Providing the proper care at the right time in the right location is the gold standard for healthcare. Hospital at Home programs are being implemented worldwide by health systems, home care providers, and managed care programs to treat acutely ill adults cost-effectively while improving patient safety, quality, and satisfaction. This type of care model encapsulates a combination of pre-hospitalization, acute, post-acute, and ambulatory services focused on a patient’s individualized care needs in their own home.
Funding through the Centers for Medicare and Medicaid Services (CMS) and many commercial payers have made establishing and providing this type of patient care a strategic focus for health organizations in 2021 and 2022.
Technology vendors have flooded the market to support Hospital at Home care delivery, but these offerings are in their infancy stage. It’s critical to understand that no one vendor can currently support all Hospital at Home program needs.
A Hospital at Home IT enablement plan means a health system will capture all appropriate patient services and reimbursement oppportunities.
While we expect vendor technology to mature rapidly over the next two years, it’s essential to create an IT enablement plan that meets today’s patient, family, and provider needs. Electronic health record (EHR) vendors offer their clients a small introductory package of workflows based on an in-patient setup to support Hospital at Home patients. The capabilities are limited, and organizations will likely need to supplement with other modules. The incomplete workflows leave large Hospital at Home program technology gaps that non-EHR vendors must address to create an effective program.
Addressing Patient Needs
There are various patient needs that the current EHR vendors are unable to support. This includes patient identification, enrollment (registration), scheduling, dispensing, and routing medications, imaging, labs, and other outpatient orders that may be appropriate for a Hospital at Home patient. Since the EHR Hospital at Home workflows are based on an inpatient build, any non-DRG code services will require manual intervention. This coding gap will impact the revenue cycle by requiring manual charge entries to capture all appropriate patient services and reimbursement opportunities.
Operationally, this must be accounted for in the non-clinical staffing approach to ensure resources are assigned to manage this appropriately. Numerous remote patient monitoring vendors claim to support Hospital at Home patients with daily monitoring. Still, very few can meet program demands, such as automating the supply chain, maintaining a Hospital at Home patient registry, providing real-time data, alerts, analytics, and regulatory reporting for operations.
While most vendors offer EHR integration, their integration approach and the timing of data feeds vary widely. This impacts the Hospital at Home workflows and the clinician’s ability to care for patients proactively. It also adds to the complexity of maintaining a complete data story within the longitudinal patient record for the enterprise.
Final Thoughts
As health organizations create and expand capabilities to care for acutely ill patients in their homes, it’s critical to patient care and a Hospital at Home program’s success to outline an operational plan first. The plan should include a staffing model, patient stratification and identification approach, specific clinical protocols, care delivery, revenue cycle documentation and workflows, and analytics. These elements will inform an IT enablement plan that will be “right-sized” for your Hospital at Home services to meet your patient’s needs and avoid program technology gaps. Leverage these operational criteria to identify the appropriate combination of EHR and non-EHR technical solutions while the vendor market matures in the Hospital at Home space.