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SHSMD 2020 Trends: Health Care Away from the Hospital

By The SHSMD Team posted 02-18-2020 04:34 PM

  
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Health care is increasingly taking place outside the hospital, whether in ambulatory surgery centers (ASCs), retail clinics or the home. As early as 2017, Mark Bertolini, the CEO of Aetna, declared, “If you have to go to the hospital, we have failed you. What if that were the way the system was designed?” 

Health care is increasingly taking place outside the hospital, whether in ambulatory surgery centers (ASCs), retail clinics or the home. As early as 2017, Mark Bertolini, the CEO of Aetna, declared, “If you have to go to the hospital, we have failed you. What if that were the way the system was designed?” As often happens, the technology is ahead of culture and complex systems like health care and the legal system and it assumes greater capacity for benefit than for harm. While tools like the Apple Watch can identify patients with previously undetected atrial fibrillation, it also has the potential to make inaccurate diagnoses, causing unnecessary worry and testing, or to create a false sense of security for those who wear the watch. 

In 2005, 32 percent of surgeries took place in ASCs and by 2017, more than half were performed there. In a 2019 survey, 37.3 percent of health care leaders cited technology as the biggest driver of the growth of outpatient services and facilities, followed closely by consumerism at 31.6 percent. Telehealth is growing rapidly but still represents less than one percent of all commercial health insurance claims. 

Home Visits: Back to the Future

Ten years ago, a physician who visited patients at home was a throwback to the past. Now, home health visits from physicians or nurses are increasingly common and companies like Pager, Heal (which acquired Doctors on Call), Medicast, Dispatch Health and Anywhere Urgent Care are growing. While most of these offerings are available only in densely-populated cities like New York and Los Angeles, they may be quite useful in remote areas. While many of these services are designed for older adults, PediaQ collaborates with Children’s Memorial Hermann Hospital in Houston to provide pediatric house calls. 

In 2019, President Trump issued an executive order designed to encourage kidney donations and home dialysis, with a goal of 80 percent of patients with newly-diagnosed end-stage kidney disease to receive kidney transplants or home dialysis. Currently, approximately 12 percent of dialysis users now have home treatment. 

Insights from CES 2020

During the famous Consumer Electronics Show (CES) in January 2020, robots and health monitoring tools were everywhere. Some of these were designed specifically for health care or at least with health care uses in mind, such as home assistance robots that can detect falls or smart clothing, including underwear that continually monitors vital signs. 

Sleep was another major theme, with several companies announcing wearables and apps to monitor and improve sleep for adults and for infants. Wearables for seniors can monitor activities beyond sleep, such as eating, showering or cooking. Most hospitals and health systems aren’t ready to receive streams of data like this, let alone determine what is relevant and what is not. Collaborations between health care providers and technology companies can help to answer those challenges. 

Strategic questions to ask

✔ What is our organization’s priority for this trend?
✔ Where are we now?
✔ If there is a gap, what are the steps to bridge it?

For more information and inspiration, check out SHSMD’s full collection of resources on ambulatory and outpatient care, growth strategies and delivery system transformation. SHSMD’s tools on the topic include presentations, articles and case studies, webinar recordings and reports.  

Want to discuss this trend, ask colleagues about who’s doing what, validate your thinking with peers or share your perspectives? Please join the discussions on MySHSMD, a lively members-only discussion list.  
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