Healthcare is evolving and even where clinical care is delivered is changing. Fifty years ago, patients stayed in the hospital for weeks after an appendectomy. Today they go home the same or the next day. Some patients nowadays stay due to common problems: for DVT prophylaxis after surgery, for physical therapy, for antibiotics and serial CBCs to monitor the progress of infection, and so on. But as technology evolves, some of these clinical tasks could be done at home.
Consider that we now have wearables that can monitor basic vital signs better than CNAs (nursing assistants) on the hospital floor. We also have a growing list of devices within the Internet of Medical Things (IoMT, you read it here first) such as continuous wearable ECGs, face-to-face communication devices, portable insulin pumps, and many other technologies that produce useful data, and all these devices could be integrated to provide care for patients at home on the same level, or even better, than in the hospital.
Medically Home Group, a technology-enabled services company out of Boston, Mass, was displaying its know-how at CES 2018, and we stopped by to check them out. According to Richard Rakowski, the company’s CEO, up to 25% of patients currently in the hospital could be cared for at home. Medically Home’s technology, dubbed Cesia Continuum, integrates evidence-based pathways and various devices to make sure that patients receive the highest levels of care surrounded by their family at home, or as the company calls it, “micro-hospital unit in the home”. According to Rakowski, at the time of CES 2018, the company had 23 patients being cared for at their homes, and 88 patients in clinical trials. The company has clinical collaborations with nonprofits Atrius Health and VNA Care to bring the Medically Home Program of Care to patients.
More about the Cesia Continuum technology, according to Medically Home:
Cesia Continuum™ is a custom-assembled/dynamic orchestration of IP and technologies, creating the ecosystem needed to operate a temporary micro-hospital in a patient’s home. The ecosystem allows patients’ homes to operate inside a connected network under the command of Medically Home’s remote telemedical Mission Control Center. Cesia Continuum™ links together:
• Physician oversight of patients via telemedicine
• Evidence-based care delivery protocols for Medically Home’s unique model of care
• Two-way audio/visual communication between patients and their care team
• Patient biometrics monitoring combined with predictive analytics
• The supply chain of on-demand in-home provision of required services and equipment
• Rapid response protocols and resources in an urgent or emergent event
The three legs of Cesia Continuum™
• Patient’s Home – custom configured hardware, software, analytics, safety processes (IP) and sensors to allow the patient’s home to serve as a temporary micro hospital unit, centrally managed by a remote telemedical Mission Control Center
• Mission Control Center – an integrated team of dedicated physicians, NPs and nurses that use customized care delivery protocols (IP), custom-configured hardware, unique software and clinical work flows (IP) that serve to centrally manage and document the Medically Home episode of care at-scale with patients in their homes from multiple providers, catchment sites and payers in multiple states
• Supply Chain – the required network of clinical/non-clinical services and equipment/supplies provided by partners from across 13 categories to reliably and efficiently ensure the needed hands-on care in patients’ home on-demand, in short-notice, and after-hours
It should be noted that company’s technology is HIPAA compliant and could be integrated with EMRs such as Epic for live monitoring and clinical data processing.