Thanks to the COVID-19 pandemic, more patients found themselves receiving care at home through telehealth, remote patient monitoring and other technologies.
According to a June 2021 survey from McKinsey, 13% of patients started having virtual home health visits during the pandemic and expected such care to continue after it was over. Approximately 16% of patients aged 65 and older were more likely to engage in home health services than before COVID, 46% people aged 35-44 said they felt the same way.
These numbers represented a sizable shift from pre-pandemic attitudes and are a major reason why digital health investors and stakeholders are strongly buying into care-at-home technologies. For Medicare fee-for-service and Medicare Advantage beneficiaries, $265 billion worth of care services could shift to the home by 2025, according to McKinsey’s analysis.
What do patients at the forefront of this shift think about receiving care at home? Digital Health Business & Technology spoke to two who participated in home-based digital health pilots -- one who was diagnosed with COVID and another who dealt with post-surgery complications. Here are their stories.
In August 2021, Thad Stappenbeck came down with COVID-19. This diagnosis came after he had been battling viral pneumonia for a few weeks. He left his vacation spot on Cape Cod in Brewster, Massachusetts, and went back home to Worchester and isolated himself. A few days later, he found himself in the hospital, struggling to breathe.
“They wanted to admit me,” Stappenbeck said. “I didn’t want to go.”
His wife Mary wasn’t sure she’d ever see him again. “I had COVID, so I couldn’t visit him,” Mary said. “It was very unsettling.”
Stappenbeck, who was 78 at the time, had fortuitous timing. UMass Memorial Hospital, the Worcester hospital where he was in the emergency room, had started a hospital-at-home program a few weeks prior. Across the country, the program has been buoyed by a temporary waiver from the Centers for Medicare and Medicaid Services that pays hospital diagnosis-related group payment for hospital-at-home patients.
UMass, one of 250 hospitals to receive that waiver, was ready to begin its hospital-at-home program using technology from Boston-based Current Health. Stappenbeck was ready to be patient number one. Sort of.
“The home health representative told me I’d be patient number one and it threw me off. I was resistant to be the first of anything,” Stappenbeck said. “You just wonder, ‘How good could they be at it?’”
What changed his mind was consulting with his son, who is a physician at Cleveland Clinic, as well as his local rheumatologist. Both told him to give it a go.
Stappenbeck came to the hospital on Sunday and went back home in an ambulance on Tuesday. He said home care workers, mostly emergency medical technicians, followed him back and set up a tablet to connect with the hospital via telehealth and remote monitoring devices to track his vitals.
The hospital-at-home nurses came to his house twice per day. “The nurses spent a full hour with me on my first day. I had never been attended that way at any time I was ever in a hospital,” Stappenbeck said.
Stappenbeck also spoke to the doctor via telehealth every day as long as he needed it, to, he said. When one of the remote monitoring devices wasn’t calibrated and started going off irregularly, someone from the program came and fixed it.
These situations reassured him that communication with his care team would never be an issue even as he lay in bed outside the walls of the hospital.
“Everything that touched us about this program was right,” Stappenbeck said. “We were the first in line. A lot of times it doesn’t work out and things fall apart. But this did work out.”
It was January 2020 when David Rader’s knees buckled. After walking down a slight incline, Rader fell and laid in a ditch for over an hour. While he avoided hypothermia in the cold Morganton, North Carolina winter, his injuries required surgery that would begin the domino-effect of a long recovery.
Raders’s initial surgery successfully repaired his knees, but during the recovery the 81-year-old faced eight infections and was shuffled through five recovery programs. After his blood sugar couldn't be regulated, he required a heart catheterization.
“I knew I was in bad shape after the accident and the surgery,” Rader said. After his doctor encouraged him to go through a remote monitoring trial with the New York-based Cadence, he was sold. “I wanted to go through with this program. Whatever [my doctor] told me to do, I was going to do it and do it the best I knew how, so I would be healthy.”
During his recovery, Rader said he had two goals: the first to visit and get well for his wife, Betsy, who is battling Alzheimer’s Disease in a nearby facility, and secondly to play nine holes of golf.
“I could see the light at the end of the tunnel, and I wanted to get well as soon as I could,” Rader said.
Once enrolled, Rader received a cellular connected scale and blood pressure cuff. He is still enrolled in the program and will be as long as he has heart failure.
Rader’s daily readings are sent to the platform, and reviewed by remote care practitioners. If necessary, the Cadence platform can forward results to Rader’s care team who are affiliated with LifePoint Health. The care team is available around the clock for Rader to check in with and can make minor tweaks and titrations to his medications.
Rader said he had few doubts after learning how to correctly monitor his blood pressure and weight. Even though it was a novel concept, he wasn’t intimidated about entering the program.
“The quicker you can get help and get it diagnosed the more apt you are to live a healthy life” Rader said. He said is on track for his goal to play golf by the end of September.