Live simulation of Discovery’s Hospital at Home demonstrates sophistication of hospital-level care in the home

On 14 July 2022 members of the media and healthcare professionals, convened at Discovery’s Sandton headquarters, together with local and international thought leaders in home healthcare, to witness a live simulation of Discovery’s Hospital at Home programme.

“Participants gained first-hand experience of just how sophisticated the system is and how safely and meticulously hospital-level care can be delivered in the comfort of a patient’s home,” explains Dr Botho Mhozya, Head of Professional Risk and Hospital at Home at Discovery Health.

She facilitated the live demonstration on an immersive, physical set which showed the admission process, demonstrated the technology powering Discovery’s Hospital at Home, and role-played the interactions between doctor, nurse and other caregivers in treating a patient admitted to this innovative programme.

Discovery Health Medical Scheme members have had fully funded access to Discovery’s Hospital at Home since January 2022, as included in the Scheme’s hospital benefit rules. The programme delivers the highest-possible quality of hospital-level care safely and effectively in a patient’s home.

An alternative care setting – the patient’s own home – for a range of medical and post-surgical conditions

• On 15 June 2022, Hospital at Home took first place in the ‘Product & Service Innovation’ category at the 2022 Efma-Accenture Innovation in Insurance Awards, which recognise the most exciting and effective innovations in the global insurance space.

“Hospital at Home demonstrates the power of merging traditional healthcare delivery with cutting edge medical technology and innovation, resulting in the patient receiving the best possible care in the comfort and dignity of their own home,” explains CEO of Discovery Health, Dr Ryan Noach. “In a nutshell, this unique programme provides a very attractive alternative setting of care – the patient’s own home – for a range of medical and post-surgical conditions that would otherwise require hospital admission. Importantly, the evidence shows that outcomes are as good, if not better, than in the case of in-hospital care.”

“Globally, hospital-at-home programmes have existed for several years. The first hospital-at-home service was introduced in Scotland in 2011. Since then, and particularly in the wake of COVID-19, many leading medical institutions across the world have begun to introduce these offerings. This includes some of the world’s top-rated hospitals such as the Mayo Clinic, Cleveland Clinic and Brigham and Women’s hospital (a Harvard Medical School teaching hospital in Boston, Massachusetts).”

“Through the pandemic hundreds of patients across many countries (including South Africa), who required hospital treatment for COVID-19 and other conditions, were cared for through hospital-at-home offerings. Care has been delivered by expert multidisciplinary teams, with well-documented, excellent outcomes.”

“Ultimately, the pandemic accelerated the adoption of digital healthcare technologies, particularly remote-monitoring technologies that enable hospital-at-home care delivery. Along with this, substantial clinical research has now been conducted on hospital-at-home models, conclusively demonstrating that these models often achieve superior patient experience and better clinical outcomes than traditional hospitals.”

Expert guests report on the quality and safety of hospital at home

The event’s in-depth discussions and live simulation centred around the international hospital-at-home care experience and resulting research into this offering, its relevance to South African healthcare settings and a view of future patient management in this context.

• Presentations featured independent experts including Dr David Levine - General Internist and Clinician-investigator at Brigham Health and Harvard Medical School; Dr Unben Pillay - Africa Telehealth Collaboration Co-chair; and Dr Sandeep Pulim - Physician and Medical Director at Biofourmis, a biotechnology company based on Boston, Massachusetts.

Experts agreed that hospital-at-home models are a transformative innovation with the potential to greatly increase access to care while improving patient experience and outcomes in a lower cost setting. Several clinical trials and research have conclusively demonstrated that hospital-at-home care options provide very high-quality, cost-effective care.

Dr Levine shared findings from research at Brigham and Women’s Hospital, where he works as a senior researcher and internal physician, into how hospital-level care in a patient’s home lowers cost and uplifts care - resulting in lower readmission rates -, all while improving the patient experience. Various admission-related metrics have been shown to improve, promoting healing and everything from better sleep to more physical activity. In contrast, Dr Levine pointed out that traditional hospital care settings often result in exposure to hospital-acquired infections, feelings of isolation, disturbance of sleep patterns, and potentially protracted lengths of stay, also with 1 in 10 patients reportedly experiencing adverse events during their in-patient stay.

