Life expectancy has increased dramatically in the past century as advances in medicine and technology allow adults to live healthier and more fulfilling lives. Today, people can live with chronic conditions for years. This is thanks, in part, to long-term and post-acute care (LTPAC).
Right now, the health care industry is shifting its focus to the patient, which will require providing care with methodologies that are more in-line with patient needs. This is especially important as we face an aging population.
Georgia Brown, a solution executive with analytics and community care at Cerner, joined a recent episode of The Cerner Podcast to discuss the current and future state of long-term and post-acute care and how technology can alleviate the challenges of the large 65-and-over population and increasing rates of chronic diseases. She has more than 20 years of experience developing, growing and aligning organizations, and has recently joined Cerner to support the LTPAC organization.
Improving care, engaging consumers with technology
With the United States’ age 65-and-over population projected to nearly double over the next three decades and the increasing rates of chronic diseases, what challenges does this present to the health care industry, and what can be done about it?
Georgia Brown: It’s an exciting time. Cerner has data that can impact patients’ lives outside of the acute facility. Most of the time, people think about care in the hospital or in the doctor’s office. But, home is the safest, easiest and most cost-effective place to receive care. Unfortunately, in health care we have a cycle, in which, we go to the hospital and get treated, then we get discharged, and then we come back to the hospital. We want to break that cycle and create a flat road to stability that allows people to stay in their homes longer with a higher quality of life. It takes technology to do that.
Baby boomers today are tech savvy. They are using smartphones and apps and they are on the internet. So, this is a perfect way to engage them in their own health care. Connected consumers are driving health care today, not physicians.
Where can technology, such as remote patient monitoring and predictive intelligence, help to alleviate the challenges of the large 65-and-over population and increasing rates of chronic diseases?
The flood of seniors into the population is a huge health care challenge, but it doesn’t have to be a negative thing. In fact, it is an opportunity to improve care. One of the problems we are facing, is a clinician shortage. Remote patient management, virtual care is one way to fill that gap.
We have to figure out ways to use artificial intelligence to predict the right time and level of care for a patient. If a patient is experiencing a change in their health care status at home, a provider might be able to provide the appropriate clinical care via a video visit or a phone call. If a patient’s condition requires physician engagement, maybe it can be done at the physician’s office instead of the emergency room.
Remote patient monitoring is a great thing. Unfortunately, it is sometimes disconnected from the patient’s health record. You hear the phrase, “alert fatigue,” which means we are sending irregular vital signs to clinicians and expecting them to make an intervention without any context about the patient. With technology, we can engage patients and capture important information—such as their vital risk profile and symptoms—upfront to better manage care. All these things allow us to spread out the clinical knowledge base to touch a broader group of patients at a lower cost.
Breaking the hospital readmission cycle
There are figures that show as many as 70 percent of patients leave acute care and go home without access to any post-acute care services, which puts them at higher risk for readmission. What are some strategies for breaking this cycle?
We put a lot of focus on post-acute venues, such as skilled nursing facilities or assisted living or rehab. Sometimes, we forget post-acute care at home. It might be two or three months after a hospital stay before a patient sees their physician, and their physician might not even know they were in the hospital.
Most readmissions to the hospital happen within the first 10 days at home. We must widen our clinical focus to get more information about a patient’s lifestyle outside of the health care facility. For example, if a patient has a wound that requires dressing and antibiotics, we need to know if they can get the antibiotics and take them, and if they have someone that can help them change the dressing. Using technology to get this type of data gives us the chance to stop that 10-day readmission, and possibly, the 30-day readmission and the 90-day readmission. This is how we can get the cycle of care to become flat and steady.
Using technology to provide more, better care at home
What does the concept of the “engaged patient” look like in today’s long-term and post-acute care landscape?
When we talk about the concept of consumer-driven health care, these are patients that are really engaged in their health, and they are becoming more active. We can seamlessly engage them all the time through their smartphone or virtual assistant devices. Failure to seek care is one cause of hospital readmissions. This means you have someone sitting at home who isn’t doing well but doesn’t want to be a burden to their family. They wait until they are extremely sick to go to the hospital, which puts their health in jeopardy and is also costlier.
Yet, if we can use at-home health technology to catch symptoms early on, we can do things—such as lab work, an oral antibiotic, more education or someone overseeing them from a community care management perspective—that don’t require a hospital stay. There is so much we can do with technology, and I am so excited about all the ways that technology can help us assist seniors in living long, fulfilling lives.
Where is long-term and post-acute care heading in the next three to five years?
More and more, care is going to be provided outside the four walls of the hospital. Our technology is going to get broader with smart homes. Imagine that we will be able to get clinical data about a senior just from them walking into the front door of their home. Regulations are going to change. We’ll have facility-based post-acute care and non facility-based post-acute care instead of so many silos.
Consumers are going to demand better and timelier care, and the industry must follow suit. Let’s get on the bandwagon and partner with consumers to figure out how to drive care that is clinically appropriate, cost-effective and scalable to the globe.
Cerner shares a commitment with long-term and post-acute care providers to help make senior care management better than it is today and create a future where the health system works to improve the well-being of individuals and entire populations. Learn more here.