Recent research highlights a shift towards advanced care at home programs (ACAH), which provide patients with complex conditions access to care outside the hospital. This article explores these programs, the eligibility criteria, coverage, and research into remote patient monitoring (RPM) and home health monitoring devices which are often used in ACAH programs.
What do Advanced Care at Home Programs Cover?
Advanced care at home is also known as acute hospital at home. ACAH is an alternative to traditional inpatient hospital stays.These programs provide comprehensive medical care tailored to each patient’s needs through a care plan.
The core services typically offer telehealth, remote patient monitoring of vital signs, medication, laboratory testing, and physical, occupational, and speech therapy. Hospital at home may also coordinate mobile imaging and ultrasound services, behavioral health support, social work assistance, and specialty physician consultations as needed.
Bringing comprehensive hospital-level care into the home setting, aims to improve patient experience and outcomes while reducing costs compared to traditional hospitalization.
Eligible Conditions
Advanced care at home is for patients who require high-acuity care. The conditions for which patients are eligible may include:
- Congestive Heart Failure
- Asthma
- Cellulitis/Soft Tissue Infections
- COPD
- Complicated UTI/ Pyelonephritis
- Gastroenteritis/Dehydration
- Pneumonia
Advanced Care at Home and Remote Patient Monitoring
Remote patient monitoring plays a pivotal role in advanced care at home programs as it enables effective care coordination, monitoring, and intervention. Recent research studies have explored how advanced care at home programs using RPM prevented unnecessary hospital readmissions and enhanced patient recovery during the COVID-19 pandemic. Mayo Clinic analyzed data from over 7,000 patients across 41 U.S. states. Their RPM program reported the following results.
- High patient participation and engagement rates: 80% of low-intensity enrollees and 78% of high-intensity participants digitally engaged for at least one day.
- Adherence to care plan: 61.6% among low-intensity patients and 72.5% among high-intensity patients.
- Low levels of hospitalization: 9.4% of patients were admitted to the hospital within 30 days of enrollment or discharge.
- Low 30-day mortality: 0.4%, with 27 total deaths, all of whom were patients with high-risk factors.
The Mayo RPM program had previously been used to manage chronic conditions such as heart failure and COPD. However, the health system rapidly adapted and scaled the program to cater to the specific needs of patients during the pandemic. These findings show the potential safety, efficacy, and positive outcomes that can be achieved through well-designed RPM initiatives, especially for managing widespread infectious diseases.
Scaling At Home Remote Patient Monitoring Programs
During the COVID-19 pandemic, many other healthcare organizations quickly scaled their advanced care at home RPM programs to assess patients. A study published in the American Journal of Managed Care evaluated the feasibility of scaling an ACAH program within Kaiser Permanente for patients requiring hospitalization from April 2020 to November 2021. Kaiser Permanente advanced care at home rapidly scaled up to an average of 12.7 patients, peaking at 22 patients per day.
A total of 1005 patients were admitted to the program. As the program scaled over three stages, there were decreases in escalation rates back to the hospital, from 17.5% to 10.8%, shorter lengths of stay, with median length of stay decreasing from 7.43 days to 5.46 days, and lower readmission rates compared to earlier stages, dropping from 9.79% to 9.24%. Patients treated at home were 64% less likely to experience delirium compared to admitted patients. The study demonstrates the feasibility of scaling remote patient monitoring within an integrated delivery system to create significant inpatient capacity while maintaining quality metrics.
Understanding Advanced Care at Home
The shift towards advanced care at home programs presents an innovative approach to healthcare delivery, particularly for patients with complex conditions. Through comprehensive medical care tailored to individual needs, ACAH programs offer a viable alternative to traditional inpatient hospital stays, fostering improved patient experiences, outcomes, and cost savings. Remote patient monitoring plays a pivotal role in these programs, enabling effective care coordination, monitoring, and intervention.
The previous research findings highlight the potential of well-designed RPM initiatives to not only address acute healthcare needs but also manage chronic conditions and infectious diseases with efficacy and safety.
If you are a chronic care, telehealth, RPM services, or software company member, book a consultation and free demo to learn more about leveraging Tenovi’s FDA-cleared remote patient monitoring devices and data aggregation solutions.
