TEN TRANSFORMATIVE TRENDS 2021 Hospital Home continued from page 14


sent home, when appropriate, with tools including a pulse oximeter to monitor blood-oxygen levels, and a digital thermom- eter and acetaminophen to reduce fever and any muscle aches or pains. Geisinger divided up COVID patients into three categories, based on need, with the most serious being those who needed 24-hour monitoring, which is provided by Current Health, a leader in home-based technology solutions. “Technology is one thing that really allowed us to do this,” Sciandra stated.


Rhonda Wiering At the same time, while technological


advances and operational imperatives are pushing more and more care and care management into the home environment, there are structural impediments and chal- lenges to creating an architecture of remote care delivery. In the eyes of Christopher McCann, CEO and co-founder of Current Health, it’s not the continuous monitoring or data integration between devices and systems that pose the biggest challenge; rather, it’s simple broadband issues. “In our populations, we fi nd that between 25 and 50 percent [of people] don’t have home internet. And that’s not just in rural America; it’s in downtown Manhattan, Los Angeles and San Francisco,” he said as a panelist during the Healthcare Innovation vir- tual event. These patients are also the ones who most need to be addressed—due to low socioeconomic status and old age—but can’t get equitable access, McCann added. “The problem is really hard to solve; we [have] provided plug-and-play cellular activity for patients in the home, but getting that right has taken signifi cant investment, and we still don’t have it right. [More than half] of the support we deal with daily relates to home connectivity,” he reported.


Federal help has come, but will it last? To take pressure off hospitals during the surging pandemic, the Centers for Medicare & Medicaid Services (CMS) in


November took several steps to increase the capacity of healthcare systems to provide care outside a traditional hospital setting, including in the home. Its Acute Hospital Care at Home program is an expansion of the CMS Hospital Without Walls initiative launched earlier last year as a part of a comprehensive effort to increase hospital capacity and maximize resources, while keeping Americans safe. Now, this updated program creates additional fl exibility that allows for certain healthcare services to be provided outside of a traditional hospital setting and within a patient’s home. In late January, according to a CMS web page on the initiative, the program has grown to include 92 hospitals in 24 states. In Boston, Brigham has been gradually building its program over the past fi ve years, and was one of six health systems with extensive experience providing acute hospital care at home to be granted a waiver by CMS in November to scale up its program. Levine, who credits the waivers as “an amazing opportunity for Americans to get care in their homes,” explained that the federal agency has cre- ated two tiers for its program, depending on how advanced a specifi c organization is in its hospital-at-home work. To get a waiver, it’s on the applicant to demonstrate they have the ability to truly take good care of patients at home. They need to prove they have the right contracts and standard operating procedures, as well as the right care teams, noted Levine. The program also has to report to CMS, either every week or every month, depending on which tier it’s in, whether any patients unexpectedly died while at home, and if any patients escalated their care—meaning they went from home back to the hospital—as well as if there were safety reviews of any cases. Speaking to the fact there are now more than 90 hospitals who have signed onto the CMS program in just a few months, Levine called it “phenomenal uptake.” But where does it go from here? It’s authorized under the public health emergency (PHE), which he believes will likely continue for the entirety of 2021. “In discussions with CMS, it’s not entirely clear what [will happen next], but a lot of us hope it will become a permanent benefi t for Medicare benefi ciaries,” he said, noting that it’s too early to tell if that could happen without Congressional action.


Nonetheless, Levine and others inter- viewed for the piece are quite bullish on continuing their hospital-at-home journeys and demonstrating its impact through research. “If home hospital were a pill, everyone would pay for it,” he said. “Every single payer would pay for a cardiology pill if it meant that patients would get readmitted 70 percent less often.” HI


18 hcinnovationgroup.com | MARCH/APRIL 2021 Digital Doors continued from page 16


company Kyruus. After building a detailed directory of more than 10,000 providers in the Kyruus platform, the health system deployed the provider match tool to give consumers a more modern and effi cient way to search for providers on its website. Already enabling consumers to search based on a range of key matching criteria, Banner then expanded this to include fi ltering based on which providers offer online booking. From there, an integration with the health system’s electronic health record (EHR) platform allows consumers to choose an appointment based on real-time availability, health system offi cials explain. Then in March 2020 as the pandemic started to unfold,


the organization’s


clinical and digital teams recognized that they could leverage the online schedul- ing it was already doing to do the same thing for COVID-19 testing and fl u shot appointments. “So we were actually able to use creative thinking and work together to reinvent or repurpose those existing capabilities,” says Christen Castellano, vice president of customer experience channels at Banner Health. “And that allowed us in December to [think about] how we could do this in a scalable way for vaccines. That’s really been the opportunity gained—tak- ing your digital front door assets and thinking creatively about how we could make them portable to a new situation,” she says. And as of late January, just one month after launching the tool for vaccine scheduling, Banner had more than 110,000 vaccine appointments scheduled online, Castellano reports.


Indeed, in the era of COVID-19, the time for health systems to address patient experience is now, as it’s arguably never mattered more. There is a fi nancial incen- tive to do so, too: the aforementioned Accenture research indicated that those health systems that evolve to meet new consumer experience needs can expedite fi nancial recovery and capture patients from competitors, potentially increasing their revenues by 5 percent to 10 percent pre-COVID levels within 12 months. For a $5 billion health system, this would mean between $250 million and $500 million in additional annual revenues. As such, moving forward, leaders at Intermountain and Banner strongly believe they need to keep innovating and adapt- ing to meet consumers’ needs. Mabbut specifi cally refers to Intermountain’s My Health+ tool as “a living thing.” He says, “We cannot stand still and declare that the digital front door is ‘fi nished.’ It is key to how we stay relevant to consumers in an increasingly competitive and complex healthcare environment. And just like the Disney experience, we see it as an impor- tant differentiator for the organization.” HI


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