Hospital Impact: Move over, hospitals and health systems—home is where the care is

Home care nurse giving patient physical therapy
The ways in which hospitals are managing patients post-discharge is driving changes in the way care is delivered. Image: Getty/Photodisc
Andrea Simon

At my firm, we have been working with a number of different organizations that are deeply involved in the shift from ancillary providers, nursing homes and home care agencies to hospitals that are launching mobile applications to monitor and manage patients.

What we are seeing is a complete sea change in the values, beliefs and behaviors of consumers and clinical practitioners at all stages and levels of the care delivery system—not just a new venue for delivery of care or new way of cost shifting.

Baby boomers want to stay in their homes, not in a nursing facility or a senior community

The result? A wave of opportunities for new business models and innovative solutions is emerging.

Specifically, the ways in which hospitals are managing patients post-discharge as they return to their homes is developing into a new service line, replete with care delivery challenges.

The old solution (visiting a physician or hiring a nurse or aid) no longer works

While recently conducting research for a home-care visiting nurse service, we listened as individuals, each with different needs, discussed the complexity of caring for loved ones, family members, neighbors or spouses after they had been discharged from a hospital. Similarly, some were struggling to care for individuals with a chronic condition, often dementia or cancer, who needed care in their homes.

The needs of the sick wife, husband, mother or brother were straining the capabilities of those now thrust into the role of caregiver. Untrained in nursing skills and forced to adapt quickly, they needed innovative ways to obtain these skills and get the support they required, specifically:

  • Someone to talk to when they needed to talk
  • Ways to search for answers and solutions quickly and easily, possibly by connecting with a support person online or by phone
  • How to know if they were doing things correctly rather than just improvising

These “amateur” caregivers we spoke with also wanted more control over selecting solutions and caregivers. They wanted the same nurse or aide to come to the home all the time so they could build trust and a relationship with that person.

They also needed support with daily living duties, from bathing to shopping to cooking. As we quickly learned, their needs were bigger than what a trip to a doctor's office could provide.

Perhaps there are new home-care models emerging that could add great value?

In the past, patients were expected to come to the doctor, wait in the reception area (often for a long time) and then get 10-15 minutes of evaluation and prescribing by a physician or physician assistant. Now, patients and their caregivers want 24/7 accessibility to someone, but not necessarily in-person or in an office. Furthermore, patients want caregivers who can help them stay in their homes, remain active and involved, and help them manage their aging in a positive environment.

Mimicking Airbnb and Uber, several companies are now offering platforms to connect those who need care with those who are best trained and suited to provide it. This innovative use of technology is opening up new, broader and faster solutions that are more in keeping with the accelerating pace of this potentially huge demand.

Two initiatives we are watching that capitalize on these unmet needs are Honor and HomeHero. Both were developed after their founders realized that their family members could not find the type of care that best suited their needs.

With these two models, patients get experienced, reliable and “vetted” caregivers; families get better service, consistency and control; caregivers get higher pay ($15/hour versus $9/hour) in many cases; and providers incur less overhead to manage their workers. Talk about a win-win.

Case in point: HomeHero has provided 1 million hours of care to seniors in the greater Los Angeles metro area since launching in January 2014 and has on-boarded more than 1,500 caregivers.

For hospitals, this new way of delivering in-home care represents a serious challengeand opportunity

The concept of a platform connecting those who have a need with those who have solutions represents a tectonic shift from the old model, in which hospitals and doctors held the reins, controlling the solutions in their facilities on their schedule. The ease and speed, along with the quality and convenience, of the new models can readily be seen by hospitals as a threat to their dominance in the healthcare arena.

Or, if hospitals are smart, these new platforms for home-care delivery might trigger a whole new wave of innovative approaches, encouraging them to venture outside their walls into the populations that need—and would use—their help to stay active and healthy, at any age. It is certainly something fascinating to watch. Stay tuned.

Editor's note: This article has been changed in order to correctly reference Honor, an organization that connects individuals with home care professionals. 

Andrea Simon, Ph.D., is the principal and founder of Simon Associates Management Consultants. She has more than 20 years of experience as a senior executive with financial services and healthcare institutions.