Meeting patients where they are is a guiding principle to us at HTL.
Hospital at Home
“Home Hospital” or “Hospital at Home” (HaH) is an innovative, evidence-based approach that delivers hospital-level care to patients with acute care needs in the comfort of their own home. Appropriate use of HaH improves patient experience and lowers the overall costs of care.
Technology makes this possible and is imperative to scale any HaH program. As technology advisor to MGH Home Hospital, we collaborate with the team to discover and pilot new technology. This includes remote patient monitoring, telemedicine, care team coordination, and supply chain management.
As technology advisor, we use the following methods and approaches to improve clinical outcomes, operational efficiency, and the care experience for patients and clinicians.
Human-centered Designing Thinking – needs finding and pain point identification
Technology Advising – technology market scans, presenting solutions
Operationalizing – pilots; implementing into workflows.
A recent NEJM Catalyst paper we published highlights much of our work (see here–reach out if you can’t access full version)
Remote Patient Monitoring
Vital signs of patients need to be carefully monitored in Home Hospital programs. As we at HTL engage in this work, important questions arise. What is the technology that allows patients to get the most reliable monitoring and feel comfortable and safe? Is it a patch on the chest, an arm band, a watch? How often should monitoring occur? What are the best tools for monitoring vital signs, falls, and arrhythmias? How can we then effectively transmit the data to clinical teams or alert them if the patient’s health is changing?
Our work is to figure out these exact solutions. With our technical expertise, we have performed market analyses and evaluated dozens of devices that monitor vital signs (heart rate, oxygen saturation, etc.), including falls, to confirm their suitability to monitor patients at home. Through rigorous testing we are developing quality and safety standards as the basis for making decisions about which tools are most appropriate for which conditions. We have also sought opportunities to work with start-ups and/or established companies to collaborate on the creation of solutions that meet the needs of patients in this new model of care. We anticipate this creation of an “electronic safety net” of monitoring to enable us to expand this program even further — much to the delight of patients looking to recover at home.
We are advancing remote communication programs to connect patients and their clinical care team at the hospital. HTL is developing new ways to use technology to enhance remote care communication with integrated monitoring systems and communication tools. These tools give patients comfort and confidence that there are people on call to address their needs and provide a rapid response when needed.
Distributed Clinical Team Coordination
The distributed nature of home-based acute care presents a unique opportunity to help team coordination with technology. The core unmet needs of this type of work are more than what the current electronic health record (EHR) can manage. This includes shared task management and seamless messaging between clinicians in the field. HTL has worked to test and implement technology and workflow efficiencies that enhance communication and connectivity of clinicians on the go. New technology also aids in route planning and coordinating care with Mobile Integrated Healthcare Paramedics. Because there are no platforms on the market currently that solve for these issues, HTL has worked to spread awareness of these issues to vendors.
Distributed Supply Chain Coordination
Given the acuity and complexity of home-based acute care, there is a need for robust order-to-entry fulfillment for the following supply chain services:
- Infusion medication and administration
- Respiratory care, including oxygen delivery
- Diagnostics (labs, radiology)
- Food services
- Durable Medical Equipment (DME)
- Physical, occupational, and speech therapy
- Social work and care coordination
As home-based care programs grow in patient volume and geography, the need for technology-enablement of these services will only continue to grow.