As treatment costs in traditional hospital settings continue to escalate, health care providers are increasingly shifting to smaller facilities for both inpatient and outpatient care — including "hospital-at-home" care. Meanwhile, many traditional hospital facilities are being repurposed for specialized care, according to an article in The Wall Street Journal.
For all types of facilities, health care providers are increasingly using telemedicine, as well as data analytics to improve their delivery of care, as well as enhance preventative medicine.
In many locales including rural markets, providers are building free-standing emergency rooms and "microhospitals," or neighborhood hospitals that typically include emergency rooms and beds for short-stay recovery. Nearly all (92 percent) of patients who come to the microhospitals are treated and sent home in an average of 90 minutes, and 8 percent are admitted overnight for care such as intravenous-medication administration, according to Craig Goguen, CEO of Houston-based Emerus Holdings Inc., which partners with big health systems to open microhospitals.
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More providers are also instituting hospital-at-home programs, including Mount Sinai Hospital in New York City. It's HaH-plus program is for some patients who show up at the emergency department or are referred by their primary-care doctors. The program provides a mobile acute-care team provides staffing, medical equipment, medications and lab tests at home, and is on call 24/7 if a condition worsens.
Bruce Leff, a professor at Johns Hopkins University School of Medicine, tells the WSJ that hospital-level care at home for certain conditions can be provided for 30 percent to 50 percent less cost than inpatient care — with fewer complications, lower mortality rates and higher patient satisfaction.
More and more traditional hospitals are being turned into specialized facilities, while still handling emergencies and other community needs. The former Roosevelt Hospital in New York City has been rebranded as Mount Sinai West, specializing in orthopedics, neurosurgery and complex ear, nose and throat cases, as well as mother-and-child services.
Providers are also increasingly using telemedicine, even for specialized care.
For instance, specialists using two-way video and audio technology can monitor and recommend care for newborns in multiple neonatal units from one hub, while a patient with a rash or wound needing special care can use Skype or FaceTime to consult with a specialist from their local doctor's office, home computer or mobile phone.
Traditional hospitals are also using predictive analytics to improve their delivery of care. Some uses include determining who is deteriorating quickly in intensive care, identifying which patients are likely to end up back in the hospital once they've been discharged, and ensuring operating rooms are available when needed for surgeries.
Providers are also using data analytics to enhance preventative care and catch issues before they deteriorate into more costly diseases. For example, Geisinger Health System based in Danville, Pa. is conducting a study, the MyCode Community Health Initiative, sequencing the genome of volunteers to look for risks such as cancer and heart disease.
The study has caught some before problems progress, says Geisinger CEO David Feinberg. In many cases, "people have a medically actionable condition, and there is something we can do."
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Katie Kuehner-Hebert
Katie Kuehner-Hebert is a freelance writer based in Running Springs, Calif. She has more than three decades of journalism experience, with particular expertise in employee benefits and other human resource topics.
