Industry Voices—Can care at home succeed in the long term? Not without interoperability

Key points:

  • Interoperability is now a table-stakes expectation for new home health programs and digital health tools. And that’s good.
  • Point solutions for remote care make interoperability more challenging/create too much work for health system IT teams to tie everything together. And these solutions disrupt the care-at-home promise of a holistic view of patient health.
  • The cost of non-interoperable solutions, including duplicative workflows and increased administrative work, is too high.

In the delivery of healthcare, data are not inherently meaningful or actionable. Instead, we must layer on the relevant context and history and then present that information in a manner and location that enables the clinician or patient to take the right action. There is perhaps no corner of the healthcare industry where this challenge comes into sharper focus than in the evolving world of care at home.

Care-at-home programs promise improved patient experiences and outcomes by generating data about a person’s health and environment and enabling communication with care teams.

For instance, we can see the real-time impact of a disease like congestive heart failure or COPD on a person’s daily life. By watching oxygen levels and step counts, we can see whether climbing the stairs in the home makes a patient short of breath. At a certain threshold, their provider is notified and can order a medication change and monitor in real time whether the change improves the patient’s quality of life.

But without interoperability, care-at-home programs will struggle to impact patient care, quantify success and unlock long-term value. Effective care at home isn’t just about vital sign readings but also the conversations patients have with their care teams, their engagement with daily tasks and, ultimately, patient outcomes.

Interoperability enables clinical action

Making clinical decisions when a patient isn’t in front of the clinician requires a meaningful view of the latest vitals readings, symptoms and visibility into the rest of the patient’s context and history, which lives in the electronic health record. These two points of interoperability—the patient in their home and the historical data in the EHR—are the minimum standards of interoperability for care-at-home programs.

But EHR integration is often no small feat due to the complexity and deep customization of these systems as well as the challenge of securing internal resources to execute integrations. However, tying your care-at-home platform into the EHR is critical for reducing duplicative work for providers and ensuring you have a holistic view of the patient during and after their care-at-home experience. Further, EHR integration allows health systems to maximize existing investments and reduce redundant tools and vendors.  

The next level of interoperability between the care-at-home platform and EHR should include patient eligibility notices and referral workflows, orders for diagnostics and therapeutics, patient alarms, care team notes and coordination, logistics services for devices and transition to the next site of care. Reducing duplicative work and simplifying workflows are crucial to program adoption among providers. 

From the patient perspective, we know that patients resist constantly downloading and using multiple apps across their medical providers. Logging into and keeping up with various digital tools can be frustrating and taxing on consumers, contributing to low adoption and engagement. Integrate digital interactions for care-at-home with MyChart or other digital front doors to deliver an accessible experience and drive adherence.

A flexible platform allows for scale

In the past few years, we’ve seen a proliferation of care-at-home and remote patient monitoring solutions. Most of these are point solutions designed to facilitate care for a specific population or a few clinical conditions.

Point solutions for remote care make interoperability more challenging and create significantly more work for health system IT teams to tie everything together. Ultimately, this approach disrupts the care-at-home promise of a holistic view of patient health.

A flexible platform capable of facilitating care for all populations and conditions provides the most long-term value and scalability. Key points of flexibility include a range of integrated RPM devices, a variety of clinical pathways, intuitive patient communication tools, integrations with ancillary service providers to close the loop on in-home care and risk stratification with smart notifications to care teams.

For health systems to realize long-term value from care at home, these programs must be able to scale patient volume. A single solution that can support a variety of care-at-home scenarios—from Hospital at Home to chronic care management—is the best route to capturing and sustaining value.

Adam Wolfberg, M.D., is chief medical officer at current Health, a Best Buy Health company.