Healthcare-at-home services, including routine care in the home, remote home monitoring (RHM), and remote therapeutic monitoring (RTM), have exploded onto the healthcare scene. These services have been bolstered by new, post-COVID CPT codes. For example, Medicare-, Medicaid-, and commercial eligibility for RHM is no longer the exception, but the norm. McKinsey estimates, “Up to $265 billion worth of care services for Medicare fee-for-service and Medicare Advantage beneficiaries could shift to the home by 2025.” Health at home that leverages digital technology and moves to a greater focus on whole-person care holds great promise in particular for the lives of patients with chronic conditions and has the potential to make healthcare more convenient, personalized, and effective.
Some of the players in this growing space are fast-moving startups looking to benefit from patient telehealth adoption and new revenue opportunities that have emerged since COVID. These companies are building their delivery models de novo and betting that the healthcare-at-home wave is here to stay. Simultaneously, COVID forced more established healthcare organizations to move quickly toward disruptive innovation by removing previously impenetrable roadblocks to home health and remote monitoring services.
The companies diving into healthcare at home are looking to quickly capture a share of the market, but the proliferation of these services is making it hard for individual companies to differentiate themselves from the crowd. One promising way for these companies to stand out is to focus on patient engagement and relationships. Home-health programs have the unique opportunity to have more touchpoints with patients and to meet patients “where they are” both emotionally and physically, enabling deeper personalization of care. Personalized medicine helps patients achieve dramatic improvement in their daily lifestyle behaviors, which results in better health outcomes.
Patients with chronic and pre-chronic diseases are a logical population to target with enhanced, personalized, health-at-home services. Lifestyle-related conditions such as prediabetes, type 2 diabetes, heart disease, and chronic kidney disease have seen little progress in health outcomes under the standard care model, as evidenced by the fact that the prevalence of these conditions is at epidemic levels and still growing. And the primary drivers of these diseases are not just genetics and aging, but daily self-management behaviors, lifestyle choices, living conditions, and other social determinants of health. This kind of health information is easier to measure, observe, and address from patients’ homes and in their communities.
Delivering care in settings closer to home also has the potential to reduce health inequities by tailoring patient care plans to the specific, culturally relevant, geographically relevant issues that impact a patient’s health. And highly personalized digital touchpoints can be more convenient and lower costs for patients as they reduce travel time and the need for work and family arrangements compared to traditional clinic-based visits.
Integrating more personalization into healthcare-at-home services starts by augmenting the services that companies already offer with the collection of additional information and data to contextualize the results. Remote home monitoring devices do a great job of tracking patient vital signs to identify out-of-range values that require clinical action to avoid escalation. When this RHM data is combined with patient-provided information and the valuable, in-person information collected during home visits, it has a high potential to drive improvements in care by informing more responsive, relevant, and longitudinal care plans.
Patient-reported information can be collected in advance of a clinical visit using quick-to-complete and easy-to-distribute assessments via text or email. A 2021 survey of Americans found that 97% of patients are willing to spend time prior to doctor visits answering online surveys about their daily health habits if that information allows their provider to help them reach their health goals (e.g., lose weight, eat healthy, or prevent or manage chronic disease). When this information is collected before an at-home visit, the interaction between the provider and patient is greatly enhanced. Now the care plan can reflect not only the biometric indicators and the observable at-home factors, but it can incorporate discussions, referrals, and resources in the specific areas flagged in the pre-visit assessments. Visits become hyper-efficient and focused on the specific, personalized items that the patient needs to work on and is interested in working on to improve their health.
The healthcare-at-home space is crowded, and if growth estimates hold true, we will continue to see a proliferation of services and opportunities in this space. Health at home holds great promise for patients – making healthcare more convenient and more accessible – but making it more personal will be the true differentiator. At Silver Fern, we are working with remote home monitoring and healthcare-at-home companies to do just that. Our toolset is the only comprehensive solution in the marketplace that systematically assesses and helps you address the daily behaviors and social, psychological, and environmental factors that impact patient health. Our toolset has been proven to engage patients and drive significant improvement in health outcomes. Reach out to us today if you’re interested in collaborating.
Garry Welch, PhD is an expert in behavior medicine for chronic disease care. He has extensive experience leading clinical research on behavior change strategies for people with diabetes and other chronic diseases. Dr. Welch’s 30+ years of clinical research led to co-founding Silver Fern Healthcare. He leads research and development at Silver Fern.