Dr Levine added, “At-home hospital care is a powerful lever for broadening access to affordable, high-quality hospital-level care and is in fact the most evidenced-basedhospital service that exists.” In other words, in Dr Levine’s analysis, hospital-at-home has been analysed and studied in more detail than has any other type of hospital setting.

Dr Noach noted, “The COVID-19 pandemic initially filled up hospitals, and with inadequate beds for required admissions, necessitated care in alternate settings. It has with time also resulted in increased reluctance by both doctors and patients to be admitted to hospitals.”

“It is also important to recognise that many events requiring hospital-level care can be managed as effectively in the home setting as in-hospital, particularly when enabled by cutting-edge remote monitoring technology. This often results in a quicker return to a functional level for the patient, and lower overall costs. Our analyses further show that costs are reduced by about 20% per admission.”

“The convenience and personalisation of care at home means that, globally, hospital-at-home models have been well-received by patients. Similarly, Discovery’s Hospital at Home model is proving compelling to doctors and patients alike, with the assurance of the highest possible safety and quality standards (including continuous, digital clinical monitoring and a dedicated care team available 24 hours).”

Cutting-edge clinical monitoring and an expert clinical oversight ensure optimal patient care

Discovery Health offers Hospital at Home in partnership with Biofourmis, a US-based provider of digital therapeutics and virtual platforms that power personalized predictive care.

The Hospital at Home solution includes sophisticated monitoring of various clinical readings and a patient-facing companion app providing immediate virtual access to doctors and other caregivers, with personalised information, based on the patient’s condition.

Multidisciplinary healthcare teams visit the home to set up the patient-monitoring systems, including remote monitoring devices (like the cutting-edge Biofourmis device, which is worn on the arm). These devices, monitored by specialised clinical teams, include advanced artificial intelligence that allows for early detection of potential complications.

• The Biofourmis platform and linked Biovitals Analytics Engine have FDA clearance. Their AI-powered analytics engine has been used to remotely monitor more than 100,000 hospital-at-home patients globally

Dr Pulim shared that the Biofourmis platform was developed with Harvard Medical School’s teaching hospital, Brigham and Women’s, alongside their remote patient-monitoring devices. They use artificial intelligence (AI) and advanced FDA-approved analytics to establish patient’s baselines and, through early warning systems, detect early clinical deterioration enabling rapid escalation of care if required.

Dr Mhozya says that, “Broadly speaking, the COVID-19 pandemic has accelerated the adoption of digital healthcare technologies across the spectrum, and on a global scale. Accenture’s 2020 Digital Health Consumer Survey found that patients embraced virtual care during the pandemic itself, with the majority finding virtual care as good, or better, than in-person care. And, importantly, around 60% of these patients reported that they wanted to use virtual care and related technology in future. At Discovery, we’ve seen a similar increase in the uptake of digital healthcare options, with an exponential - 763% - increase in the use of telemedicine through Discovery Connected Care, since 2019.”

Dr Noach adds, “The growing scientific evidence base around digitally empowered, remote care offerings like Hospital at Home and related programmes is proving the huge potential these platforms hold for enhancing healthcare ecosystems on multiple levels. Indeed, it is our hope that we will see more businesses invest in this form of care and expand at-home hospital offerings in our country over time.”

• Discovery’s Hospital at Home programme covers a range of clinically appropriate low acuity medical and postsurgical conditions that would otherwise require an admission to hospital for a general ward level of care.
• The service is nationally available with capacity extended to enable admission of up to 750 patients at any given time. This makes it the largest hospital at home provider in South Africa.
• All services offered are funded from the member’s hospital benefit where there is a valid preauthorisation in lieu of hospitalisation. It is the right and responsibility of the treating senior clinician to select which patients are safely admitted into the programme.

Find out more about Discovery’s Hospital at Home here.