It's really better to not be in the hospital.
We're all familiar with the infections, mistakes, and poor healing conditions that can occur in even the best hospital settings. That said, most people assume that hospitals are just plain necessary for the patients who are admitted.
Dr. Brian Leff, a professor of medicine at Johns Hopkins, is questioning just that. For the past few decades (since the late 1980s), Dr. Leff has been involved in trials that aim to see whether patients "admitted to the hospital" but treated at home, could see as good or better results as those who stayed in the hospital.
In his first trial, 150 patients with 4 diagnoses were treated at home instead of the hospital (most opted into the program.)
As the New York Times reports, the findings were good: "Offered the opportunity, most patients agreed to be treated at home. They were hospitalized for shorter periods, and their treatments cost less. They were less likely to develop delirium or to receive sedative medications, and no more likely to return to the emergency room or be readmitted."
That said, there are challenges to this concept. It involves careful vetting on the front end. Sometimes patients need to be readmitted.
There are are also several challenges to it that we think could be easily solved with a hybrid store-and-forward telemedicine platform to ensure that good healthcare collaboration happens -- even outside of a hospital context:
- Specialists are not always accessible.
In our experience with home-based wound care, specialists aren't needed most of the time. The challenge with home-based care is making sure that in the minority of times when they are needed, they're accessible. A telemedicine platform helps ensure that the nurse or aide who is seeing the patient multiple times per day has the tools to access a specialist whenever they need them -- without the specialist needing to make house calls to all of the patients.
- Hospitals help providers coordinate care.
Coordination of care is crucial, especially as there are evermore providers on a single case. When patients are in the same place, there is at least a better chance that providers will be sharing information in person or on paper. (Although we've all seen the limitations of this kind of coordiantion.) A healthcare collaboration platform in which all collaborating providers can consult with each other is crucial for a home healthcare setting.
- Phone calls and texts are not enough.
If nurses and aides aren't able to securely share pictures and videos of what's happening with the patient, it can be very difficult for specialists or other providers to assess what's happening. Look for a telemedicine solution that supports secure transmission of multimedia.
As Dr. Leff says, this is an idea whose time has come: “My sense is that over time, hospitals will become places that you go only to get really specialized, really high-tech care,” he said.
To try a telemedicine solution for free, in your home-based healthcare setting, click here:
Photo by sophiaburke on Flickr, used under Creative Commons rights