South Africa’s healthcare system became inaccessible to many people due to the consistent neglect, poor management, and corruption of public health facilities.
This situation is further exacerbated by the unaffordability of private health care for most people in South Africa.
South Africa experiences a serious problem with the ability of state hospitals to handle the current demand.
Although telemedicine makes provision for virtual consultations and certain diagnostic procedures, the poor that cannot afford private healthcare and rural residents thus often experience reduced access to quality hospital care. But there is a possible solution…
The hospital-at-home
Due to the rising costs of medical care and more recently the Covid-19 pandemic, many healthcare organisations reconsidered how and where they deliver care to patients.
In the last few years the hospital-at-home model globally gained popularity to provide acute-level care to patients in their homes, rather than in a hospital.
Since this model has been proven as reducing costs such as shortening the inpatient stay, improving outcomes and enhancing the patient experience, it is a strong possibility to provide greater access to quality healthcare in South Africa.
The structure, implementation and patient population of hospital-at-home care varies greatly and sometimes focus on specific treatments such as oncology care or post-surgical recovery.
Although the programmes and structures may differ, it has been proven that the hospital-at-home model is well-suited especially for medium acuity patients who need hospital care but can be safely monitored from their home.
Telehealth technology
The hospital-at-home model is highly technology dependent, which allows patients to be in constant connection with their care team through video visits, and continuous biometric monitoring via telehealth technologies.
Depending on the patient’s needs and care protocol, care team members visit the patient at least once a day.
Often the qualified nurse or paramedic would consult via video conference with a hospital-based or other physician and then set up any medical equipment and initiate treatment.
Continuous remote live monitoring of a patient’s vital signs through telehealth technologies is a critical component of delivering safe and efficient healthcare in a home setting.
In the case of Discovery Health, they have partnered with Biofourmis, a global leader in digital healthcare solutions.
The Biofourmis technology continuously monitors multiple physiological signals through wearable biosensors.
The remote monitoring device automatically sends information of up to 22 physiological signals (e.g. heart rate, oxygen saturation, respiratory rate, temperature, blood pressure, stroke volume, and biovitals index) to a hospital-based care team, 24 hours a day.
The data is processed in real-time and displayed on a dashboard to enable the healthcare provider and the team of clinicians at the clinical command centre to monitor a patient’s health status.
This provides clinical teams with a predictive view of a patient’s disease trajectory to detect issues, intervene timeously and prevent potential medical crises.
Patients’ physiological data is compared to population level data to enable unique insights into a patient’s disease trajectory. An artificial intelligence analytics engine is also used to detect the slightest change that is often difficult to be observed by a human.
The platform also includes an engaging patient-facing companion app focused on patient engagement, personalised content and remote communication between patients and their care teams.
Telehealth also enables providers to provide a wide array of services at home such as hospital-level clinical diagnostic procedures (e.g. electrocardiograms, echocardiograms, and x-rays); interventions (e.g. oxygen therapy, intravenous fluids, intravenous antibiotics and other medicines); and services (e.g. respiratory therapy, pharmacy services, skilled nursing services) to manage medical and postsurgical care at home.
Benefits of home care
In addition to the reduction of costs and improvement of clinical outcomes, research indicated that treating patients at home helps to prevent the onset of delirium, reduces fall risk to almost zero, reduces the risk of nosocomial (originating in a hospital) infections and allows for increased mobility.
Discovery Health Home Hospital currently has 150 patients, but has the capacity to deliver hospital-level care to 750 patients. However, South African health technology start-up, Quro Medical, was the first hospital-at-home.
Broader access to healthcare
Recent research shows that the hospital-at-home model is an effective strategy and can reduce costs on average by 42%, mortality by 20%, and re-admission rates by 6%, while improving outcomes and the patient experience.
If telehealth technology is leveraged effectively, access to quality medical care in South Africa can certainly be improved. However, it is not only the rural or poor that may benefit, but also the elderly adults and people with cognitive impairment for whom hospital admission often is traumatic and stressful.
The hospital-at-home model is an important part of the growing use of healthcare worldwide, and could ease the burden on South Africa’s overwhelmed healthcare system.
Prof Louis C H Fourie is a technology strategist.
*The views expressed here are not necessarily those of IOL or of title sites.
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