The Hospital-at-Home Model

Around the world, countries like the U.S., Canada, the U.K. and Australia are keying in on a new model of care in response to the growing need for modernized, adaptative care. This rising movement is toward hospital-at-home, a model in which health care providers can deliver hospital-level care in the comfort of a patient’s home.   

The concept is rooted in the ongoing need to reduce patient load at hospitals, lower costs, prevent readmissions to hospital, and improve outcomes. Any time someone can avoid a trip to the hospital, or the clinic, and receive professional care or monitoring at home that keeps them safe – it is directly linked to better outcomes.   

A hospital-at-home strategy leads to outcomes that favor patients and providers:  

Not surprisingly, institutions across the world have been experimenting with how such a model could work for years now, as a potentially effective way to support patients whose care needs are not serious enough to warrant to trip to the hospital. In the U.S., the first to develop a hospital-at-home system was Johns Hopkins in the 1990s (a model validated in this 2005 study).  

Official Hospital-at-Home Program Launches in U.S.

In November 2020, the U.S. Centers for Medicare & Medicaid Services (CMS) launched its Acute Hospital Care at Home effort as a method to reduce strain on hospitals caused by the COVID pandemic. This follows a Hospital Without Walls program from March 2020 that enabled hospitals to operate beyond their centers. 

The newest program, built on a well of research confirming at-home care works, enables eligible hospitals to have the flexibility to treat certain patients in their homes. It is particularly beneficial for patients who would otherwise be admitted to hospital because they need to be monitored at least once a day for their ongoing care needs.  

The program now counts 80 U.S. hospital systems... and growing.  

Requirements for the U.S. Hospital-at-Home Program  

In order to participate with CMS’s new program, hospitals will be required to have the appropriate screen protocols set in place before treating in the place. CMS has put forward the recommended safeguards and the proper assessments needed to ensure quality care is delivered.  

What Does this Mean for Home Care Providers? 

Organizations that already work in client homes are a critical aspect of this hospital-to-home movement. While home care agencies are not hospitals, obviously, they must still be fluid members of that person’s care management plan. hospital-at-home is a moment that brings considerable opportunities to home health providers.  

The future of health care is in the home. Research has shown (like in this key U.S. study) that home-based non-urgent health care is as or more effective than in medical clinics. Home care agencies will be in the thick of the action: working with hospitals in regions they serve to provide home-based services. Hospital-at-home will work to serve people in their homes – but those people will soon want a long-term solution to staying well. And that is where home care organizations will come in.  

And the fact is that many agencies are already able to shoulder the load. During the COVID crisis, many home health care organizations stepped up and instituted their own hospital-at-home programs by taking patients from local hospitals and setting them up with care plans at home. Many had to figure out the payer implications on the fly.  

The fact is that home care agencies are set up to facilitate longer-term hospital-at-home plans. The opportunities are vast now that this model is being treated with the focus it very much deserves. Hospitals will be decompressed, and the home will be the environment of choice for everyone moving forward.  

Knowing this escalating trend, agencies must ensure that their technological systems are flexible enough to enable this collaborative care. And it becomes now more important than ever to empower family caregivers with the training, knowledge and equipment to keep their loved ones safe. Home care agencies have the strongest lens on the family relationships and are key to enabling this important role. 

 

Technology’s Role in the Hospital-at-Home Movement

There are several software features that are most important to facilitate a shift towards a hospital-at-home program to ensure stakeholders remain safe during COVID and beyond:

Mobile technology: Care workers require flexibility and efficiency, and need to access data and clinical documentation at any given time, even offline. At this point, mobile apps are the lowest-hanging fruit – but take them a step further by making them customized to what that care worker specializes in, typically administers as therapy, or performs as interventions. 

Remote patient monitoring: Any hospital that leaps into this movement without an RPM system in place will be missing an enormous boat. Home care agencies for their part should evolve their systems to capture client vitals and information in real-time, whether self-recorded in an app, captured via Bluetooth or wearable tech, or via any other method. This innovation is singularly important to any care plan’s success. 

Real-time connectivity: In the hospital-at-home model, there is of course no nurse station to visit. Yet, here, technology can significantly close the gap by bringing clients into a virtual ward where two-way dialogue is possible between care professionals and the clients they serve.   

Virtual visits: In 2020, we witnessed the rise of virtual care in swift fashion out of immediate necessity. Physicians in many disciplines now, beginning with primary care and extending to specialist care, have made this a new normal. Virtual care has also made great strides within the home and community care space as well. 

Home infusion: for various clients incapable of or unwilling to visit the hospital, home infusion is a viable option – and it’s now possible to be done virtually. It also presents a safer option for many clients who have autoimmune diseases, rare or chronic illnesses (clinics can learn best practices from providers such as Option Care Health). AlayaCare recently spoke to CSI Pharmacy to discuss how they leverage home infusion operations. Stay tuned find out more about this interview.

Interoperability/Integrations: It is a safe assumption that more than one software system will require integrations in a hospital-at-home model. For this, modern technologies rely upon APIs to enable a best-of- breed experience. A single hospital EMR is highly unlikely to support enough use cases to work stand-alone, and partners involved in patient care will have to have systems that speak to the others.  
 

 

How AlayaCare Supports Hospital-at-Home

The shift towards a hospital-at-home future allows home care providers to align, partner and strengthen hospital referral relationships.  

AlayaCare is here to support both hospitals and home care providers with the tools needed to enable this innovative care model – and effectively take care of your patients.  

• For home care agencies, our industry-leading software platform equips you with the elements needed to be partners with hospitals – and as a result strengthen referrals.   
• For hospital systems, we can support any efforts to shift to home-based care services based on expertise in what is needed from a technological perspective to do so.  

Every organization has its own needs, mission, and existing software. AlayaCare provides flexible solution that scales to meet the needs of multiple care models and service lines across all sectors.