Future of healthcare isn’t in hospitals

Innovation and policy changes fuel paradigm shift in healthcare

Medicaid Health care

“If you were given the choice between getting treatment at a hospital or your own home, what would you choose?” asked Greg Pang, president and CEO of Community Home Health & Hospice.

The trend is clear among the baby boomer generation: in-home care is overtaking hospital care when it comes to treating illness. According to a study by the American Association of Retired Persons (AARP), 75 percent of Americans over the age of 45 believe they will be able to live at home for the rest of their lives.

“That was very telling data,” said Pang. “The baby boomers’ need for independence was reflected in that data.”

In fact, figures and projections paint this same picture when it comes to generalized and specialized healthcare for Americans of all ages.

“What we’re seeing is quicker discharges from the hospital and nursing facilities,” said Randy Dalton, vice president of Home Health Services at Community Home Health & Hospice. “People want to be out of the facilities and back home faster.”

With advances in medicine and technology, an increasing number of intensive treatments are performed at ambulatory clinics and no longer require an overnight stay. In 2007, The American Hospital Association found that less than 50 percent of surgeries were performed inside a hospital, down from 90 percent in 1981. Services like rehabilitation and wound care are also moving out of the hospital.

Both Dalton and Pang, who have a combined 24 years working at Community Home Health & Hospice, believe that people heal faster when they are at home.

“I hear that from our patients and our staff,” said Dalton. “Patients want to be at home; they need to be with their families.”

Community-based care, according to Community Home Health & Hospice, is care based in the patient’s place of residence. And it’s not just patient preference that is pushing this industry-wide trend. According to Tim Strickland, a spokesperson for Vancouver-headquartered PeaceHealth, the American healthcare system is moving from paying for heavily hospital-centric care to rewarding clinics and hospitals that focus on more intensive outpatient treatment, at least in part because of the Affordable Care Act.

“Right now, if we provide care for ten patients, we receive payment for those ten patients,” Strickland said. “The model that’s coming in 2017 will incentivize keeping people out of the hospital, keeping them well enough to prevent hospital re-admissions.”

PeaceHealth, which has 10 hospitals and 900 physicians across Washington, Oregon and Alaska, has taken a strategic approach to individual and community health. The aim is to identify a care need and intervene before that person is sick enough to end up hospitalized, or worse, in the emergency room.

“The goal is better care for individuals, better health for populations and lower power-capita cost for care,” said Strickland. “The only way to achieve that triple aim is to innovate and provide care earlier and outside the hospital setting.”

And that’s just what’s happening. Innovation in personalized health monitoring and groundbreaking new technology is fast becoming the future of the healthcare industry.

“Every week, there is some sort of alert that’s coming to us by some innovation group, some firm,” said PeaceHealth CEO Beth O’Brien. “Last week, it was a contact lens that can measure your blood sugar.”

Technological innovations like e-health and telemedicine are rapidly advancing to meet the needs of busy Americans and those living in remote areas. With e-health, for example, patients can schedule follow-up appointments online.

“You can schedule an online visit and they can even look at your ears,” said O’Brien. “So, you were able to control your time, control your access, and your doctor was able to do a good follow-up in a health environment that’s a lot more conducive to your life than time off work.”

An increasing number of healthcare devices and innovative methodology are being introduced to help healthcare organizations like PeaceHealth and Community Home Health & Hospice partner with patients to intervene earlier in disease processes in order to prevent hospitalization, accelerate healing and re-establish health faster and more efficiently.

“This is the cutting-edge,” said Strickland. “There is an explosion of healthcare entrepreneurship and invention.”

Preventative care doesn’t only help people stay out of hospitals; it also saves millions of dollars on emergency room visits where resources were intended to be reserved for acute care.

“Right now, we still have a lot of patients that come into the emergency room for a chronic illness,” said O’Brien. “In the future, those patients may be assigned to a nursing clinic where they are monitored very carefully.”

O’Brien cited that increasing the number of clinics, ambulatory centers and group communication among patients (supervised by a physician) will enable communities to offer significantly more holistic care, all outside of the expensive and sometimes traumatic hospital setting. Regular contact with nurses and caretakers can help spot issues with chronic illness far before an emergency room visit becomes a necessity.

The community-based approach of Community Home Health & Hospice follows the same theory.

“A lot of what we do in the home, from a nursing component, is teaching and educating the patient on their disease and how to help monitor it themselves,” said Dalton.

Empowering patients with an active role in their own healing and healthcare is a crucial element to moving away from the hospital-centric model.

“Community-based care is a growing field now and in the future,” Pang concluded. “It keeps families together [and] patients heal faster. People just want to be at home.”