An acute hospital-at-home (HaH) program is a healthcare model where patients receive acute care services in their homes rather than in a traditional hospital setting. This approach aims to provide high-quality medical care, remote patient monitoring (RPM), and treatment for patients who would otherwise require hospitalization for acute conditions.
The concept of hospital-at-home has evolved, driven by advancements in medical technology, changes in healthcare delivery models, and a focus on patient-centered care. However, the history and timeline of hospital-at-home varies by region and healthcare systems.
Acute hospital at home programs combined with remote patient monitoring expand patient care and eligibility, enhance safety, and reduce costs. Discover what post-discharge remote patient monitoring entails as we explore this cutting-edge synergy.
Acute Hospital at Home History
Regular vital signs monitoring is routine in hospital inpatient care. That care is sometimes required after discharge in the home. Acute hospital at home programs were conceived in the 1990s and have gained momentum. The model caters to acute medical conditions, including heart failure exacerbations, pneumonia, chronic obstructive pulmonary disease (COPD), and post-surgical recovery.
The Centers for Medicare and Medicaid Services (CMS) introduced the Acute Hospital Care at Home waiver during the COVID-19 pandemic primarily to address hospital capacity issues. In addition, the model addresses parity with inpatient care reimbursement. As a result, over 250 hospitals and health systems are building or expanding their hospital-level care at home.
Remote Patient Monitoring in Acute Care
Remote patient monitoring involves collecting biometric data from patients in a non-intrusive manner to inform clinical decisions. RPM is now routinely used to manage chronic conditions. However, its potential in the acute hospital at home model has yet to be fully realized. RPM uses remote patient monitoring devices, wearables, and ambient sensors. The data collected can include vital signs, heart rhythm, and fall detection. This health data is transmitted to the clinical team for analysis and decision-making. In addition, partnering with a reputable remote health monitoring company can help create more efficient workflows for healthcare teams.
The Potential of Acute Hospital at Home Programs and RPM
A recent study noted that by extending the care continuum into patients’ homes, HaH yields favorable outcomes and cost savings compared to traditional inpatient care. Integrating remote patient monitoring into acute hospital at home programs opens up opportunities in patient eligibility, safety, and operational efficiency. In the following sections, we explore the potential benefits and combining HaH and remote patient monitoring.
Increasing Patient Eligibility
Acute hospital at home programs traditionally served patients in urban settings. With RPM, eligibility is significantly expanded to include patients with moderate-acuity medical conditions. For instance, continuous single-lead electrocardiogram (ECG) monitoring could extend acute hospital at home services to patients with heart failure.
This is significant as heart failure is one of the leading causes of hospitalizations. RPM also has the potential to make hospital at home programs economically viable in suburban and rural areas by replacing some in-person evaluations with telehealth consultations.
Improving Patient Safety
Despite the safety advantages of acute hospital at home care, there is room for enhancement. According to research, RPM can mitigate the risk of hospital-acquired infections, decrease delirium rates, and minimize the impact of post-hospital syndrome. Fall detection RPM can be particularly instrumental in reducing falls, significantly contributing to adverse hospital events. By continuously monitoring patients at risk of falling, acute hospital at home programs can develop interventions to enhance patient safety.
Enhancing Operational Efficiency and Decreasing Cost
Remote patient monitoring enables acute hospital at home programs to care for a larger patient population and helps optimize operational efficiency. Costs are reduced by replacing in-person evaluations with remote patient monitoring nurse assessments through RPM. Moreover, integrating RPM into the care continuum after hospital discharge can reduce hospital readmissions and healthcare costs.
A pilot study by Harvard-affiliated Brigham and Women’s Hospital found an average cost reduction of 30% per eligible acute hospital care at home encounter. The savings was approximately $3,000 per encounter. This resulted in over $1 million in savings per hospital. Thus, demonstrating the delivery of higher-quality and more efficient care.
Challenges and Future Directions
While the potential of remote patient monitoring for acute hospital at home care is immense, challenges and considerations must be addressed. Critical aspects include striking the right balance in monitoring modality and frequency, mitigating false alarms, and ensuring device reliability. Robust research, knowledge-sharing among early adopters, collaboration between clinicians and software experts and policy support are key to realizing RPM’s full potential in at home care.
Key Points: Acute Hospital at Home Care with Remote Patient Monitoring
Acute hospital at home programs and remote patient monitoring combined can make patient care more patient-centric, cost-effective, and safe. Embracing these innovations, backed by rigorous research and operational insights, is imperative in a new era of healthcare. The journey from hospital to home is evolving, and remote patient monitoring is paving the way for a brighter, more patient-focused future.
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