What You Should Know:
– Brigham is working with Biofourmis on a national rollout of their co-developed technology solution, which has been refined and scaled for use by other healthcare systems across the country seeking to establish and execute similar home hospital programs to alleviate COVID-related capacity issues and to receive 1:1 parity on payments from CMS.
– The Hospital@HomeTM platform provides a turnkey, end-to-end ecosystem for any health system that wants to quickly launch a hospital at home program.
– A randomized controlled trial demonstrated 70% lower 30-day readmissions and 40% care cost reduction compared with usual hospital care.
Biofourmis, a Boston-based global leader in digital therapeutics and virtual care that powers personalized predictive care, today announced the national rollout of Biovitals® Hospital@HomeTM—an artificial intelligence-based, turnkey technology platform that enables hospitals and health systems to quickly deploy a “hospital at home” program.
Biofourmis co-developed Biovitals® Hospital@HomeTM with Brigham and Women’s Hospital, a Harvard teaching hospital, for use in Brigham’s Home Hospital Program. Over the past few years they have worked together to refine and scale the platform for use by healthcare organizations nationwide to fuel programs in which patients are “admitted” to their homes for hospital-level care.
Deliver Hospital-Level Care in the Home Aligned with New CMS Program
The launch of Biovitals® Hospital@Home® coincides with the Centers for Medicare & Medicaid Services’ (CMS’) innovative Acute Hospital at Home program announced on November 25, which will quickly expand hospital capacity during the COVID-19 public health emergency. The program provides 1:1 parity with inpatient payment rates to treat patients in their homes for conditions that include more than 60 diagnosis-related groups (DRGs) such as infections, asthma, heart failure and chronic obstructive pulmonary disease (COPD). CMS said in its announcement that the agency believes these conditions “can be treated appropriately and safely in home settings with proper monitoring and treatment protocols.”
Hospital@Home co-developer Brigham and Women’s Hospital is one of only six health systems nationwide with extensive experience providing acute hospital care at home that CMS has already approved to participate in the Acute Hospital at Home program. It is anticipated that numerous other health systems across the country will also apply for similar waivers in the near future.
Randomized Controlled Trial Results
Through a randomized controlled trial (RCT) published in Annals of Internal Medicine earlier this year, Brigham demonstrated that home hospital care can decrease healthcare costs by nearly 40% compared with usual hospital care. In addition, the program improved outcomes, with 7% of home hospital patients readmitted within 30 days compared with 23% of inpatients.
“Our research has shown that we can deliver hospital-level care in our patients’ homes with lower readmission rates, more physical mobility, and a positive patient experience,” said David Levine, MD, MPH, MA, Assistant Professor of Medicine and Medical Director of Strategy and Innovation for Brigham Health Home Hospital. “During these challenging times, a focus on the home is critical. We are so encouraged that CMS is taking this important step, which will allow hospitals across the country to increase their capacity while delivering the care all patients deserve.”
Other advantages of home hospital programs include a reduction in hospital-based staffing needs, increased capacity for those patients who do need inpatient care, decreased exposure to COVID-19 (and other viruses such as influenza) for patients and healthcare professionals, and improved patient and family member experience.
“COVID-19 has accelerated the adoption of remote patient monitoring tools, but many leading healthcare provider organizations have already recognized the improved outcomes and reduced costs that can come from providing hospital-level care in the home instead of the hospital,” said Kuldeep Singh Rajput, founder and CEO of Biofourmis. “We are ready to help more health systems nationwide realize these benefits while enabling them to take advantage of the 1:1 reimbursement rate CMS is now offering for the Acute Hospital at Home program.”
CMS Acute Hospital at Home Program Overview
According to CMS, beneficiaries can be admitted to the Acute Hospital at Home Program from emergency departments and inpatient hospital beds, and an in-person physician evaluation is required prior to starting care at home. It is the patient’s choice to receive care in the home or the traditional hospital setting.
The development of the program was informed by extensive consultation with both academic and private sector industry leaders to ensure appropriate safeguards are in place to protect patients, and at no point will patient safety be compromised, CMS stated.
According to the CMS announcement, the Acute Hospital at Home program:
– Requires participating hospitals to have appropriate screening protocols before care at home begins to assess both medical and non-medical factors, including working utilities, assessment of physical barriers and screenings for domestic violence concerns.
– Will include evaluation of each patient by a registered nurse once daily either in person or remotely, and two in-person visits will occur daily by either registered nurses or mobile integrated health paramedics, based on the patient’s nursing plan and hospital policies.
– Clearly differentiates the delivery of acute hospital care at home from more traditional home health services. While home health care provides important skilled nursing and other skilled care services, Acute Hospital Care at Home is for beneficiaries who require acute inpatient admission to a hospital and who require at least daily rounding by a physician and a medical team monitoring their care needs on an ongoing basis.
To support the Acute Hospital at Home program, CMS has launched an online portal to streamline the waiver request process and to enable hospitals and healthcare systems to submit the necessary information to ensure they meet the program’s criteria to participate. CMS will also closely monitor the program to safeguard beneficiaries by requiring hospitals to report quality and safety data to CMS on a frequency that is based on their prior experience with the home hospital model.
The Hospital@HomeTM Platform
Biofourmis’ Biovitals® Hospital@HomeTM solution has been specifically designed for acute care at home. It facilitates any hospital or health system to quickly deploy the necessary workflows and technologies in a patient’s home. Clinicians can focus on their patients while the Biovitals® Hospital@HomeTM solution fuels the logistics: encrypted video, FDA-approved continuous monitoring, AI-based analytics engines, plan of care, asset management and communication systems.
Hospital@HomeTM provides clinicians with a turnkey solution to continuously monitor multiple physiology signals through wearable biosensors and peripherals in patients with acute and complex conditions. The data is processed in near real-time to provide clinical teams with a predictive view of a patient’s disease trajectory in order to detect issues and intervene early, preventing potential medical crises.
The platform also includes an engaging patient-facing companion app focused on continuous monitoring, patient engagement and personalized content and remote communication between patients and their care teams.
Designed to support programs such as CMS’s Acute Hospital at Home program, health systems will be able to seamlessly transition eligible patients from in-hospital to hospital-level care at home, which is where most patients and their families would prefer to receive care and recover.
“CMS’ decisive move to allow hospital at home programs under their conditions of participation underscores the agency’s recognition of the cost and outcomes benefits of a well-executed home program compared with traditional inpatient care,” Rajput said. “Biofourmis is proud to collaborate with Brigham on this initiative and to help other hospitals and health systems across the country who may not be sure where to start to implement their own programs.”