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Discovery

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Discovery is a proudly South African-founded financial services organisation that operates in the healthcare, life insurance,...

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05/04/2022 Insurance Innovation

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Discovery Hospital at Home provides an alternative setting of care for a range of clinically appropriate medical and post-surgical conditions that would otherwise require an admission to hospital for general ward level of care.

Innovation presentation

At Discovery, the increased adoption of digital healthcare has been evidenced by exponential increase in the use of telemedicine with Discovery Connected Care logins having increased by 763% since 2019. This increased adoption of digital healthcare globally and the need to ease the burden on increasingly overwhelmed healthcare systems, highlighted the patient’s home as an important and relevant setting for delivering healthcare. This presented a unique opportunity for technology to enable delivery of safe, efficient, and convenient hospital-level clinical care in a home environment.

In May 2021, Discovery Health launched Discovery Hospital at Home to provide an alternative setting of care for members diagnosed with COVID-19. More than 100 members of the Discovery Health Medical Scheme were successfully treated for COVID-19 in their homes during 2021, all with the same or improved levels of clinical outcomes and a better patient experience. In January 2022 the program eligibility criteria were expanded to include all clinically appropriate medical and post-surgical conditions that would otherwise require an admission to hospital for general ward level of care.

Discovery Health administered medical scheme members admitted to Hospital at Home have access to a range of benefits and services, delivered through their personalised care team. Together, these benefits and services ensure a seamless healthcare experience for patients and superior clinical outcomes. All services offered as part of Discovery’s Hospital at Home programme are funded from the member’s hospital benefit where there is a valid pre-authorisation. This includes funding for approved devices and healthcare services for those who meet the clinical and benefit criteria.

The backbone for Hospital at Home is Discovery’s Connected Care Platform, which was launched in November 2020 and includes world-class telehealth capabilities, digital tools for members and doctors and integration with Discovery’s Hospital at Home platform and remote monitoring devices. This enables real-time and comprehensive tracking of clinical progress and fast and efficient delivery of care including all aspects found in a typical hospital setting.

Uniqueness of the project

Leveraging the key learnings from successfully treating COVID-19 patients at home during 2020 and 2021, Discovery Health built the capability and capacity to enhance Discovery Hospital at Home to become the largest hospital at home provider in South Africa with capacity for 750 admissions country-wide at any point in time. This bed capacity exceeds that of any private hospital in South Africa at the moment.

Admission experience and insights have shown that hospital-level care can be delivered safely in a home-setting for a range of clinically appropriate conditions. Approximately 160 000 of Discovery’s 650 000 hospital admissions annually, can be safely managed in the patient’s home. The programme is currently across a range of carefully selected low acuity conditions and will be expanded over time to include a broader range of conditions.

Discovery Hospital at Home is powered by integrated, cutting-edge digital technology, and supported by highly skilled clinical staff, clinical protocols and best clinical practices, and appropriate medical scheme benefits. Admissions to Hospital at Home are included in standard hospital benefits and subject to standard hospital pre-authorisation procedures to ensure appropriateness of the admission in the home environment.

24/7 CLINICAL OVERSIGHT FROM A CARE TEAM SUPPORTED BY IN THE HOME CONCIERGE SERVICES

Discovery Hospital at Home includes 24/7 remote monitoring through a specialised command centre, daily in-person consultation and monitoring by the clinical team and instant access to a group of doctors and nurses operating remotely. The care team includes admitting physician, remote monitoring doctors, nurses, and allied healthcare professionals. In the home concierge services include bedside nursing, bedside physiotherapy, caregiver, and meals where clinically appropriate.

Discovery has partnered with an emergency service provider to deliver 24/7 remote monitoring in a clinical command centre. The Biofourmis technology continuously monitors a patient’s physiological signals and alerts a team of doctors in the command centre. Should a patient’s health status deteriorate, a doctor is able to engage with the patient and caregivers, perform an in-person assessment and dispatch an ambulance to the patient’s home if required.

24/7 REAL-TIME REMOTE MONITORING SUPPORTED BY CUTTING-EDGE DIGITAL HEALTHCARE TECHNOLOGIES & PLATFORMS

Patients are connected to a remote monitoring device (wearable biosensor) which automatically and continuously transmits real time clinical information (22 physiological parameters) to the care team, 24 hours a day, 7 days a week. The clinical data is processed in near real-time to provide clinical teams with a predictive view of a patient’s disease trajectory to detect issues, intervene early and prevent potential medical crises. Patient physiological data is compared to population level data to enable unique insights into a patient’s disease trajectory, so physicians can

provide the right care at the right time. The clinical care team continually assess the patient’s health status, monitor their medical stability, track treatment compliance, and recommend interventions when necessary.

The dashboard integrates with clinical workflows and Discovery’s Connected Care to streamline care coordination and the delivery of exceptional care, independent of patient location and clinical condition.

To deliver an end-to-end hospital-at-home solution, Discovery Health has partnered with Biofourmis, a global leader in digital healthcare solutions that enables the delivery of care to patients in any location and provides unique insights into each patient’s condition. The Biofourmis platform and BioVitals Analytics Engine have FDA-clearance and this artificial intelligence (AI)-powered analytics engine has been used to remotely monitor more than 100,000 hospital at home patients globally.

24/7 REAL-TIME ACCESS TO THE PATIENT THROUGH THE COMPANION DEVICE AND APP

Every patient admitted into Hospital receives a companion device with enables real time communication and interactions between the patient and their care team. With an easy-to-use interface and patient-specific customisations, the patient companion app is designed to improve patient engagement and compliance. Patients receive regular reminders, are able to conduct online video consultations, send chats (IM), monitor their clinical parameters and receive their recovery plan over the course of treatment.

HOSPITAL-LEVEL DIAGNOSTICS AND INTERVENTIONS

Discovery Hospital at Home provides access to an enhanced range of clinical diagnostic procedures and interventions to manage medical or postsurgical hospital-level care in the home.

GLOBAL ENDORSEMENT OF THE PROJECT BY ARIADNE LABS

In September 2021, Discovery Hospital at Home achieved a significant milestone by being the only international hospital at home provider to be chosen to participate in the Ariadne Labs (in collaboration with CaroNova), Home Hospital Early Adopters Accelerator Program that supports health care systems to further develop their own home hospital programs. Ariadne Labs is a joint center for health systems innovation at Brigham & Women’s Hospital and the Harvard T.H. Chan School of Public Health.

The program provides expertise in designing and managing home hospital programs via a network of over 20 hospitals and systems who collectively learn, create knowledge products, and implement their programs together as a community. The program also seeks to generate and disseminate the evidence to deliver advanced care at home and accelerate global adoption of hospital at home.

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