Digital Connected Care: Surge Care for the 21st Century

The Digital Connected Care article series elevates the conversation from tech talk to the practical application of remote patient monitoring in clinician designed workflows with evidence of improved outcomes without increasing staff burden. 

The COVID pandemic spotlighted how precarious our hospital bed availability is on any given day. In a recent article from the Associated Press, the traditional hospital model shortcomings were again demonstrated with the latest COVID surge on top of a steady stream patients returning for care previously postponed.  It depicts the plight of a small community hospital that had to call 40 other facilities in multiple states to find a bed for a COVID-19 patient.  When they found one, it was 220 miles away. The implications of these types of transfers causing potential delays in care, not to mention hardships for families and the strain on medical and transportation resources, really demonstrate the need for alternative solutions.

An earlier blog in this series, Self-Measure Blood Pressure to Manage Hypertension, proposed that the proper linking of remote patient monitoring and well-designed software to the specific needs of the patient and the primary care team can be essential in the effective management of hypertension. This model can provide value for acute illness, specifically in how it can impact hospital inpatient bed and resource availability.

Welcome to the 21^st Century with remote patient monitoring (RPM)

More and more organizations are trying new models to provide safe and effective care for acute illness outside of the hospital walls. Examples of these models include:

• RPM outpatient model

Using remote monitoring devices to obtain patient generated health data (PGHD) and partner with a clinical coordination team, lower acuity patients can access an in-home alternative to care that previously would have resulted in a patient admission to a hospital. Like other organizations, the Midwest Mayo Clinic utilized a remote patient monitoring program for COVID patients that resulted in a hospitalization rate reduction from 28% for COVID patients to an average of 11%. This was done without significantly increasing emergency department (ED) visits, average length of stay or ICU admissions. 

• RPM hospital at home model

This rapidly growing care model allows for inpatient level of care from a patient’s home versus a hospital bed.   With the right service providers and technology in place, patients can be monitored remotely by a 24/7 command center of clinicians who can quickly dispatch resources and supplies as needed.  By either diverting patients to this model right from the ED or transferring from an inpatient stay once stabilized, hospital beds can be saved for the higher acuity patients. At Mayo Clinic, rounding out the first year of our Advanced Care at Home program in June 2021, we were able to save 180 bed days that month.

We’re not just talking about saving beds

The pandemic surges have also highlighted the shortage of nurses in the acute setting.  Many facilities have expanded eICU models to include medical/surgical units to allow more experienced nurses to virtually support the influx of novice nurses or outpatient nurses being suddenly pulled into inpatient care. 

For the rapidly-aging registered nurse population, being a bedside nurse can be physically draining but the virtual role is a practical way for these nurses to still share their expertise. The average age of current registered nurses is over 50 with the majority of those most likely to retire by 2030. Creating more virtual nursing roles can help to retain these invaluable resources longer.  Combining the virtual nursing roles with the 24/7 RPM from the home setting offers another innovative solution to optimize the experienced nursing workforce and patient-generated health data to create a more effective care model for the future.  

Paving the road ahead

Healthcare organizations must look outside their traditional brick and mortar facilities to be able to keep up with patient care needs of the 21st century.  According to Sept. 29, 2021 data from the U.S Department of Health and Human Services, overall U.S. hospital bed availability is still limited with 77% of all hospital beds in use and nearly 79% of all ICU beds.

Thanks to a push from mother necessity, RPM models for care are expanding rapidly and are here to stay.  However, establishing these models for organizations can feel like reinventing the wheel when it comes to the technology hurdles, such as establishing integration with remote monitoring devices and ingestion of PGHD that provides clinicians with the data they need, when they need it. 

Working together, we can build the roads leading to increased access and availability to RPM models. HIMSS Accelerate Health is working with a community of healthcare providers and system integrators to develop and deploy the underlying tools and infrastructure that supports the effective application of PGHD to a broad range of workflows that allow for successful transitions to RPM models of care.

You are invited to participate in this effort by joining the HIMSS Innovation Organization, Personal Connected Health Alliance.

Previous Blogs in This Series:

1. The Innovation Journey 
2. Workflows by the Clinician, for the Clinician 
3. SMBP to Manage Hypertension