Moving beyond conventional healthcare delivery systems: Hospital to home

Dr K. Shweta , Medical Director, Nightingales Home Health Services highlights that the existing model of healthcare services may become unsustainable in the long run and home healthcare model can improve patients’ quality of life while reducing cost for the healthcare system

The Indian health sector, in the conventional sense,consists of medical care providers that include physicians, specialist clinics, nursing homes, hospitals, diagnostic service centres and pathology laboratories, medical equipment manufacturers and contract research organizations (CRO’s), and pharmaceutical manufacturers. The existing model of healthcare services may become unsustainable in the long run. Transitioning healthcare delivery from hospital to home is currently happening in mainly in three forms:

• Teleconsultation, a key opportunity for patients to improve their access to care at home
• Home healthcare to improve patients’ quality of life while reducing cost for the healthcare system
• Home health monitoring devices to enable more efficient management and follow up of chronic conditions

The need to  look beyond conventional healthcare

The convenience of telemedicine

A few decades ago whenever we faced any health issue, be it minor or major, we typically accessed care beyond the confines of our home, traveling to a healthcare facility like a doctor’s clinic or the hospital. But now an increasing number of patients who live in urban areas, don’t have the time nor the patience to wait for long hours in waiting rooms. Accessing care at home through a teleconsult became a much faster and easier process for most of us.  Telemedicine offers prompt treatment in the comfort of their homes at the press of a button. Telemedicine is the very epitome of technology-driven healthcare. The current pandemic has highlighted the value of virtual healthcare.

Growing geriatric population

With the growing number of nuclear families, there’s a large section of geriatric population that requires constant care. From bedside care to preventing falls and injuries, senior citizens cannot always rely on conventional modes of healthcare delivery. Some may not have the required resources to travel to a hospital whereas some may be bedridden and unable to move easily. A healthcare delivery system that allows the senior folks to access care from the comfort of their homes can improve their quality of life.

Post-surgery care

Patients with stroke, COPD, heart failure and many other conditions require medical care even after discharge. If we continue to provide post-surgery care within the hospital, it will continue to overburden our doctors and healthcare professionals. We need to find ways to ensure that transitional care can be provided at home. This not only helps ease the burden on our hospitals and medical staff, it also helps patients recover faster when they receive care at their homes.

Digital monitoring devices, use of fitness devices monitors, and the continuous capture of information about sleep, heart rate, blood sugar and other parameters,  has given healthcare providers an opportunity for preventive care. Focus of medicine will move beyond conventional clinical-based patient care to  personalised and preventative models to improve the patient experience of care (including quality and satisfaction), to improve the health of populations and to reduce the per capita cost of health care

Value proposition

Currently, there is a significant demand-supply gap plaguing the Indian healthcare system – while India accounts for 20 per cent of the global disease burden, it accounts for only 6 per cent of global hospital beds and 8 per cent share of doctors and nursing staff. The concept of home healthcare comes as a boon for the already overburdened healthcare infrastructure in India. It offers a better and cheaper alternative to hospital care. Home healthcare complements healthcare delivery by reducing the average length of stay, ensuring efficient utilisation of existing bed capacity and reducing chances of readmission. It can also improve the average revenue per occupied bed if they work out the synergy in the right manner with the homecare providers.

From a patient point of view, chances of hospital acquired infections become less and patients can enjoy the therapeutic comforts of their familiar surroundings along with continuum of care. Patients and their families are also increasingly adopting healthcare services at home because it saves the physical and psychological pressure of hospital visits and stays. Home healthcare service is also more affordable than hospital stays. With savings on real estate and infrastructure cost, the model operates at ~15-30 per cent lower cost as compared to hospital expenses for similar treatment as it utilises available capacity in patient homes.

Over the last few years, hospitals have started looking at home healthcare companies as partners in delivery of care. The pandemic has shown us that home healthcare offers a win-win situation for patients as well as hospitals. Furthermore, home healthcare can reduce unnecessary hospital visits by up to 65 per cent and reduce the overall operational cost for hospitals by up to 20 per cent. These factors along with increasing consumer receptiveness towards home healthcare, rising doctor acceptance of home healthcare, improved insurers’ willingness to cover these expenses are driving the growth of the market in India.

Shift to newer models of healthcare delivery is a consumer driven change. Hence, most traditional healthcare businesses will have to transform in significant ways to meet them where they are. Healthcare in India is poised for transformation and home healthcare can suitably address the gaps in the current Indian healthcare system.