The Future of Healthcare Delivery is in the Home

Rapid advances in healthcare technology and the economics of healthcare delivery are creating unprecedented opportunities for more healthcare services to be delivered in the comfort of patients’ homes. And not a moment too soon, because all studies point to growing pressures on our healthcare system as Baby Boomers age.

Home care is an essential—and historically under appreciated piece of the healthcare puzzle. This segment includes medical professionals like physicians, nurses, physical therapists, occupational therapists, and speech therapists, as well as medical social services providers and skilled home health aides. As the healthcare community is coming to understand, not only does home healthcare reduce the overall cost of healthcare, it also improves the quality of life of the patients and their families.

To curb rising health expenditure and improve patient outcomes, the Center for Medicare and Medicaid Services (CMS) Readmission Reduction Program—an important part of the Affordable Care Act that went into effect on Oct. 1, 2012—introduced financial penalties for hospitals with excessive readmissions. The Medicare Payment Advisory Commission (MEDPAC) submitted a report to Congress in 2007 showing that 17.6 percent of hospitalizations resulted in often-avoidable readmissions within 30 days, costing taxpayers a whopping $12 billion. Some of the top reasons for hospital readmissions include:

1. Patients not fully understanding what’s wrong with them
2. Patients being confused over which medications to take and when
3. Hospitals not providing patients or doctors with important information or test results
4. Patients not scheduling follow-up appointments with their doctor
5. Family members lacking proper knowledge to provide adequate care

Focusing on home health care presents an obvious solution. A study by the Alliance for Home Health Quality and Innovation took historical data to forecast potential savings of $10.3 billion over ten years (2014-2023) by reducing regional hospital readmissions through the use of home health as the first line to handle post-acute care episodes.

A key element is the application of technology. Here are four areas in which technology is making a real difference in home healthcare:

1. Improved medical team communication and coordination. Patients are often treated by more than one medical or health professional in the course of their care, and technology is enabling real-time team communication as never before. This could mean giving a home nurse the ability to pull up the patient’s entire record on multiple windows, simultaneously, on her tablet during a visit, or giving the home team a portal through which to communicate with the overseeing physician to provide alerts on changes in the patient’s condition.
2. Improved communication with the patient. Everyone benefits from having an informed patient. Today, technology makes it possible for home care professionals to check real-time drug interaction updates, or to share videos with their patients teaching them about the protocols for new treatments – in the language of their choice. Patients today can link up in telemedicine consults with their doctors and nurses and obtain instant responses to in-home situations, often avoiding costly doctor visits and hospitalizations. For instance, in 2007, the Veterans Health Administration (VHA) was able to achieve a 19% reduction in hospital visits and other cost savings through a program that provided telehealth services including videophones, digital cameras and vital sign monitors to patients in their homes.
3. Shift from “fee-for-service” treatment to holistic Accountable Care Organization model. When patients can stay home, hospital beds and personnel can focus on the most acute cases. Indeed, studies performed by The Joint Commission in 2011 show that patients prefer to receive healthcare services in the comfort and dignity of their own homes. By integrating healthcare into daily life, instead of limiting contact with the medical system to a few office visits or hospitalizations, the dynamic of treatment changes to emphasize self-management. Home health agencies must adopt software that is HL7 compliant in order for them to be able to partner with ACO hospitals for seamless, 360-degree patient care.
4. Increased efficiency and competitiveness for even the smallest home health agencies. Not only is advanced, Web-based software now available to help agencies work more efficiently and effectively than ever, there are also affordable choices for agencies of all sizes. With the 2014 deadline for agencies to adopt electronic medical records (EMRs) fast approaching, the jump into the 21^st Century can be pain-free if agencies invest the time on the front end to conduct a thorough software demo, including clinicians in the field as well as administrative staff in the back office, to find the option that is best for them.

With the availability of cutting-edge models in care coordination, prescription management, disease management, and behavioral education for patients, technology providers are helping home health agencies incorporate innovative and cost-effective approaches to deliver high quality, patient-centered, well-coordinated care across the health care delivery system. Patient outcomes are improving and overall health expenditure can decrease as a result. With or without the creation of a health IT czar (as reported here in recent days), the market is moving toward new technology and will bring with it a new – and welcome – focus on the role of home health care.

— John Olajide is the founder and CEO of Axxess.