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Hospital At Home - from A to Z

Updated: Apr 10, 2023



Hospital at home (HaH) - Definition


Hospital at Home (HaH) is a high-quality patient care model, which allows medical-level care in a patient's home. HaH programs, run by the healthcare providers, enable delivering hospital-level care for various acute conditions. More and more providers nowadays are in search of Remote Patient/Physiological Monitoring (RPM) tools/devices to gather the appropriate data to allow a better patient-focus care tailored for each individual.



Overview

In 1995, Dr. John Burton of the Johns Hopkins School of Medicine, and Dr. Donna Regenstreif of The John A Hartford Foundation developed a new method to provide safe and effective hospital-level care in the home. From 1996-1998, feasibility, cost-effectiveness and safety of a Hospital at Home method was proven with a pilot study comprised of 17 patients. Throughout the 2000’s several clinical studies were conducted to further assess the feasibility of such a concept, as well as its level of safety and the efficacy of treatment within this setting. In 2015, the Icahn School of Medicine at Mount Sinai, New York won a grant for testing H@H to inform a possible 30-day bundle payment model for fee-for-service Medicare, funded by the Centers for Medicare & Medicaid Services (CMS).



Hospital at home


COVID -19 Effect

The


COVID-19 pandemic stressed the necessity for such programs, delivering a high-level care from a safe distance. With the enduring shortage of manpower and overflow of patients rushing in to the hospitals and clinics, the medical staff are overwhelmed by the number of cases, underscoring the excess time invested in manually collection of the patients' vital signs.


Home Hospitalization programs conducted from the comfort of the patient’s already show that treatment delivered at home while the patients are properly monitored is safer, cheaper, and more effective than traditional hospital care, especially for patients who are vulnerable to hospital-acquired infections and other complications of inpatient care: (1)

  • Effectively reducing complications associated with longer LOS and readmissions

  • Reducing more than 30% of costs Decrease average hospitalizations (LOS of 3.2 vs 4.9 /days).

  • Fewer laboratory and diagnostic tests compared to similar patients in-hospital

To allow proper hospitalization of patients at home, there is a need for accurate and efficient medical-grade monitoring devices. While there are many devices out there that provide only some of the basic parameters, other non-medical grade/wellness devices are on the rise as they are more cost accessible to the end consumer and payers when looking at current reimbursement models. However, none fully covers the needed set of physiological parameters to allow proper H@H monitoring. Healthcare providers are still in constant search of medical-grade, regulatory-cleared devices to issue Home Hopitalization programs with hospital-level care.


As a result of this need, the digital health industry has developed partial solutions to address the gaps, and deliver a more personalized care at the point-of-care, such as:

  • point-of-care diagnosis

  • mobile healthcare

  • telemedicine solutions

  • tele- consultation

  • remote monitoring,

  • wearables & IOT and more.





Home Hospitalization - Biobeat's Advantages


The advantages and benefits of the Biobeat platform are:

  • 13 medical vital signs: non-invasive cuffless blood pressure, pulse rate, respiratory rate, blood oxygen saturation, temperature, stroke volume, cardiac output, single channel ECG, and more.

  • Medical grade regulation clearance: the platform is FDA-cleared for cuffless non-invasive blood pressure, heart rate, respiratory rate, temperature, stroke volume, cardiac output and SpO2, and CE Mark approved for all 13 parameters.

  • In-house developed health-AI platform, with an automated real-time early warning score (EWS) system that incorporates advanced algorithms to provide alerts on patients' health status and potential deterioration.

  • Decision support tool - Access to the patients' data provides advanced insights based on trends and patterns which brings efficiency into the process of healthcare delivery.

  • Data analysis - Optimization of data collection, providing medical staff the required clinical data when required.

  • Personalized care - The data collected via the Biobeat devices allow healthcare practitioners to adopt a data-driven personalized approach.


