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Why Silver Chain is investing in world-first technology to support Hospital in the Home
Australia needs innovative approaches to health service delivery if we are to reduce demand on hospitals and contain the burgeoning health costs of our ageing population.
We already know a big part of the answer to this issue will be community-based ‘Virtual Hospitals’ or Hospital in the Home (HITH). We just haven’t figured out how to make it work on a national scale.
Hospital in the Home is not new
It’s widely accepted that, for some conditions, it’s preferable to provide high-quality acute care in the comfort of a patient’s home. Care in a home setting can be offered at a comparable level to that received in a hospital, often with better outcomes – and often at half the cost.
This is why, for several years now, Australia’s state health departments have been operating HITH models, with success. Health departments will tell you that research proves that patients with qualifying HITH conditions have improved outcomes and recover at home with fewer complications.
In WA, our Virtual Hospital provides hospital-level care to more than 500 admitted patients every day – this includes 85% of all metropolitan public-hospital referred HITH patients – providing responsive, robust and at scale services with a re-admission rate of less than 7%.
In my experience, HITH is also hugely popular with patients. People don’t have to share a room with strangers or adjust to the hospital's routine. They can eat their own food, watch TV when they want, pat their pets and sleep in their own bed. Family and friends can visit when it suits the patient rather than the hospital.
The economic argument is also compelling: HITH models allow administrators to increase hospital bed capacity with limited capital expenditure. HITH is a cost effective, flexible and sustainable solution to manage the increase demand on acute services.
So why aren’t we powering ahead?
It’s not for lack of funding. There’s plenty of money in the system. But the money doesn’t always flow to where it’s needed.
Australia has three main health services systems: hospitals, which are optimised around admissions; GPs, which are optimised around the MBS payment system; and aged care, which is optimised around funding packages. As a result, many of the things needed for patients to receive acute care at home aren’t funded, while other things are funded that aren’t needed at all.
But it doesn’t have to be that way.
It’s time to optimise around the patient
That means recognising what HITH needs to look like – from both the doctor’s and the patient’s perspectives – and investing in innovation to make it work.
A lot of hospital treatments are already happening in the home. Vitals can be monitored remotely; home-based nurses can take blood, dress wounds and administer drugs. What’s missing is the doctor who needs to make a diagnosis, write prescriptions and – most importantly – explain what’s going on, discuss treatment options and help the patient and their family to make decisions.
The first step in creating a genuine home-based hospital experience is to augment existing homecare nursing staff with technology than can put our most qualified doctors into the homes of those in need.
This is why Silver Chain is exploring the use of Microsoft HoloLens to change the way HITH is delivered. We’re currently working with Saab Australia to develop a new software interface called EMMR – Enhanced Medical Mixed Reality – that can be used with the augmented reality headset to allow nurses to view real time information, through a holographic dashboard.
This world-first technology will allow patients to interact with their doctor as a hologram – experiencing the conversation as if both people are in the same room.
Yes, some of this is already possible with telemedicine, and we’ve seen many doctors adopt this, and adapt to it well. Telemedicine has also had positive results in terms of patient experience – but we know that patients feel more confident when they connect with their doctor face-to-face, and that’s where EMMR will bring truly positive results.
I believe Australia will only have HITH on a national scale when the technology we bring into people’s homes is as cutting edge as the technology we have in hospitals. When patients and doctors buy into the HITH model, we will finally make the leap we need to take a large chunk of hospital care into the home – and leave our hospital beds for those who really need them.