Healthcare provided in the home, which was previously considered a care delivery option primarily for seniors and rural patients, is now evolving into an expectation among healthcare consumers of all stripes.
Today, consumers want healthcare to come to them, in much the same way that Amazon brought the mall to them, said Rami Karjian, co-founder and CEO of Boston-based Medically Home Group. Karjian spoke at a virtual panel about the state of home health during the MedCity INVEST Digital Health conference on Monday. Aneesh Krishna, a partner at Mckinsey & Co., moderated the panel, which was sponsored by Workpath.
Patients are aware of the myriad benefits offered by home healthcare, including improved care quality, Karjian said. The volume and quality data that can be collected at home is one of the main reasons why home-based care results in better outcomes.
For example, when a patient pushes the nurse call button in a hospital, there can be significant delays in a nurse actually coming to the bedside, but nobody knows how long the delay is or how many times the patient has pushed the button, Karjian said. But in the home healthcare arena, those metrics are available.
“We have exquisite data on how long it takes a nurse to get there, how long it takes for a doctor to get to the phone when you call in,” he said. “[There is] more detail around the richness of the data you get in the home.”
Eddie Peloke, CEO of Richmond, Virginia-based Workpath, echoed Karjian during the discussion.
The healthcare consumer mindset has shifted irrevocably, especially in the wake of the Covid-19 pandemic that prompted a shift to home-based care, he said. Patients are open to receiving higher acuity care at home, which provides opportunities to expand the patient population that typically receives this type of care.
One population for whom home healthcare can be scaled quickly is clinical trial patients. Vulnerable patients from any part of the country can stay home and still participate in a potentially life-changing trial.
“When you think about enrolling diverse patients [and] participants, improving engagement, reducing dropouts — really performing that care in the home can be a huge benefit to the clinical trials [population],” Peloke said.
Not only that, but home healthcare can provide insights into social determinants of health, which have a huge impact on patient outcomes.
According to Peloke, his great uncle-in-law, who is 97 years old, had heart surgery and was discharged with the usual instructions. A nurse later came to visit him and discovered details about the home, including that it had narrow staircases with no handrail and a wood-burning stove, that changed their recovery plan for him.
“The stuff they told him to do, he was never going to do,” Peloke said. “He couldn’t do it.”
As home healthcare becomes increasingly popular, there are certain precautions that need to be taken, especially with regard to the technology infrastructure supporting this model of care.
Technology provides clinical insights, but there can be biases in the IT systems and algorithms used that skew medical decision-making. The teams building technology for this space and the providers employing it need to guard against this possibility.
“As we are moving very fast, it’s easy to bypass some of those things you will consider in a [healthcare technology] data science or engineering team,” said Serrah Linares, vice president of partnerships at Nashville, Tennessee-based Change Healthcare during the panel. “And if you are in one, having an expert who is the clinician or someone who is an expert in the field you are building the insights for [is] a really important part of the development.”
It is up to industry stakeholders to build trust and consumer confidence in the technology and apps being used in the home health field, she said.
Photo: selimaksan, Getty Images
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