Distributed healthcare is the concept of providing decentralised care services, like monitoring vital signs and diagnostic tests, and moving these services closer to the person in need. This way a healthcare system can help to keep people healthy, and in their own homes, by providing the right care and support at the right time.
At the beginning of this century, healthcare services were predominantly provided in the home. House calls by clinicians were the norm. With the evolution of modern medicine, specialised clinics and hospitals replaced house calls. Hospitals could house the expensive technology and accommodate large numbers of patients seeking healthcare.
However, the advantages of hospital-based care have started to be questioned, especially with the high costs involved. How could this be addressed? The first choice by most health systems is to reduce the cost of healthcare provided in hospitals. Alternatively, they could achieve the same outcome by maintaining the same level of healthcare to people by shifting the service provision away from high-cost settings such as hospitals and into the person’s home.
By moving services into a person’s home, distributed healthcare has the potential to improve quality, reduce costs and improve the experience for the person receiving the care. Recent studies of home healthcare provision, using existing technologies, have shown cost reductions of 15-30% compared with hospital-based care for similar patients populations. These savings have not been at the expense of health outcomes, with equal effectiveness being shown.
Current home-based healthcare provides greater convenience and satisfaction for patients; this is especially true for older and less mobile people. Programs that exist focus on patients suffering from chronic illness. Interdisciplinary teams visit the home, performing diagnostics and encourage compliance with treatment protocols. The aim is to monitor the patient and identify any exacerbation in their condition, then proactively manage the patient to prevent any hospitalisations.
The interdisciplinary teams provide coordination for the patient’s care, identify problems and gaps that can be resolved, plus involve the patient and their family in the communication. These home-based healthcare programs serve patients goals rather than just treat the disease. They put the patient at the centre of their own care.
The issue is how does a health system transition from the traditional model of a hospital-based system to the new model of distributed healthcare? The new model creates complexity requiring coordination of services across multiple organisations, providers, community and social services.
This requires a common data platform to enable a shared, dynamic view of the person’s medical record. This workflow needs to enable the team to work together across care settings, and to include the person and their family as a key part of the care team from within the home.
Being able to view a secure shared care record allows the timely, safe and informed decision–making to occur, for and with the patient. A study from Canterbury District Health Board on an integrated person-centred healthcare outlines their journey to provide an integrated, person-centred health system that crosses the boundaries between primary, community and hospital-based care.
Canterbury has developed a program to prevent acute admissions to hospital. It is designed to meet the needs of all people who would otherwise be referred to hospital but who can safely be managed in the community. It is currently focused on children, older people and people with respiratory or cardiology-related conditions.
Learn how Canterbury District Health Board accesses patient data from secondary and primary care providers and makes that data visible in a single shared patient record at the point of care. Read the case study now.