OPERATING ROOM


to a hospital or physician office for care, today it is becoming much more distributed and COVID has accelerated that. The need for care expansion is breaking down the walls of the hospital. At Hillrom we find ourselves in a perfect position because we have the trusted experience, footprint and solutions to support this shift, coupled with the desire to help.”


Continuity of care inside and outside of the hospital The U.S. healthcare industry has increas- ingly turned to long term acute care (LTAC) facilities to care for higher acu- ity patients transferred from hospital intensive care units (ICU). The COVID-1 pandemic has accelerated this trend by driving a greater number of sicker patients into LTAC settings as hospitals reach ICU capacity. While acute care patients have the same


care needs regardless of the setting, caring for critically ill patients is more challenging outside of the ICU. “Patients requiring care in long-term care facilities are dispropor- tionately older and chronically ill, and they often enter long-term care after an acute hospitalization,” states the Agency for Healthcare Research and Quality (AHRQ).5 “When transitioning patients from costly and resource/space con- strained ICUs to LTAC facilities, it is critical to maintain a similar level of high acuity monitoring and care to ensure safety and prevent untoward events,” explains Mike Hodge, Director Business Development, Alternate Care Solutions, Drger. “According to the AHRQ, Patients in long-term care settings may be particularly vulnerable to safety problems in the course of their care.’”5 Drger has applied its 100 years of critical care expertise and know-how to specifically address the needs of the LTAC environment. For example, the company’s bedside monitors can be transported along with the patient within hospital units and through to the LTAC. This facilitates continuous ICU level monitoring while eliminating the need for separate transport monitors.


Mike Hodge


Remote patient monitoring Remote patient monitoring (RPM) can help providers and patients by facilitating safe and effective continuity of care all the way through to the home. As Frank points out, hospitals struggle to strike a balance between reducing length of stay (LOS) for financial reasons, but not discharging patients so early that they are at risk for


readmission (and the risk for reimburse- ment penalties). Remote monitoring can help overcome this challenge. “A patient can be discharged with a monitor and instructed to perform spot checks three or four times per day. The data is transmitted to the clinician or a central location to monitor trending and act on it accordingly,” said Frank. “This can significantly reduce the risk to the hos- pital that the same patient is re-admitted and they don’t get reimbursed for that second stay.” While there are obvious benefits to this approach, Frank says there are also many logistical challenges to a hospital sending its monitors out into the community. He states: “You have all of these patients with


assets worth thousands of dollars that belong to the hospital. So how do you discharge them and how do you bring them back There is a whole back-end logistical infrastructure that needs to be put in place.” Frank says there are service providers


that have built businesses around the need to supply and manage remote monitoring equipment, and Hillrom has partnered with some of them. In these cases, Hillrom provides the monitoring devices, and the service providers handle the logistics, as well as engagement strategies to drive patient compliance with the prescribed monitoring.


Early detection and disease management Patients with chronic conditions require close monitoring to manage health status and detect deterioration. Monitoring patients in their daily lives is fundamental to effective population health manage- ment. ven before COVID-1 hit the U.S., 88% of providers surveyed said they had invested or were evaluating investments in RPM to support management of patients with chronic conditions and at risk for hospital readmissions.6 “arly detection and avoiding patient deterioration present a huge value propo- sition for digital and connected tech- nologies,” explains Frank. “Secondly is managing patients at home. COVID has forced us to do that in many ways, but there is undoubtedly a huge, proven ben- efit of patients being able to recover in the comfort of their homes with connected infrastructure around them.” Frank describes how Hillrom has com-


plete solutions for remotely monitoring patients and delivering useful insights back to clinicians. One example is a device for the detection of arrythmias, where the patient wears a sensor that captures every


heartbeat for up to two weeks. The device collects the data, transfers it to a central location for analysis and delivers a diag- nostic report to the patient’s physician(s) as a service. Another is a solution that enables pro-


viders to easily perform retinal exams in a remote setting. Patients with diabetes can be at risk for losing their eyesight due to retinopathy, so they require regular screening. The clinician uses a device to take a photo of the patient’s eyes, and the image is transmitted to a qualified retina specialist. Upon analysis of the image, the clinician reports back with a diagnostic screening result and recommended course of care, such as referral to a specialist.


Harnessing the value of data As Frank explains, the volume of data generated by connected devices grows at a rapid rate. In some cases, this data has surpassed the human capacity for analysis, driving the need for artificial intelligence (AI) to help clear through the clutter and get down to what is most valuable for clinicians. Because there are so many device manu- facturers, each with their own proprietary technologies, the challenge for healthcare organizations is finding a way to collect data from each device, aggregate and normalize it, and present it in a way that makes sense. Frank speaks to one business model that has emerged as a solution. “There are companies serving as neu-


tral data aggregators that provide either connectivity software or data analytics on top of the information they are gather- ing,” he comments. “They provide back to the healthcare organization workflow insights or clinical insights that drive better outcomes, whether they are better clinical outcomes, lower costs or greater efficiency.” According to Frank, collaboration throughout the healthcare industry and beyond, including non-healthcare infor- mation technology (IT) providers, is key to harnessing the value of connected device data. Hillrom has partnerships with Microsoft, Apple, Amazon and Cerner for cloud, AI and software development work. For example, combined offerings from Hillrom and Microsoft dynamically analyze real-time sensing data from medical devices and historical medical record information and communicate potential patient risk and hospital pro- tocol actions directly to caregivers at the point of care. They leverage Hillrom’s clinical knowledge and streaming opera- tional data from medical devices and Microsoft’s cloud, including Azure IoT


hpnonline.com • HEALTHCARE PURCHASING NEWS • October 2021 15


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