When people hear “home care,” many people still think that this approach to care is only for elderly, multimorbid patients who need a visiting nurse to come and check on them after they are discharged from the hospital. is required.
But home care is much more than that. Health systems and home care companies are working hard to decentralize high-acuity, longitudinal care away from facilities and bring it into the home, Pippa Schulman, medically homeChief Medical Officer of the U.S. said during an interview last week hlth in Las Vegas. She thinks that accelerating the decentralization of hospital-level care will improve health care access and health equity issues.
Medically Home provides hospitals with a technology and service platform that allows physicians to treat a wide variety of conditions in patients’ homes, including high-acuity conditions that would traditionally be treated in a hospital setting diseases, such as heart failure, pneumonia, and cancer. Its competitors include Homeward and Optimize Health.
The Boston-based company has partnered with several health systems to further this mission. Two of these partners include Kaiser Permanente and Mayo Clinic, both of which also invested a combined $100 million in the company last year.
According to Schulman, working with health systems is an important part of decentralized hospital care.
“There is a lot of consolidation happening in healthcare right now, especially around payers and retail clinics, which is extremely exciting when you think about access. However, people still prefer to get their care from a doctor or nurse practitioner or from the health system. And they want it to be an easier, better and faster experience. When they have a problem, they seek help. We can help health systems get there,” she said.
For Medically Home’s health system partnership to be successful, health systems must recognize that centralizing all care around brick-and-mortar facilities is a dying model, Schulman declared. She thinks that eventually, these facilities will only be used for complex care and “the sickest patients.”
According to Schulman, health systems with medically home partners “should be passionate about the idea that health is not happening in a building, but health is happening in your everyday world”. In his view, home care does a great job of humanizing patients and giving providers a window into how they live and maintain their health.
When providers care for patients in a hospital, they walk into a room that looks like every other room in the hospital and see a patient who is lying in the same gown that every other patient is wearing. Creating an individualized care plan like this is difficult.
“As a doctor, I can ask a lot of questions, but time is very limited,” Schulman said. “When my primary doctor in my home is by a patient’s bedside and the tablet camera is turned on, I can now see the pictures on the wall. I see the plants, I see the dirt, I see the cleanliness, I see the dogs and cats walking around. Think of all the information that could go into a therapy plan – people are not diseases, people are the sum total of all their life experiences and the people around them.”
Home-based care also has the potential to address health equity concerns by reducing mistrust in populations that have traditionally been poorly served by the medical system. Schulman pointed out that for vulnerable populations who have been structurally discriminated against because of their race or socioeconomic class, a power dynamic immediately occurs when they go to the hospital. When a therapist enters a patient’s home, that power balance is reset so they are more on an equal footing, she said.
For health systems to set up hospital-at-home programs properly, Schulman said they must prioritize equity. This means ensuring that the barrier to entry is as low as possible. At Medically Home, he says he has created a home-care model that can Execution anywhere.
Technique has to be simple, not dependent on the patient to bring anything to the table. According to Schulman, setting up antennas or having a strong connectivity is not a burden patients should face.
“The only requirements we have in our program are electricity, running water and access to bathrooms,” she said. “We’ve done it in trailers, apartments, houses, rooming houses — all over the place.”
Photo: Kate_September 2004, Getty Images