Wearables will track patients as remote home care optimizes hospital resources.
Next month, UMass Memorial Health, a nonprofit health system in Central Massachusetts with more than 14,000 employees and 1,700 physicians, plans to begin offering patients more opportunities to receive care outside of the hospital, using innovative wearable medical devices, as well as other home devices, to increase hospital capacity, and provide better experiences and outcomes for all patients.
"COVID-19 illuminated capacity issues at hospitals worldwide—ours included," says Eric Dickson, MD, president and chief executive officer of UMass Memorial Health. "Our team's ability to quickly build out a field hospital to care for patients during the height of the pandemic has inspired us to think differently about how we can deliver care outside our hospital walls. We see an opportunity to pioneer a new care delivery model that not only addresses hospital resource constraints, but also enables more preventive care and improved patient experiences and outcomes at scale. This is why we're so excited to launch our Hospital at Home program with Current Health."
Eric Alper, MD, is the chief quality officer, chief clinical informatics officer, and vice president at UMass Memorial Health. Photo courtesy of UMass Memorial Health.
Current Health, which makes the remote care management platform offering, will assist UMass Memorial Health in monitoring the patients.
The technology backbone of UMass Memorial Health's Hospital at Home program, provided by Current Health, will provide real-time insight into patient health and coordinating in-home clinical care and services. Current Health will enroll UMass Memorial Health patients eligible for the program through Current Health's platform and configure everything patients need to remotely engage with their care teams, including monitoring equipment, in-home connectivity, and a tablet for chat and video communication.
UMass Memorial Health will use the Current Health platform to:
- Quickly detect signs of patients whose conditions are deteriorating, in order to foster early, preventive, and life-saving intervention and treatment
- Identify patients needing immediate or in-person care to optimize limited hospital resources
- Centrally coordinate in-home visits from UMass Memorial Health clinicians or in-home services
Current Health's platform is also integrating with UMass Memorial Health's Epic EHR to ensure a seamless experience for patients and providers alike.
The initial hospital-at-home enrollment will start with five patients, growing to 10 by September or October, says Eric Alper, MD, chief quality officer, chief clinical informatics officer, and vice president at UMass Memorial Health. In the next year, the program may double to 20, depending on patient demand, and limiting factors such as hiring adequate staff to do home and telehealth visits, he says.
Executives at UMass Memorial Health had been talking about implementing a hospital-at-home program for some time before CMS' waiver allowing remote care of patients kicked in at the beginning of the COVID-19 pandemic in 2020, Alper says.
Being able to generate revenue from the program "definitely sealed the deal for us," Alper says. But executives also thought the program would create value for some of the 50,000 patients in UMass Memorial Health's accountable care organization, primarily Medicare, but expanding into Medicare Advantage and some Medicaid patients, he adds. UMass Memorial Health currently has about 800,000 patients in its overall active patient database, he says.
The concept of hospital-at-home in healthcare is not new. "People have been doing this for probably 15 years, in smaller amounts," Alper says. More than 80 studies have examined the concept and results consistently show that hospital-at-home can improve quality of care, he adds.
Even though CMS has granted about 150 waivers for other hospitals and programs to do this kind of care at home, "we do feel like a pioneer," he says. "No one else is doing this right around us."
Some of the lessons learned so far involve getting medications to home-based patients, defining the requirements around getting infusion nurses into the home, and ensuring the safety of patients and staff alike, Alper says.
Time will tell to what extent such programs can be an alternative to expanding the number of rooms in the hospital itself, Alper says.
"If this goes really well, we could create lots of capacity," Alper says. "That would potentially reduce the need for us to build new beds."
Among the devices employed by Current Health in its remote care management platform is an FDA-approved wearable with flexible armband worn on the upper arm, says Adam Wolfberg, chief medical officer at Current Health. The wearable streams core vital signs up to Current Health's web-based platform via Wi-Fi to a cellular-enabled home hub provided by Current Health. Patients do not need to install their own Internet connection or to download an app to their mobile or desktop devices, Wolfberg says.
The wearable must be recharged for 15 minutes every two days, and if needed, may be left on the patient's arm while recharging, Wolfberg says.
Besides this continuously streamed data, the Current Health platform also integrates with wireless blood pressure cuffs, spirometers, skin temperature sensors, weight scales, and continuous glucose monitors, Wolfberg adds.
Editor's note: This story was updated on July 15, 2021.
“If this goes really well, we could create lots of capacity. That would potentially reduce the need for us to build new beds.”
— Eric Alper, chief quality officer, chief clinical informatics officer and vice president, UMass Memorial Health
Scott Mace is a contributing writer for HealthLeaders.
Patients will be tracked via wireless devices communicating to web servers, some continually streaming data.
Hospital capacity issues, illuminated by COVID-19, expedited build-out of UMass Memorial Health's program.
The platform enhances central coordination of in-home visits and integrates with Epic EHR.