More Advantages of Hospital at Home



  1. Comfort and Convenience: Hospital at Home allows patients to receive medical care from the comfort of their own home, avoiding the stress and inconvenience of hospital stays. Patients can stay in their own bed, use their own bathroom, and have access to their own food and entertainment. This can lead to a more comfortable and relaxed experience overall, which can be especially beneficial for elderly patients who are recovering from illness or surgery.

  2. Lower Costs: Hospital at Home can be more cost-effective than traditional hospital care because it eliminates the need for expensive hospital infrastructure and staff. Patients who receive care at home typically do not require expensive medical equipment or specialized nursing care, which can result in significant cost savings. Additionally, Hospital at Home can reduce the length of hospital stays, which can further lower costs.

  3. Reduced Risk of Infections: Hospital-acquired infections can be a significant concern in traditional hospital settings, particularly for patients with weakened immune systems. Patients who receive care at home are less likely to be exposed to these infections, which can lead to improved overall health outcomes.

  4. Personalized Care: Hospital at Home provides patients with more personalized care, withone-on-one attention from a dedicated medical team. Patients can receive more individualized attention and care that is tailored to their specific needs and preferences. This can result in a more positive and supportive experience overall, which can lead to better outcomes within a short period of time.

  5. Improved Recovery: Being in familiar surroundings can lead to a faster and more successful recovery, as it reduces stress levels, especially among the elderly. Patients who are recovering from illness or surgery often feel more comfortable and at ease in their own homes, which can help them relax and focus on their recovery. Additionally, patients who receive care at home may have more opportunities to engage in activities that support their recovery, such as spending time with family and friends or engaging in light exercise.

  6. Increased Autonomy: Hospital at Home gives patients more autonomy and control over their care, allowing them to participate more actively in their own recovery. Patients can work with their medical team to create a personalized care plan that fits their specific needs and preferences and can have more control over their schedules and daily routines. This can lead to greater empowerment and engagement in the recovery process.

  7. Better Outcomes: Studies have shown that Hospital at Home can result in better outcomes for patients, including lower rates of readmission to the hospital and improved overall health. By providing patients with more personalized care and support in a comfortable and familiar environment, Hospital at Home can help patients recover more quickly and effectively, leading to better health outcomes in the long term.


Hospital At Home
Hospital At Home

Challenges of Hospital at Home

  1. Adequate Monitoring: Providing adequate monitoring and care can be challenging in a home setting, particularly for patients with complex medical conditions or who require close supervision.

  2. Limited Resources: Home care providers may have limited resources compared to traditional hospital settings, which can limit the availability of certain treatments or equipment.

  3. Home Environment: Patients' homes may not be equipped to provide the level of care required, and may not have the same level of cleanliness and infection control measures – if needed – as a hospital.

  4. Family Support: Patients who receive care at home may rely heavily on family members or other caregivers for support, which can be challenging for both the patient and the family.

  5. Communication: Communication between the patient, family members, and care team can be more challenging in a home setting, particularly if the patient is isolated or experiences language barriers.

The Future of Hospital at Home


The future of Hospital at Home is promising, with many healthcare providers and policymakers exploring the potential of this approach to healthcare delivery. As healthcare costs continue to rise and the population ages, there is growing interest in alternative models of care that can improve outcomes and reduce costs.


Hospital at Home has the potential to address many of the challenges facing traditional hospital care, including high costs, limited patient autonomy, and the risk of hospital-acquired infections. Advances in telehealth and remote monitoring technology are also making it easier to provide high-quality care in the home setting.


However, there are still challenges to be addressed, including regulatory barriers and the need for more robust reimbursement frameworks. Despite these challenges, Hospital at Home is likely to play an increasingly important role in healthcare delivery in the coming years, offering patients a more personalized, convenient, and cost-effective alternative to traditional hospital care.



References:

1. B. Leff, L. Burton, S. L. Mader et al., Hospital at Home: Feasibility and Outcomes of a Program to Provide Hospital-Level Care at Home for Acutely Ill Older Patients," Annals of Internal Medicine”, Dec. 2005 143(11):798–808.








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