Prior to the pandemic, telemedicine was thought by many to be a solution only applicable to reaching patients in rural settings. During the COVID-19 pandemic, we've come to recognize telemedicine as an incredibly valuable, multifaceted model of care delivery. What's unfortunate was that we waited for a pandemic to realize its role when we could have expanded access to virtual care, and its benefits, sooner. In-home care now stands at a similar precipice.
Traditionally in-home services have fallen into two buckets: first, home health services performed by non-medical professionals such as bathing, housework, or meal preparation, and, second, in-home care services delivered by nurses, therapists, doctors, and other providers. Both have long been affiliated with care for the elderly. Now, with the horrific impact of COVID-19 on nursing homes and long-term care facilities, more people today recognize the benefits of the latter -- what we'll call in-home care. President Biden even included expanded support for in-home care in his .
The reasons why in-home care is valuable for the elderly are clear. The vast majority of elderly Americans prefer the independence and comforts of home, and in-home care removes barriers that some elderly patients face in visiting the doctor. Meeting patients in their homes can also help providers better understand elderly patients' needs, revealing if they have a narrow apartment staircase, not enough food in the fridge, or lack air conditioning. Finally, it offers a way to reach patients where there is a lack of brick-and-mortar clinics or specialists, and provides a touchpoint outside of regular office hours.
But these benefits aren't exclusive to the elderly -- these are improvements to the patient experience that could benefit many.
Consider the mother or father of three young kids who needs an appointment to get a routine blood test. Should they take a day off of work, possibly forgoing pay, bring all three kids along to sit in a waiting room, or pay for childcare to schedule a visit? None of these options are particularly appealing, so perhaps they might postpone the visit.
This parent would benefit from an in-home care visit. There are countless similar examples -- the busy student, the night shift worker, or the immunocompromised patient who is concerned about visiting a hospital.
Beyond only addressing barriers that prevent patients from getting care in hospitals and clinics, in-home care can better meet patients' expectations. Even prior to the pandemic, more people were watching movies on Netflix, not in a theatre, and getting their groceries delivered, not at the store. Consumers expect more convenient options for their entertainment, food, and shopping experiences. Now, increasingly, they are setting the same expectations for their healthcare, preferring to stay home to save the time, money, and hassle of visiting brick-and-mortar locations.
For many patients, telemedicine can make care available where and when they need it. However, there are limitations to virtual care. Telemedicine isn't a good solution for some patients, such as those with limited digital literacy, or for certain types of care such as a vaccination or lab test. In these instances, in-home care is a strong alternative or complement. In-home care can marry many of the advantages of virtual care with the benefits of a traditional in-person visit.
In-home care has demonstrated the ability to facilitate high-quality care and patient health outcomes across a broad range of applications. In-home care models led by primary care physicians to lower costs, improve outcomes, and lower utilization including ER visits and hospitalizations. Similarly, , in-home acute care (often called Hospital at Home) has shown to be an effective option , , and , helping lower their readmissions, other downstream care utilization, and, in many cases, lowering total costs. In-home care can also help patients better recover as they transition from a skilled nursing facility or hospitalization, . Finally, in-home care can also improve compliance, reducing the rate of missed or cancelled lab tests, which benefits patient's health and providers' workflows alike.
In-home care can also be a resource for providers to address gaps in our healthcare system. Meeting patients in their home is an effective way to expand providers' reach without the investment in building new clinics or labs, a key solution to the vast care deserts across the country. This expansion of access and ability to offer those in medically underserved areas high-quality care is important to advancing health equity.
Of course, in-home care does face limitations. Surgical procedures and intensive care have a place in facilities designed for those services. Similarly, there are benefits to brick-and-mortar facilities for particularly complex or emergency needs where patients can be attended to by a variety of specialists in a 24/7 setting. Still, by shifting other kinds of care to the home, we can reserve in-person capacity for those who need it most -- an important lesson learned during the pandemic when hospital volume was strained for months.
We shouldn't wait for a world-changing event to reshape how we see the value of in-home care -- it's time to bring the house call into the 21st century. We're beginning to see some momentum, with health plans investing in in-home care for their members, health systems building out home-based services, and telemedicine companies looking to complement their virtual care. What's needed next is for the healthcare system to be willing -- as we've begun to see with telemedicine -- to test, measure, and analyze where and when in-home care can deliver on the triple aim of higher quality care, lower costs, and an improved patient experience. Care for the elderly is one place we know this model works, but we owe it to patients to find the others.
Eddie Peloke is CEO of Workpath, a technology platform powering on-demand, in-home healthcare services nationwide through a full-service application programming interface.