The Covid crisis highlighted four essential challenges facing healthcare services today. 1. Increase the volume of care; 2. Improve care outcomes for patients; 3. Protect the health of medical and care providers; 4. Improve the overall quality of care.

Each challenge points to a requirement to improve the efficiency of healthcare, a requirement that is being met through the increasing use of remote care and technology.

The Need to Reduce Hospitalisation

The benefits of remote patient monitoring (RPM) can be broadly divided into two categories: patient benefits and provider benefits. Patient benefits are largely psychological, eg reassurance and engagement, while the benefits to care providers concern process efficiency and efficacy. Both contribute to one overriding benefit, which lies at the root of healthcare efficiency: a lower number of hospitalised patients.

The estimated cost of a hospital stay in the UK is £400 per day. The longer a patient stays in hospital, the more vulnerable they are to further infections and loss of physical condition. There are also many more emergency readmissions than necessary, due to discharged patients not adhering to their prescribed course of treatment. The quality of healthcare will improve if patients can receive healthcare at home until hospitalisation is really necessary.

RPM tackles these challenges by greatly improving the quality of care that can be given to patients at home.

Increasing Patient Accountability

The risk for patients requiring ongoing outpatient care, including those with chronic ailments such as diabetes and cardiac conditions, is that they lose interest and fall behind with their treatment. In some cases, this loss of interest is actually an aversion, either caused by fear or a dislike of the clinical environment.

Patients who have been equipped with RPM report feeling much more comfortable and familiar interacting with their care giver via their own enabled device in their own home, and thus become more engaged. They also find it reassuring that their clinical team are ‘with them’ once they leave hospital, and the regular interaction encourages them to be more accountable for their own health. This reduces non-adherence and thus the likelihood of hospitalisation.

In one study of chronic patients using RPM in the US, the re-hospitalisation rate was reduced by two thirds. A similar reduction in unscheduled attendances was recorded in a program of remote monitoring for patients with cardiac rhythm management devices in Dublin.

The regular monitoring and feedback that RPM affords also helps to reduce missed appointments, which represent a severe drain on healthcare budgets. In the UK, the cost of missed appointments amounts to around £1billion per year.

Raising Care Providers’ Capacity

While the comfort and convenience afforded by RPM have proven benefits on patient engagement, the technical attributes yield major efficiencies for care providers.

Patient feedback, coupled with monitoring of vital signs using RPM connected wearables, provides a wealth of data that helps care managers to prioritise patients accurately and thus manage their case load more efficiently. In some cases, care managers have achieved a 15-fold increase in their case load without any additional demand on their working hours.

As the technology develops, artificial intelligence and machine learning will be able to take care of much of the day-to-day care, looking for patterns in the data and raising the alarm when it detects abnormalities. It will be able to generate automated messages to patients to remind them to take their medication, report how they’re feeling, do their exercises etc, and simply maintain that regular contact that patients find so reassuring.

The data collected from each patient will help care providers to deliver a better quality of care individually, but there is also a wider benefit when the data from all patients is aggregated. Care outcomes can be analysed to assess which treatments are more effective than others and the lessons gleaned can be applied to improve the efficiency and quality of care.

In summary, remote care technology is changing the way outpatient cases are managed from an outbound process, where care managers have to chase patients to check on their progress, to an inbound model, where patients take more interest in and responsibility for their own care and send their feedback to the system.

This reduces the burden on healthcare providers, reducing the physical and mental impact on staff, saving costs and enabling a better outcome for patients all round. And as AI comes increasingly into play, those efficiencies will only increase.

Ask for a demo of Medix Journi a remote monitoring engagement solution.

For hospitals and other care establishments, every day sees the challenge of streamlining service efficiency without compromising the level of care. It’s a balancing act that constantly runs the risk of failing on both sides – gaps appearing in the patient care continuum and no money in the budget to plug them.

Digital healthcare has the potential to solve this problem by increasing the efficiency of service, saving process and staffing costs and delivering a better patient experience. To illustrate the point, we’ve picked out four of the most common and most costly pitfalls.

