How Healthcare is Moving Away from the Hospital

Hospitals have traditionally been the center of the healthcare universe. To attract more patients, they’d build a new wing or add more beds. These traditional models are on their way out now, as volume moves to value with hospitals rewarded for efficiency and safety and penalized for readmissions. Today, healthcare executives are openly discussing a new model of more patient-centered care where treatment is delivered via the patient’s own home. What trends are pushing patient care outside the hospital ER? What are the benefits for caregivers and patients? The real question is: Has technology finally fully enabled our ability to bring the house call back?

Healthcare Dive reported on the U.S. News & World Report’s Healthcare of Tomorrow Conference, which brought together leaders from around the field. Aetna’s CEO at the time, Mark Bertolini, made the startling prediction that the healthcare models of the future would be local and as close as the patient’s living room. He stated, “If you have to go to the hospital, we have failed you. What if that were the way the system was designed?”

“You don’t need to go to a hospital or any other healthcare facility, you can be anywhere on the planet. That’s the main difference in how earlier visions pictured telemedicine and how it finally evolved.”
The Medical Futurist

At the Healthcare of Tomorrow conference, Dr. David Tsay, the Associate CIO at New-York Presbyterian Innovation Center predicted big changes to the industry in the next decade, stating, “Hospitals will primarily be ICUs and ORs, and the rest of care will be done in the convenience of the home.”

Tom X. Lee, from One Medical agreed, suggesting, “More changes over improving the virtualized and service experiences coming into healthcare,” along with, “more remote care delivery models as an oncoming disruptive force.”

Other healthcare leaders predict the same trends. Becker’s Health IT & CIO Report interviewed the Executive Vice President of Medical Devices at Abbott to find out his impressions of where the market was headed for smart medical devices that can connect doctors with patients in their homes. Using chronic heart conditions as an example, he suggested, “The ability to monitor the patient’s condition remotely not only enhances the quality of care, it also improves clinical efficiency. And, it can substantially reduce healthcare costs.”

Approximately one million people annually are diagnosed with heart failure in the United States at a cost of $30 billion. It is one of the leading causes of hospitalizations for those aged 65 or older. By 2030, the cost of treating these disorders is predicted to hit $70 billion, according to the Becker’s article.

But technology can alleviate many of these costs. In the interview with the Abbott executive, he described implanted cardiac devices that can monitor the heart’s rhythms remotely, allowing patients to stay at home. More timely interventions through proactive monitoring reduce hospital admissions.

While this is just one example, it appears to support the predictions from the Healthcare of Tomorrow Conference, that suggest at-home care will replace more hospital admissions in the future.

Chiefly driving these trends, of course, is consumer demand. How is our insistence on the convenience of fast food and smart devices forcing changes in even the most reluctant doctor circles? What other external and internal factors in healthcare are shifting the care delivery paradigm into something outside the traditional hospital model?

The first trend driving hospitals to look for new outpatient models is value-based care itself. Under these models, hospitals are penalized for readmissions within 30-days of discharge. Healthcare IT News reported on a Frost & Sullivan study that showed that the “fear of readmission penalties,” is driving a booming remote patient monitoring market predicted to grow more than 13% in the next five years.

Remote patient monitoring devices fall under telehealth technologies, which were designed to bring together a remote clinician with a patient via videoconferencing tools. These tools include biometric sensors and software to monitor patients and provide clinical grade data for doctors to monitor. These devices are pushing healthcare models away from episodic care delivery to a proactive and continuous care model. Most believe this is a crucial change at a time when chronic diseases and an influx of retiring Baby Boomers are reaching critical mass.

There is ample proof that telehealth tools allowing remote monitoring are having a positive impact on hospital readmission penalties and the cost of care delivery. Last year Healthcare IT News reported that mega-system UPMC was seeing substantial savings through live video visits and remote monitoring of patients in their homes. Medicare data shows patients utilizing these services were 76% less likely to be readmitted to the hospital. Further, patient satisfaction was higher than 90%.

Which leads us to the final driver behind the healthcare paradigm shift from inpatient to local care; our patients want it. Most healthcare leaders have recognized that our patients are demanding more convenient and transparent care. EHR Intelligence says:

Whether it’s a prescription for an antibiotic or a consult for a feverish child in the middle of the night, remote care is gaining traction as 64% of patients now say they are willing to consider a video chat instead of a drive to their primary care provider.

Today, one in five Americans would prefer a video visit to a drive to the local hospital. Parents with children are “significantly more likely to wish to avoid the emergency department.”

With patients now used to the hands-on immediacy of all other services, healthcare leaders are now responding by seeking new care delivery mechanisms. While convenience is just one benefit, the added reductions in hospital readmission penalties and reduced care delivery costs mark telehealth as a model on the rise for the hospital of the future.

Telemedicine for Homecare