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 Today in Health it, the Story is a new care at home initiative, which paints the blueprint for the future. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of this week in Health IT a channel dedicated to keeping health IT staff current. And engaged today. No sponsor. Just wanted to make you aware of a couple things.

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The title is Health Systems Care Delivery Group's, Amazon Launch Hospital at Home Initiative. I'm really getting tired of talking about Amazon. They're everywhere when it comes to talking about healthcare and their healthcare plans. But let me talk a little bit about this. 'cause I, the, so what on this is, I think it, it does really paint a picture for where the future is and where these tech groups and others have identified as the opportunity to really grow healthcare and to launch their services.

All right, so this is straight from the article. Founding members of this coalition include Amazon Care, Ascension largest Catholic health system in the country. I st I believe still it might be. Yeah. No, it's still the biggest dispatch. Health Aara CL Caring, Intermountain Health Care Home instead.

Landmark Health and signify health. . Interesting group. Actually, lemme tell you what their policy priorities are. Number one, expand the services covered in a home-based setting. So expand the services. Number two, retain important hospital without walls, site of care, flexibility to support home-based hospital services.

So they're gonna try to. Make sure that the, the funding is there, which includes the second one, which is, or the third one, which is ensure equal access for seniors through fair reimbursement for home-based evaluation and monitoring codes. Alright? So you have to fund it and you have to make sure that it's constantly growing and expanding higher levels of acuity and different levels of care.

Advocate for a bundled payment model. For extended care in the home. And then finally encourage greater flexibility for home-based care services to meet commercial and Medicare Advantage network adequacy standards. So there you go. That's their, that's their, their policy priorities is what you would say.

And that seems pretty basic, pretty straightforward. I think the first thing to look at, to be honest with you, is the partnership. You have Ascension and Intermountain two very forward-Leaning Health systems. You have Amazon Care, you have Landmark Health. This is an interesting group that comes together.

Let's go on in the article, see if we can pick up some more things that are going on here. Moving Health Home members point to an array of statistics. They say bolstered their case for more technology enabled virtual care. They point, for instance, to an A-A-A-R-P study that saw three in four adults. 50 years or older preferring to age in their home and communities.

That's absolutely true. So there's a preference from people beyond that. The quality and cost improvements are apparent. They said noting CMS estimates that show home healthcare in Medicare saves at least 378 million a year. In just the nine states that there are part of home health value-based purchasing, you know, 370 million here, 370 million there tends to add up.

And if that's only in nine states, you multiply that out to get to. Yeah, it's five times, five times. Uh, 400 million is, I don't know, 2 billion, but that ends up being a fair amount of money. They also point to research showing home-based care to reduce likelihood of hospital readmissions. Patients using home-based care services within 14 days of discharge from hospital are about 25% more likely to avoid readmission within 30 days of discharge.

Okay, so you have quality. You have cost reduction and you have consumer preference. So these are the three things they're pointing to and they're saying, look, now is the time for care in the home. Alright? So they go on. Many healthcare leaders have said this trend, moving in this direction is, has been happening for some time.

Mayo Clinic platform president and former guests on this weekend, health it, Dr. John Halamka, for instance. He said he foresees a future of virtual centers in what were formerly known as hospitals. It's going to be the emergency department for heart attacks or strokes in ICU tower right next door, which will take care of the sickest of the sick that can't possibly have home healthcare.

So what essentially John is saying is, look. These beautiful towers that we have, we're we're gonna end up with virtual hospitals and we already have virtual hospitals. Mercy Health out of St. Louis has a virtual hospital and they've expanded that with a partnership with Humana. And Intermountain also has a virtual hospital, so

The organizations that are seeing the future are saying, look, we're gonna put in these buildings. And, and Mercy's, for instance, has 300 different clinicians in that virtual hospital monitoring, uh, patients, seven by 24. Not only the remote ICU, which we know exists, but also home-based care, which they're now expanding with Humana.

