If the first months of 2020 have taught us anything, it’s that when it comes to our health, we are all connected. In a matter of weeks, Covid-19, like H1N1 and SARS before it, has jumped borders and is changing our daily life. It is also taking a toll on our aging population — and pressing the limits of our health care system.
Our health care system was not built for the type of public health crisis we are dealing with today. COVID-19 will push patients toward institutions where they are at greater risk for exposure to the virus, instead of away from them because that is traditionally where the care is delivered and the science happens.
But it’s 2020, and innovations in science and technology allow us to provide health care to more people in more places than ever before. As Covid-19 expands rapidly, our health care system has to quickly adapt to what could be the new normal, and that means driving more care away from the hospital and into the home.
According to the WHO, our elderly population and those with underlying health conditions are at an increased risk for severe infection for COVID-19. The surge of cases will severely strain and may push our hospitals beyond the brink, as we saw in Italy. Nursing homes will be restricting visitors to prevent tragedies like the one we saw unfold in Seattle.
What we need now is to help keep people out of hospitals and skilled nursing homes unless they absolutely have to be there.
To do that, we need to use all the new tools we have at our disposal. Our home health workforce is uniquely prepared for the moment at hand. They have been on the front lines of previous infectious disease outbreaks, from H1N1 to the HIV/AIDS crisis, and are highly trained to go into homes and deliver care and expend the reach of our health care system to help people heal at home. Our home health workers uniquely serve as the best and most frequent point of care for those at high risk of complications — older adults and those with more complex or chronic health conditions.
What we need to do now is strengthen our home health system so that seniors and those at greater risk can get the most of their routine care at home. Imagine if someone could come to an at-risk patient’s home to administer a test for COVID-19, eliminating the potential of cross-contamination of the health care workforce at hospitals.
As a first step to doing that, we need to make two simple regulatory changes and do so as quickly as possible.
First, we need to expand the number of people who are able to get health care at home. Currently, Medicare limits home health care to those who are “homebound.” By expanding the definition of homebound patients to include those who should be avoiding health care facilities during this pandemic, we reserve hospitals for only those who need to be there and keep seniors who are already healthy away from potential exposure.
Second, while Seema Verma, administrator of the Centers for Medicare and Medicaid Services, vastly expanded telehealth coverage and payment, we need to rapidly scale all of the technologies at our disposal that enable timely, data-informed care without patients leaving their houses. Remote monitoring of vital signs, patient self-management tools, and automated triage software that use patients’ own home voice assistants must play a role in 2020 and beyond, as we confront this and future crises.
The technology and the framework exist to make our health care system ready for the likely surge in patients ahead as a result of the pandemic. It’s time to pull out all the stops to put it into action and reserve our hospitals and skilled nursing facilities for only those patients who truly need that level of care.
Picture: DaevichMikalai, Getty Images