1. Patient non-attendance

In the year 2017/18, UK NHS hospitals recorded nearly eight million missed appointments, not including those cancelled in advance. At a cost of £120 per appointment, that amounted to nearly £1billion of wasted money.

Failure to turn up for assessments or treatments is not simply a matter of poor organisation on the part of patients. There are more deep-seated psychological reasons, which need to be addressed through good communication in the lead-up to the appointment, while the patient is still at home.

For many patients, any sort of healthcare intervention is a daunting prospect. There is a fear of the unknown. The more healthcare providers can do to educate patients and offer them reassurance ahead of any hospital visit, the more likely patients are to attend.

How digital healthcare can help

Digital healthcare apps like Medix Journi can be downloaded onto patients’ own devices, opening up a channel for easy communication with healthcare professionals. This enables the sharing of information in the form of documents and videos, and even video counselling where it is required, all of which helps to keep the patient engaged and, therefore, more likely to turn up at the prescribed time and place.

2. Lost patient records

Once in hospital, the sharing of patient information is crucial to the hospital’s ability to provide timely and accurate care. But in many hospitals this gathering and sharing of information still relies on archaic methods that don’t join up, meaning patients have to repeat the same answers to different practitioners at different stages of their treatment and inconsistencies arise.

More concerning is that approximately two million patient records are lost within the NHS every year, causing extra administrative work, delaying treatment, putting patients at risk, wasting doctors’ and nurses’ time and leaving hospitals exposed to financial penalties.

How digital healthcare can help

Digital healthcare apps enable the joined-up gathering and sharing of patient information at any point in the patient journey, whether at home prior to admission, at the bedside or in treatment rooms in hospital, and back at home post-treatment. Information is collected in real-time, enabling healthcare professionals to make more timely interventions. Once collected, it is stored securely and is easy to find on any connected device in any part of the hospital.

By replacing paper-based record keeping with digital, it is estimated that an average hospital with 500 beds could save £395,000 each year, £60,000 in the production of the physical data sheets and £335,000 in human resources.

3. Patients overstaying in hospital

In 2013 a report by the NHS Institute for Innovation and Improvement estimated that an annual saving of £2.5bn could be achieved within NHS hospitals by reducing the length of patient stay. That doesn’t mean discharging patients before they’re fit to leave, it means eradicating the all too common problem of keeping patients in hospital longer than is good for them.

Overstaying is costly for hospitals and not good for patient recovery. Research has shown that the longer a patient remains in hospital, the more vulnerable they are to infections or deconditioning – becoming permanently less mobile or able to perform tasks they could before. More than one in three 70-year-olds experience muscle ageing during a prolonged stay in hospital and that figure rises to two thirds of over 90s.

How digital healthcare can help

The reason for so many unnecessary overstays is the speed of information informing patient flow management. The solution is to track patient movements in real-time to enable more effective bed management.

Digital healthcare apps enable nurses to feedback information about the use of beds in their ward in real-time to a central data hub, where patient flow can be efficiently managed across the entire hospital. This facilitates a more timely admission and discharge process, avoiding overstay, making more efficient use of physicians’ time, enabling a better level of care and saving money.

4. Patient readmissions due to non-adherence

According to a study by the American College of Preventive Medicine, around 10% of hospitalisations are due to patients not adhering to their prescribed course of treatment and having to be readmitted. Analysis from the Nuffield Trust released in 2018 revealed a 41.3% rise in emergency readmissions for potentially preventable conditions.

This is bad news for patients and hospitals, with financial penalties being imposed in the form of a cessation in reimbursements for patients readmitted within 30 days of leaving hospital. A study from John Hopkins University in 2014 put the cost of non-adherence to the US health system at $300bn per annum.

Why patients are not adhering to treatment is the subject of conjecture – and therein lies the problem. A lack of data showing which readmissions are unavoidable, which are planned and which could be avoided is not helping.

