Breaking Down Barriers to Successful Home Care
One of the most promising opportunities to improve care and lower the costs of care is to move care delivery to the home from more expensive settings. There is a growing number of organizations that are launching and scaling models to move acute, primary, and palliative care to the home. For vulnerable patients, home-based care can delay the need for more expensive care given in hospitals. There are examples of this, like the results from Independence at Home, a five-year Medicare demonstration to determine the effectiveness of home-based primary care. It showed that all participating programs were able to reduce emergency department visits, hospitalizations, and 30-day readmissions for homebound patients – that saved an average of $2700 per beneficiary per year while increasing patient and caregiver satisfaction.
There are a lot of opportunities to improve care through these home-based care models but there are risks and challenges to their broader adoption as well. We first need to look into who home care is suitable for and then at the key barriers to moving care to the home and potential solutions to overcome these successfully.
Who is Home Care Suitable For?
Home care settings are suitable for patients who need care but have difficulty getting out of the house. These patients can be those who are healing from serious injuries, elderly patients, or patients avoiding complications after childbirth.
At other times, home care settings are for patients who may not have difficulty getting out of the house but still need medical care while preventing frequent hospitalizations or emergency room services. This category of patients includes:
- Those who are receiving complex medical treatments such as wound care or IV medication.
- Patients who are learning how to manage chronic diseases like hypertension and diabetes.
- Patients who need diet management for weight loss/gain.
- Patients who are monitoring the intake of prescribed drugs and cannot miss a dose.
- Patients need to regularly record their vital signs like breathing rate, temperature, blood pressure, and heart rate.
- Patients with mild COVID-19 who need supportive treatment.
Patient Preference
As home-based care grows in use and implementation, it is important to consider what the patient prefers between home-based care vs. care in hospitals. A study of older persons’ preference for a treatment site shows that more than 50% of surveyed patients had a preference for a hospital rather than home when it came to treating acute illnesses.
Many factors can drive a patient’s preference for settings other than home. These can vary from social causes, emotional reasons, and the inclination to stick to what is familiar which is going to the hospital when feeling sick.
Wanting to seek in-person care rather than home care may also reflect the loneliness and the need for social connections/interactions that a hospital setting could provide. A desire to leave the house may also indicate negligence from caretakers or elderly abuse.
A physician has to prioritize such preferences of a patient who is unwilling to receive in-home care as recommending this for a reluctant patient can actually yield adverse psychological and physiological health outcomes.
A major key to understanding a patient’s needs is for the physician to take information about treatment preferences from the patient rather than the provider of care such as a family member.
Giving Choices to Patients
Although a home-care routine may be recommended clinically it can still be the wrong choice for a patient/ the solution to this problem is to treat a patient’s preference for hospital care or home care fluidly.
There is a need to develop strong relationships between home-based care program providers and hospital care providers. Such strong relationships will allow for the fluidity of transitioning between the two healthcare systems and accommodate any changes in patients’ choices. Additionally, strong connections between the two parties can facilitate handoffs between these two care settings.
Patient Communication and Safety
The challenge of safety in home care runs the gamut of many factors. Practitioners must consider psychological safety from potential abuse, physical security through the presence of adequate infrastructure, medical safety such as infection control along with the risk of not having continuous health monitoring, and the unique challenges of communication safety through patients and family caregivers having enough information and training.
Supporting patients in home settings to sustain life, monitor them, and manage acute care needs requires support and infrastructure. Safety has to be considered in each patient interaction. Lack of security can exclude a patient from receiving home care. Therefore, consideration should be given to managing patient autonomy with its potential risks.
Improving Patient Safety
To make sure that a patient is as safe at home as they would be in a hospital or skilled nursing setting, home-care settings have to integrate safety considerations into a care plan. Communication needs to be clear on the roles and responsibilities of patients, their caregivers, and the home-based care professionals.
When communication is strong, safety concerns can be addressed quickly for frail and vulnerable patients. This is where Hucu.ai can be a huge help.
Hucu.ai is a HIPAA-compliant healthcare communication application. Home-care teams are dispersed and use Hucu.ai to communicate in real time, instantly, and remotely. When home-care team members use Hucu.ai to communicate med lists, patient history, schedule needs, and other relevant information, they are better able to serve customers. Patients are always connected to the care team and feel secure. When caring for post-acute patients who are vulnerable and frail, home care team members feel much more confident as they have instant team support via Hucu.ai to help them make quicker decisions.
Hucu.ai supports interprofessional collaboration in healthcare and also connects a patient’s family and care providers. With video conferencing features and family chat channels, Hucu.ai can help them stay up to date with their loved one’s health status. Hucu.ai offers a virtual infrastructure to support better communication and thus, a better quality of care and safety for patients at home.
Using Hucu.ai for home care is advantageous because it is practical features for clinicians such as sharing information on patient medications in real-time, flagging anomalies, receiving critical support without delay, and video conferencing for visual and media sharing as well. It helps keep the medication schedules.
Using Hucu.ai for home care, a clinician can help specify the scheduled time for medications and nudge patients with notifications on delayed drug administration. This can help elderly or forgetful patients with their drug intake and allow them to stay on track with their medication plan. This can directly affect the patient outcome as well.
Clinician Training and Safety
There is a gap in the healthcare market for more trained clinicians in home healthcare. There is a similar gap for home health software/technology to integrate features that help train clinicians on technical features to stay compliant with HIPAA while providing home health care. Applications, technology, and solutions that support home healthcare are growing in traction and clinicians need to receive more training in academia to use these platforms in order to reduce the need for hospitals in patient care delivery.
Conclusion
We live in a technologically advanced time when disruptive and innovative health care systems are needed more than ever. The pandemic has served as a powerful reminder of how front-line clinical care can be done at home, with family members serving as caregivers. Many were using home testing kits for screening; others were self-quarantining and carefully monitoring their symptoms.
The pandemic has encouraged many patients to be their own primary caretakers, thereby reducing the burden on the health care systems and reducing costs. Home care during the pandemic has shown us its potential to improve outcomes for many patients.
Home healthcare can be redefined from care only offered to frail, elderly or vulnerable patients to health care provided to any patient at home regardless of their capacity. The availability and presence of home care systems can be integrated with mobile health solutions that provide tools for patient communication, assessment, evaluation, plan of care, and treatment notes.
Through applications like Hucu.ai, healthcare can be managed by medical providers outside the walls of a hospital. Hucu.ai also improved clinicians’ assessment of patients through data analytics and AI.
The result of home care services enabled through mobile software, and applications is an offer that no patient or healthcare system can refuse because it offers maximum value for money, better patient outcomes, increased patient autonomy, and decreased burden on hospitals.
Tags: home care, home healthcare, telehealth, covid-19
Sources: advisory.com, hbr.org, onlinelibrary.wiley.com
