A closer look at the case for home healthcare
As people age, the prospect of leaving their homes for the support of an assisted living facility is often painful. Home is where the heart is, after all.
For example, take Anne and Michael S. They are in their sixties and have lived in the same home for more than three decades. They raised their children there, and now their grandchildren are coming home to play. They have made lifelong memories in their home.
Unfortunately, Anne and Michael have health problems. Anne, 62, has multiple sclerosis (MS) and is in a wheelchair. Michael, 64, was badly injured in a farming accident in his youth. Both of his knees and hips have been replaced.
As they look ahead, Anne and Michael worry about how they will access the medical support they need to successfully manage their health conditions. They like the idea of creating a plan to continue living independently in their home as they age.
"We love the thought of being able to watch our grandchildren grow up and play in the same places our children played when they were young," says Anne.
For them, the prospect of "ageing at home" is deeply appealing. It means staying in their house and managing their everyday care from home. If they can use modern technology to make it work, it is the best of both worlds.
Factors driving the rise of home healthcare services
As baby boomers, Anne and Michael S. are part of a generation living longer than ever before. This increase in life expectancy, alongside a rise in smaller households, is sparking a desire for ageing at home.
But with adult children often busy with their own lives and sometimes many miles away from their ageing parents, who will provide that care on a daily basis? As technology improves and market forces intervene, companies are increasingly ready to step in to provide home healthcare services that would previously have been coordinated by family members.
It makes sense for payors and providers to offer greater home healthcare. The more care that can be triaged remotely, the more it will relieve the strain on traditional healthcare systems.
"It is about finding ways of helping reduce costs, and keeping patients out of hospital beds and waiting rooms in doctors' surgeries, as well as out of ambulances that are making potentially unnecessary trips to A&E," explains Chris Brown, Senior Strategy Manager in the UPS Healthcare Strategy Group.
At the same time, the rise of e-commerce and the growth of on-demand services are influencing patient expectations regarding healthcare. If you can order a ride via your phone, why not request a nurse to administer a shot?
"The global trend of consumers wanting to be catered to and do things in their own time will drive the continued push towards care in the home, where patients are more comfortable, and it is less stressful and more convenient," says Brown.
"It is about finding ways of helping reduce costs, and keeping patients out of hospital beds and waiting rooms in doctors' surgeries, as well as out of ambulances that are making potentially unnecessary trips to A&E."
Telehealth as a home healthcare service
One key plank of home healthcare is telehealth: the provision of healthcare services over an internet connection or phone line.
Telehealth is nothing new, but much of the uptick in telehealth services is being driven by the younger generation of adults who are used to managing their lives through digital devices. With telehealth, patients can receive medical advice, schedule testing, and get prescriptions issued from the comfort of their own homes - or from wherever they choose to make the call.
Anne and Michael S. are prime candidates for telehealth. However, they currently receive no health support in the home and do not access health services or information over the internet or phone. Instead, they attend medical appointments twice a month across town, about 45 minutes away.
For seniors who are not digitally savvy, the industry is working to get technology into their hands. Doctors can issue devices such as tablets and health monitors to patients that can be used outside the doctor's surgery.
Having reliable access to telehealth services is an important component for seniors committed to ageing at home.
The logistics of delivering home healthcare services
While telehealth's benefits are numerous, it is only one part of the equation. "Just because care is being offered digitally through technology like telehealth, the treatment still has to happen physically," explains Mark Taylor, Director at UPS Healthcare Strategy Group. "That means patients still need to physically receive medication, or medical devices."
Coordinating the arrival of essential supplies into the home is a common pain point for home healthcare providers, says Taylor. "Nurses can spend significant amounts of time chasing supplies and medications, or they arrive at a home to provide treatment and the supplies are not there."
Here, technology has a role to play in better synchronising the delivery of supplies to caregivers by providing real-time visibility regarding the progress of products through the supply chain and providing greater control over their scheduling.
The increasingly intelligent deployment of medical goods to forward stocking locations, driven by the predictive analysis of inventory flows, can help enable the staging of necessary medical supplies, diagnostic test kits and equipment closer to patients' homes.
