How Best Buy Will Help Mass General Brigham Scale At-Home Healthcare

November 13, 2023 - With the hospital-at-home model gaining steam nationwide, health systems are seeking technology partnerships that can help them sustain and scale their program. The latest in a string of provider-vendor partnerships focused on hospital-at-home services is between Mass Brigham General and Best Buy Health.

Mass Brigham General is not a hospital-at-home novice. The health system launched the Mass General Brigham (MGB) Home Hospital in 2022, combining the hospital-at-home programs at Massachusetts General Hospital and Brigham and Women's Hospital, established in 2017. The Home Hospital offers daily in-person and virtual visits, 24/7 access to the care team by phone and video, remote vital signs monitoring, oral and intravenous (IV) medications, diagnostic testing, physical and occupational therapy, social work, and food delivery, among other services.

The Home Hospital provides care for various clinical conditions, including asthma, pneumonia, heart failure, chronic obstructive pulmonary disease, complicated urinary tract infections, pancreatitis, and acute hepatitis. As of January 2022, the program had reached a combined average daily census of nine patients, Stephen Dorner, MD, chief clinical and innovation officer for Mass General Brigham Healthcare at Home, told mHealthIntelligence.

“Patients and clinicians alike love the therapeutic relationship afforded through the home-based environment,” he said. “What could be more patient-centric than a care delivery model focused on supporting healing and recovery in a patient’s own home?”

Mass General Brigham also operates the largest Medicare-certified home health business in New England, offering skilled and supportive services for homebound patients during an illness or injury. The Home Hospital and home health business are components of Mass General Brigham’s overall Healthcare at Home portfolio, which Best Buy Health will now support.

Per the new partnership, the organizations will develop new solutions and processes to support the expansion of healthcare-at-home services, starting with scaling the Mass General Brigham Home Hospital.

THE PARTNERSHIP AND ITS GOALS

In September, Mass General Brigham announced that the Home Hospital would launch at three community hospital sites in Massachusetts: Brigham and Women's Faulkner Hospital, Newton-Wellesley Hospital, and Salem Hospital. This will bring the combined average daily census to more than 25 patients, with plans for continued capacity expansion, Dorner said.

Overall, the health system plans to shift about 10 percent of inpatient care across its five hospitals to patient homes over the next five years.

Dorner noted that these hospital-at-home expansion plans require added support, leading the health system to seek a partner. The health system conducted a market assessment to identify a platform that could effectively support the growing Home Hospital and home healthcare efforts.

“It was clear that Best Buy’s Current Health platform offered a best-in-place platform to facilitate that connectivity due to the technology, but we also found that the broader vision of the future of healthcare shared by Best Buy Health and Mass General Brigham was clearly aligned,” Dorner said. “We both believe that the future of healthcare is in the home and have a shared commitment to build that future.”

The shared commitment has produced numerous goals. These include facilitating connections between patients and clinicians across long distances, breaking down logistics barriers to ensure that medications, equipment, and care teams are available in patients’ homes when needed, and advancing workforce training to support home-based acute care.

Through the new partnership, the health system will deploy not only Current Health, Best Buy’s care-at-home platform, but also Lively Mobile Plus, the company’s personal emergency response system (PERS) device, to detect falls and connect patients with an urgent response agent.

Additionally, Best Buy Health is “developing customized systems and capabilities to enhance the experience for patients receiving care through Mass General Brigham’s Healthcare at Home portfolio,” said Diana Gelston, chief commercial officer at Best Buy Health.

BOOSTING PATIENT CARE AND PROVIDER EXPERIENCE

Numerous studies support the implementation of hospital-at-home models. Dorner and Gelston noted that research shows acute care provided in the home can enhance quality outcomes, improve patient experience, and reduce readmission and post-acute utilization rates.

An analysis published in 2021 found that patients in hospital-at-home programs had similar mortality risk, a 26 percent lower readmission risk, and a lower risk for admission into a long-term care facility compared with their in-hospital counterparts.

The analysis included nine studies, providing data on 959 participants. The hospital-at-home interventions involved at least one home visit by nurses or physicians who provided treatment that would have otherwise been administered in the hospital,

The researchers concluded that the hospital-at-home intervention was "a viable substitute to an in-hospital stay for patients."

And it's not just patients who benefit from the implementation and expansion of hospital-at-home care.

“Clinicians report a high degree of satisfaction in connecting with patients in their own environment where they can have a better vantage point of the drivers of health and wellbeing,” Dorner said. “To that end, we see the incorporation of home-based care into clinicians’ care portfolios and the associated job satisfaction it carries as a burnout mitigator, helping to retain more clinicians in the workforce.”

Gelston echoed this sentiment, adding that Best Buy Health and Mass General Brigham are also planning to make significant investments in the community to grow the next generation of at-home healthcare workers.

“We are focusing on opportunities for individuals interested in pursuing nursing, paramedic, and digital technology careers by offering scholarships to students choosing the at-home setting of care as their desired professional environment,” she said.

HURDLES TO HOSPITAL-AT-HOME CARE

While there are numerous patient care benefits to at-home healthcare services, barriers to adoption remain.

Critically, the model has only recently gained widespread support, though home hospitalization emerged as a concept in the 1970s, Dorner said. While healthcare organizations were deploying hospital-at-home services before the COVID-19 pandemic, this model of care received a significant boost in November 2020 when the Centers for Medicare and Medicaid Services (CMS) launched the Acute Hospital Care at Home initiative. The initiative allows hospitals to apply for a waiver to provide acute-level care at home for Medicare and Medicaid beneficiaries. As of November 8, 304 hospitals in 37 states had been approved for the waiver.

Thus, “the biggest challenge associated with Home Hospital is the newness of it all, the rate of change, and the imperative that we support the continued development of this space,” Dorner said.

Many clinicians did not train in a home hospital environment, and the technology and capabilities that can effectively support acute care delivery in the home have only been developed in recent years, he added. Thus, educational campaigns and advocacy at the state and federal policy levels are urgently needed.

Healthcare utilization is trending up following a decline in 2020. According to Dorner, hospitals nationwide, including those in Mass General Brigham’s network, are facing inpatient capacity issues and crowded emergency departments (ED).

“Home hospitalization provides a way to respond to the capacity crisis, improving access to care through a more patient-centered delivery model that is also lower cost than traditional care,” he said. “Embracing all of those benefits, the expansion of Home Hospital is one of Mass General Brigham’s strategic priorities.”