Infrastructure reimagined – connecting the patient bed to the data center

Ed Note: This is the second of three articles, powered by CHIME Digital Health Insights and sponsored by Spectrum Enterprise, examining how healthcare providers can modernize their enterprise infrastructures to meet increased connectivity demands — including care anywhere and emerging technologies like AI — and upgrade their governance and service partnerships to support this “new normal.”

Patient care continues to move beyond the traditional healthcare facility, promising improved outcomes and other benefits, but placing increased demands on healthcare provider networks and digital transformation. For these expanded models of care to succeed, organizations need technology infrastructure that’s robust enough to support secure information sharing and collaboration among disparate members of the clinical care team­ ­– this includes devices as well as internet and connectivity.

Homeward bound – improved outcomes

After decades of small-scale initiatives, in late 2020, the U.S. Centers for Medicare & Medicaid Services (CMS) issued Acute Hospital Care at Home flexibilities. Nearly 300 hospitals have participated to date. Though the program remains small in scale, McKinsey has estimated that up to 25% of all Medicare spending, some $265 billion per year, could be shifted to a care at home model.

The shift of the patient’s bed outside the hospital presents significant opportunities. Patients are more comfortable in their own homes. Hospital-related complications are reduced. Advances in diagnostic and remote monitoring technologies, along with connected devices, are streamlining critical data delivery and connectivity, making it easier for care teams to coordinate care and keep close tabs on patients without being physically present.

Care at home offers potential advantages to the appropriate patients – namely, those with acute medical conditions who otherwise don’t require 24/7 nursing supervision. They can recover in a familiar space, where the risk of hospital-acquired infection or a fall is significantly reduced. Additionally, care teams can more readily identify and address social determinants of health, such as limited access to food or poor ventilation.

On the operations side, overhead costs and readmissions are reduced. American Hospital Association data shows that providing care at home can cost approximately 40% less than an equivalent hospitalization and reduce 30-day hospital readmission rates. Looking specifically at the Acute Hospital Care at Home program, a Journal of the American Medical Association study found mortality rates “consistent with the hospital-at-home literature” along with “minimal complications” that required an emergency department visit or readmission.

That said, organizations cannot overlook the operational and technical infrastructure necessary to support care at home.

Meeting significant connectivity demands

The U.S. Centers for Medicare and Medicaid Services (CMS) has significant expectations for Acute Hospital Care at Home: Contracting with a range of third-party services (from lab and pharmacy to food services and durable medical equipment), supporting daily visits from practitioners, and establishing “immediate, on-demand remote audio connection” with the care team. That’s a significant lift considering the average “length of stay” under the program is just five days, according to JAMA research.

The requirements for chronic condition management are less explicit but equally challenging. Patients need reliable technology to monitor vital signs and share patient-reported outcomes with their care teams; that includes devices as well as internet or cellular connectivity. Patients and caregivers often need assistance in obtaining, administering, and managing medications, especially those delivered by injection or infusion.

To support shared decision-making, care teams need access to patients’ longitudinal records in applications familiar to them, along with the ability to collaborate virtually and make the right care decisions for the patients they serve. Given that care teams may include paramedics, social workers, and therapists in addition to employed nurses or physicians means supporting stakeholders with highly variable clinical workflows and work settings.

A one-size-fits-all approach to connectivity, data access, and collaboration is ill-suited to support a multidisciplinary care team. A solution that works for hospital-based staff may not meet the needs of traveling nurses, or vice versa. Poorly executed solutions are unlikely to be adopted, and outcomes are likely to suffer due to miscommunication, unidentified care gaps or non-clinical needs, limited insight into patient progress, and delays in providing necessary care.

Instead, a multifaceted approach featuring a customized, scalable healthcare technology infrastructure results in better coordination, security and connectivity. This leads to fewer interruptions to care and, ultimately, better insights and outcomes.

Infrastructure that supports access

A 2022 study in BMC Health Services Research described success in continuity of care as providing “predictable and accessible care with continuous follow-ups” while establishing “cooperation based on knowledge, trust, and respect.”

Patient experience significantly improves when organizations achieve these outcomes in their care-at-home models. Data from Press Ganey reveals a 12% improvement in patient experience for those receiving hospital care at home compared with those receiving in-hospital care.

Providers supporting care at home need technology infrastructure that delivers access to data, decision support, and collaboration without taking them out of the applications they already use. This helps ensure care teams meet patients’ needs and demonstrate the value of care at home to their patients and their organizations.

A trusted technology partner can implement a digital infrastructure that secures important health data and ensures information is accessible among clinicians, departments and locations. By simplifying IT infrastructure with managed services and a scalable network, organizations can free up staff to focus on the mission of transforming lives through patient programs and care.

About Spectrum Enterprise

Spectrum Enterprise, a part of Charter Communications, Inc., is a national provider of scalable, fiber technology solutions serving many of America’s largest businesses and communications service providers. The broad Spectrum Enterprise portfolio includes networking and managed services solutions: Internet access, Ethernet access and networks, Voice and TV solutions. The Spectrum Enterprise team of experts works closely with clients to achieve greater business success by providing solutions designed to meet their evolving needs. For more information, visit enterprise.spectrum.com.