to a study in the Annals of Internal Medicine[i] (n=91) that compared outcomes and costs of hospital-level care provided in the home.
30-day re-admissions to the hospital are lower at for patients at 7% and 23% of the at-ome and hospital patients, respectively. The at-home patient cohort was more physically active and had fewer lab and imaging tests.
What do Hospital Administrators think?
It is a trend seen at many of the nation's largest health systems that are actively seeking ways to reduce costs by treating patients at home instead of admitting them to the hospital. Traditionally, hospital administrator strategy research has shown that administrators are concerned about filling beds but are looking for new business models that lower costs. A joint venture between Pittsburgh-based Highmark Health and Contessa, a company that wants to bring hospital-level care into the home of the patients will allow clinicians to focus on the hospital’s sickest patients, while actively treating patients at home that don't require continuous monitoring.
Home healthcare is positioned for significant growth, driven primarily by the baby boomer aging population. Hospitals are an expensive place to deliver care and are under pressure to reduce the costs of care while improving quality and outcomes. Medicare is enabling home healthcare growth through new policies that allow non-skilled, in-home support to chronically ill patients over 65 y.o. By providing care to patients at home who don't need continuous monitoring and do not have a life-threatening diagnosis, the use of home healthcare medical devices reduces pressure on hospital administrators.
The New Channel – Home Healthcare to the Patient
All this spells opportunity for the medical device industry. Contessa's technology covers 150 diagnoses where patients can be treated at home. As always, the medical team decides if treatment at home is appropriate but once the handoff is made, Contessa manages everything, including reimbursement with payers for services and the technology it brings to its partner healthcare institutions.
In a Becker’s interview with Abbott executive Robert Ford[ii], he stated that hospital costs can be reduced by remote monitoring, which sends patient data to a hospital, clinic or physician at regular, pre-determined intervals. Providers can review and evaluate the information to intervene appropriately with remote or in-person follow-up at the office of the provider. Patients feel confident that they are connected to their physician and can continue daily activities without travel to the doctor's office or emergency visits to the hospital.
What role can AI and Machine Learning Play in Home Healthcare?
Ford also said, “…data alone is not enough[iii]. The explosion in digital health technology is making it easier than ever for data from multiple sources to be shared across connected devices, apps and cloud-based services. Given the trends we're seeing in healthcare — the growing cost pressures on hospitals, health systems and patients themselves, as well as the prevalence of chronic conditions that need to be managed 24/7 — future innovations in medical device connectivity and remote monitoring must provide real, measurable value to the patient and to the healthcare institution. It must be accessible to the masses; it must be affordable. We must focus data insights to understand trends, predict outcomes and inform health actions. Will it help patient compliance? Can we use the data along with advances in machine learning to deliver personalized precision therapies?”
What is Abbott doing in Home Healthcare?
According to Ford, Abbott has developed several life-changing innovations that provide data and insight that are meaningful, actionable and provide clinical benefit. He referenced the Confirm Rx insertable cardiac monitor, which incorporates Bluetooth® wireless technology. This allows patients to connect their implanted insertable cardiac monitor to their smartphone with a secure mobile app. Once it's implanted, the Confirm Rx continuously monitors the heart and data is communicated to the doctor using the mobile app. Patients can record symptoms from their own smartphones using only the app, simplifying patient usability of the system.
The CardioMEMS™ Heart Failure System is an easy-to-use wireless technology for remotely monitoring pulmonary artery pressure. It is implanted into the pulmonary artery and sends data through the cloud to the physician, who can adjust the treatment plan, often before patients are symptomatic and without requiring follow-up physician appointments or hospitalizations. Ford states that the CardioMEMS HF System significantly reduces heart failure hospital admissions.
The FreeStyle Libre system uses a sensing technology that transmits glucose information from a patch using connectivity and remote continuous glucose monitoring. The device is approved in Europe and is used with a mobile app that allows people with diabetes and their caregivers to monitor glucose readings in real time. Sharing glucose trend data is important for people who are caregivers or patients who cannot manage their glucose levels.
The human factors usability features of the FreeStyle Libre system are designed to fit into the patient’s lifestyle. Medical device human factors research has helped Abbott design a device that doesn't require finger sticks, which drives patient compliance and a reduced incidence of hypo- and hyperglycemia.
Connectivity is a critical part of the equation when it comes to medical device innovation. It leads to true improvements in patient care and better health outcomes.
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REFERENCES
[i] https://annals.org/aim/article-abstract/2757637/hospital-level-care-home-acutely-ill-adults-randomized-controlled-trial
[ii] https://www.beckershospitalreview.com/healthcare-information-technology/what-does-the-future-of-remote-patient-monitoring-look-like-abbott-executive-robert-ford-weighs-in.html
[iii] Ibid.