Home care: The Next Frontier in Healthcare Innovation

My experience with home care goes back 20 years as an occupational therapist in a small community. Paper charting, long meetings, lots of windshield time in between patients and a pager for communication. Yep, a pager. If there was an urgent message to immediately call back, the number 911 was used and then the number to call back.

Home health care was fragmented, disjointed and inefficient. Restoration and remediation efforts with little chance of effective preventative care. Scripts, protocols and recipe driven care. If that is how I felt as a home care provider, imagine how the patient felt? Needs not met, concerns not addressed timely and I would say afraid, concerned and out of touch.

Providers now have service-connected devices with EMRs that have updated drug databases, instant communication with the patient and anyone involved in the patient’s care, required documentation signed at point of care and integrated into the patient medical record. Really, these are just the basics for many providers and these tools have become the norm. Where will it go from here?

The increased demand for in home care has brought new faces and new technologies combined with a renewed interest by providers to meet patient’s needs in their homes. Physicians, Physicians Assistants, Nurse Practitioners, wound care specialists and access to these providers through Telehealth to patients who otherwise wouldn’t make it to an in-person office visit. The excitement around care in the home and ways to meet patient needs is palpable.

What was at best fragmented is changing in home health care and communication is making all the difference. Clinicians have access to information and support in a way that they never had before. Patients have access to their providers and are more active participants in their care needs.

In the past, patients had often been more directive to care providers in their homes however typically this was identified with a negative connotation. Because care efforts in the past relied so heavily on the approach and care relationship with a single provider, in a single admission visit, patients often denied symptoms or their needs weren’t identified. Now, the patient and provider have an enhanced ability to work together to meet their needs and the support system behind the provider is in the loop. Message threads, photos of wounds with measurements, vitals tracking, sign or symptom tracking is possible in ways that are exciting to explore.

What a great time to be involved in home health care! Patients, caregivers, group homes, assisted living environments, retirement communities, surgical centers are looking for the best home care providers and agencies and ways to coordinate efforts with them. The technology to support individual providers is there and will continue to improve. Care will be provided in the home because it is effective and patient specific and it is sustainable when delivered in value-based models. Securing the correct payment for those services will be critical now but the cost savings will be instrumental in preserving skilled and necessary care for decades to come.

There will still be windshield time to deliver this care but the value of each provider visit is supported in ways that I couldn’t imagine so many years ago. Now we can look at how to coach and mentor home health care clinicians and teams. Now patients can be directive in their care and be less fearful and more knowledgeable about steps to take to live their lives more fully.