The Centers for Medicare and Medicaid Services just released data on its Acute Hospital Care at Home initiative, which thus far has admitted 11,159 patients suffering from respiratory infections, heart failure and severe sepsis. While the program has proven successful in reducing hospital visits, the level of manpower it requires is costly and likely unsustainable for the already overburdened healthcare system.

Karin Schifter-Maor is CEO of Essence SmartCare, a senior and chronic care technology and services company. She believes the solution lies in technology that can accurately monitor vitals with the option to personalize to a patient's needs. In this way, hospitals and health systems can save costs by reducing the strain on healthcare workers making personal visits while improving patient outcomes to help guarantee the CMS program's continuation.

Healthcare IT News sat down with Schifter-Maor to ask her about scaling the Acute Hospital Care at Home program, how remote patient monitoring can help scale the program, how RPM can make the care-at-home program affordable, and the need for centralized patient data to keep track of patients and improve health outcomes.

Q. You contend CMS' Acute Hospital Care at Home program needs scalability to survive. Please elaborate.

A. The CMS' Acute Hospital Care at Home initiative has demonstrated its potential to revolutionize healthcare delivery by providing acute care services in the comfort of patients' homes.

However, the current program relies heavily on manual processes and in-person care, making it operationally challenging to expand as it requires patients be visited at least twice daily in person by a paramedic, and once daily, either in person or virtually, by both a registered nurse and a physician or advanced practice practitioner.

As funds are depleted and patient numbers rise, without scalability, the initiative risks stagnation and may fail to meet the demand for home-based care services.

Home-based care services are expected to surge in the coming years, with the home care market projected to reach $272 billion by 2026. This is largely driven by an aging population and increasing preferences for care in familiar surroundings. Yet, traditional care delivery models are untenable amidst rising healthcare costs and workforce shortages.

To overcome these challenges, healthcare provider organizations must embrace and leverage technologies to expand care delivery capabilities beyond traditional parameters and into the home without sacrificing on quality. By enhancing the patient experience through continued monitoring and harnessing patient data to improve operational flows, systems can ultimately meet the growing demand for home-based acute care services while optimizing resources.

Q. One of your answers to this problem is remote patient monitoring. You suggest RPM can make hospital at home scalable. How so?

A. Leveraging RPM technologies, healthcare providers can remotely monitor patients' vital signs, symptoms and adherence to treatment protocols in real time. A proactive and predictive at-home care system can check routine vitals, perform automatic spot-checks and alert healthcare providers of any abnormalities.

This optimizes resource allocation and reduces the burden on healthcare workers for frequent in-person visits.

RPM enables continuous care management to allow healthcare teams to intervene promptly in case of any deterioration in patients' health status. For example, if a patient's vital readings reach dangerous levels, emergency services can be immediately dispatched to prevent further deterioration that would require hospitalization, or fatal instances.

Q. You further suggest RPM can make hospital at home affordable. How can the technology make this happen?

A. RPM reduces healthcare costs associated with traditional care delivery models by minimizing the need for frequent in-person visits and hospital admissions. For example, one study looked at an RPM program for patients with Type 2 diabetes and found it could improve glycemic control and reduce the incidence of complications as well as management costs.

Additionally, early detection of complications and promoting timely interventions can prevent costly adverse health events and hospital readmissions. Another study looked at a 30-day hospital readmission rate for heart failure patients using RPM and found those using the digital health system have a readmission rate of 10% compared with the national readmission rate of approximately 25%.

RPM empowers patients to actively participate in their care management and adhere to preventive measures they would not have received otherwise.

The technology also stands to support long-term health maintenance and chronic care conditions, which are some of the costliest patient groups, contributing significantly to the 5% of the population who consume 50% of healthcare spending in the U.S.

The incorporation of RPM into hospital at home can make home-based care more cost-effective and sustainable, helping to reduce the costs associated with these patient cohorts and ultimately benefiting patients, providers and payers alike.

Q. On another note, you say hospital at home needs centralized patient data to keep track of patients and improve health outcomes. Where is this data going to come from, and what must hospital and health system IT executives do here?

A. Centralized patient data is crucial when it comes to implementing and managing home-based care programs like Acute Hospital Care at Home. Armed with comprehensive information about patients' medical histories, treatment plans, monitoring data and outcomes, hospitals and health systems are able to get a realistic picture of patients' overall health, which helps identify specific needs and areas of improvement for patient care.

Staff, in turn, can make more informed decisions about treatment and care to identify health trends and patterns that may prove useful in improving overall patient outcomes. By investing in digital health IT infrastructures, executives can enable a seamless flow of information across care settings to enhance the effectiveness of hospital at home initiatives and ultimately improve health outcomes for patients.

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