So that is the future, and that is the So what the, so what is, how quickly can you get into the home and with what partnerships do you need to build that capability out? And why is this important? It's important because it represents the biggest vulnerability to health systems period in the country, period.

Build out a new tower. They don't have to go to the equity markets. They don't have to go get bond funding to build a new hospital tower. Essentially, what they have to do is a one time deal to stand up a virtual hospital, hire about 300 clinicians, do the marketing, and then go into 20, 30 states where they are monitoring people out of their home.

This is a, uh, phenomenal service. So let's talk a little bit because it, it is about health it. What does this entail? It entails the use of technologies which are readily available at this point, and accessible through companies like Best Buy. We've talked about Best Buy, repositioning their company as a healthcare company, standing up these hospitals at home.

It's a great pivot for them, and going into the home is not easy. We did this. At St. Joe's all these years ago, oh gosh, nine, 10 years ago now, where we went into the home and we did it on a pilot basis, but it's challenging. It's challenging to go into a home. It's challenging to send technicians into the home.

There are certain aspects that you don't think about in terms of liability and protection. The various, I don't know, let's just call it differences in everybody's home and how you're gonna set these things up. The, that's one aspect of it. The second aspect is. How people use the technology outta their home.

It's very different. And organizations like Best Buy and the Geek Squad have been used to this for quite some time. They have to set up TVs in the home and, and home speakers and audio and those kinda things. So they've gotten used to setting up this equipment. So it works. And I'm telling you, the stories are, are just hysterical of what people will do with an iPad if you put it into their home.

It, it, it is not, it's not straightforward. So there's partnerships in terms of getting into the home and getting the technology set up. Then there's the technology partners. So we put this stuff in the home. and found out that it has to be just simple to use. Otherwise, you're gonna get the phone calls.

Back in the day there, I was on a help desk for a very short period of my career. Hardest job I've ever done because we were doing home-based support of computers. And back in the day, if you don't know this, you'd press a button and the CD player would pop out and you'd put the CD in, you'd . Press the button in and the old cartoon was, they pressed that button and they would say things like, my cup holder isn't working.

So the CD player would act as a a cup holder. We got those calls on the help desk. Those are real calls. Those really happen. You have to figure out how to make this stuff simple. It's the one button pressure cuff. It's, it's any kinds of care devices you're gonna put in the home. Have to really be as simple as passive.

Step on a scale, sit on a toilet seat, which takes your blood pressure, you name it. It has to be really simple stuff that is monitoring these patients. And then finally, for us, the cost of monitoring ended up being one of the most significant costs in this. And the technology, again, was not that hard. We, we had to use wifi.

We, we would probably use five G if we were doing it today. The devices, you end up going out there and finding the right devices to stitch together. You get 'em connected to the network. They're monitoring, they're coming back. But at some point you need to stand up that virtual hospital with those clinicians who are looking at it.

And those clinicians end up being more than just clinicians. They end up being for some people who are isolated and battling chronic conditions. They end up being, I don't know, really mental health, like they're calling on a daily basis just to check in, just 'cause they have a phone number and there's somebody who's nice on the other end of the line.

So you have to build those tiers in to the, uh, call center on the other line. So that's what you have to put together. And I would say time is of the essence because a new kind of health system gonna start popping up and it's gonna look like Airbnb and I've talked about this earlier this week. It's gonna look like Airbnb and they're gonna come in and all of a sudden you're gonna have thousands of hospital beds in your city being managed by someone other than the health system because they have recognized that the Airbnb model is the best way to get into healthcare in your community.

And to provide these services, especially if you start to see reimbursement money coming from the various sources that this entity is looking to get it from. That's my so up for today. Uh, a new competitor right on the horizon, they're gonna come in to your market, through the home and start to deliver services that way, and it could be a new high tech company.

Or it could be one of your favorites. Could be Amazon, it could be Intermountain, it could be Mercy Health out of St. Louis could be a competitor that you didn't think was gonna be in your market, and now all of a sudden they're managing beds in your market. That's all for today. If you know of someone that might benefit from our channel, please forward them a note.

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