Technology has a role to play in better synchronising the delivery of supplies to caregivers by providing real-time visibility regarding the progress of products through thesupply chain and providing greater control over their scheduling.
Crossing the threshold and other considerations
Shrinking the home healthcare supply chain is an important element of creating what Taylor calls "a strong patient consumer experience."
At the same time, taking the supply chain all the way to people's homes by delivering medical goods and supplies requires new considerations. Take the handling of temperature-sensitive medications, for example. The requirements for managing cold chain deliveries are well-established for healthcare products moving within traditional channels. Brown says UPS is exploring delivery customisations to help safeguard deliveries made directly to homes. One such option might be giving a customer with limited mobility the ability to request that the driver waits a certain time after calling at the door.
There is also the question of allowing a medical professional to enter the house. With the development of home healthcare services, households will be inviting more and more people they do not know into their homes. Allowing a medical professional to cross the threshold of your home requires trust, but the upsides are significant.
For people like Anne and Michael, who have difficulty getting to the doctor's surgery and do not want to risk getting sick from a visit to the potentially germ-laden surgery, a vaccine administered at their home would be ideal.
Driving efficiencies in the healthcare supply chain
The healthcare supply chain can be well known for its inefficiencies. Managing complex inventories and restocking supplies across many facilities may lead to waste.
A 2019 survey by Cardinal Health found that almost three quarters (74%) of clinicians and nurses identified "searching for supplies that should be readily available" as having the biggest hit on their productivity at work. In turn, frustration can prompt inefficiency in ordering replacements. But where there is a challenge, there is also an opportunity.
"We believe that one of the biggest opportunities is in streamlining the delivery of supplies and equipment used in home healthcare, staging them closer to the point of care to shorten the supply chain, and providing more delivery flexibility and visibility for both patients and care providers," remarks Brown.
Brown suggests working more closely with home health agencies, who could help facilitate not only the efficient delivery of supplies but also services as well. For overburdened nurses, an efficient supply chain could increase job satisfaction.
"One of the biggest opportunities is in streamlining the delivery of supplies and equipment used in home healthcare, staging them closer to the point of care to shorten the supply chain, and providing more delivery flexibility and visibility for both patients and care providers."
Managing chronic conditions and post-acute care
The targeting of complex or chronic conditions is a key area of focus for experts in the healthcare supply chain.
Providing services for patients with chronic conditions— from diabetes and respiratory disease to heart disease and renal care—drives approximately 90% of total annual spending on healthcare in the United States, according to the CDC.
Developing comprehensive home healthcare services may help drive down costs in this area. There is also an opportunity for logistics providers to explore specialised services —for example, delivering medical devices within the home.
And it is not confined to chronic conditions. Improved support for home healthcare may create greater options for post-acute care, says Taylor. "Traditionally, after going through open-heart surgery for example, you would be spending quite a bit of time in a hospital bed with continued care and monitoring from nurses."
With improved home healthcare options, there is the possibility of getting the patient home sooner and sending out nurses to perform monitoring, supported by tech-enabled medical devices. This frees up hospital beds faster while giving patients the chance to convalesce in the comfort of their homes.
Home healthcare and a gradually maturing market
It is still early days for the home healthcare industry in the United States. The sector remains highly fragmented and the technology is relatively immature, with a lack of widely adopted best practices. This may drive unnecessary costs and makes it harder to shift more complex care to the home. Recognising this, larger insurers and health providers are pushing for greater industry consolidation.
In Brown's opinion, "insurance companies are acting like healthcare providers, and healthcare providers are essentially becoming technology companies, all with the goal of reaching patients and providing care at lower costs."
Home as a platform for ageing in place
Upgrading your home to accommodate ageing in place does not happen by itself. Anne and Michael S. have already made modifications to their home—adding chairlifts to the stairs and other wheelchair adaptations, to make the 3-level home accessible for Anne—but there is more they know they need to do.
"Our independence means a lot to us. We do not want to leave our home, but we really need the house remodelled to fit our needs," Anne says. "We would love to have a service come to help us ‘age at home,' so we would never have to go to a nursing home—it would be great to have an expert to guide us."
Find out more about how UPS is helping the healthcare industry with the development of logistics services for home healthcare.