How digital healthcare can help

Digital healthcare apps like Medix Journi enable doctors and therapists to keep patients engaged with their treatment after they have been discharged from hospital. Healthcare professionals can hold remote consultations, send useful documents and videos to keep patients informed and demonstrate what they need to be doing, as well as sending reminders and checks to monitor whether patients are following their prescribed course of medication

Digital apps also enable data to be gathered from patients when they are out of hospital, which can all be fed back to provide a much clearer picture of the reasons for readmission.

By using digital applications to keep patients engaged from end to end of the care journey, hospitals can begin to achieve that elusive balance of delivering an ever-improving standard of care while reducing costs.

The Medix Care Platform delivers advanced patient engagement while improving hospital workflows and efficiency. Request a demo today!

The provision of healthy meals in hospitals and other care establishments is an essential component in the delivery of effective healthcare. The recommended balance of vitamins, minerals and fibre and the control of sugar and saturated fat consumption are part of the Government’s guidance on eating well.

However, many hospitals are still struggling to meet the guidance on meal provision as they try to balance cost with the practicalities of feeding hundreds of patients with widely varying dietary requirements. Elderly patients, for example, tend to be undernourished, whereas obesity is the more prevalent problem among the middle-aged.

How can hospitals raise nutritional standards and meet the individual dietary needs of their patients within budgets that are already overstretched?

Improving efficiency in hospital meal ordering

In recent years, hospitals that have introduced Electronic Meal Ordering have seen marked improvements, both in patient satisfaction and operational efficiency. Even if the menu remained the same, the operational benefits of Electronic Meal Ordering would save health services millions of pounds each year.

The traditional process involves the distribution of paper menus, which patients mark with their meal choice. These then have to be collected, taken to the catering office and processed. Because of the time involved, patients are usually required to order their meals a day in advance. If a patient is discharged in the meantime, the meal goes to waste. Of the £400million spent on meal provision in hospitals each year, around £25m goes to waste*.

By contrast, Electronic Meal Ordering requires no paper forms to be printed, no extra staff to distribute and collect them, no manual processing. For a typical hospital of 500 beds, the savings on processing alone amount to an estimated £40,000 per year*.

The speed and accuracy of orders also cuts down on food waste. Menus can be translated and presented with pictures, so that all patients understand exactly what they’re being offered. The reduction in processing time means that meals can be delivered much faster (within two hours as opposed to the 15 hours typical of paper-based meal ordering). For that same 500 bed hospital, these two factors can save £57,000 per year* in food waste.

Improving health by raising nutritional standards

These savings cumulate close to £100,000 per year for the average hospital to invest in a better standard of nutrition, wider choice of menu, individual dietary requirements and more flexibility for timings of patients’ meal delivery. These components combined ensure a higher standard and quality of food in hospitals and care establishments

As a higher standard of nutrition is delivered, further benefits are realised. Studies have shown that an increase in food consumption among elderly patients is linked to a reduction in their length of stay in hospital. Patients recover sooner, more beds become available and more money is saved. In a typical 500 bed hospital a 5% reduction in length of stay achieved by Electronic Meal Ordering equates to £50,000 a year* cost saving.

Electronic Meal Ordering also enables large amounts of patient data to be collected, giving caterers valuable insights into what meals are most popular, seasonal preferences etc, which in turns improves their ability to provide nutritious choices that patients actually want to eat. It also enables care providers to track dietary behaviours and identify patterns that could facilitate a more tailored care service.

A virtuous circle of nutritional excellence

Through better service, increased operational efficiency and reduced waste, the average hospital stands to save £147,000 a year. As money is saved and reinvested in a higher standard of meal provision, the health benefits to patients continue to increase, fewer meals are wasted and more money is saved.

By introducing the Medix Nutrio Electronic Meal Ordering solution, hospitals are creating a virtuous circle that is self-maintaining and can release money for other needs besides catering, as well as qualifying them for funding from sources like the Commissioning for Quality and Innovation (CQUIN) framework. The ultimate benefit is better healthcare for everyone.

*Source: Deloitte: The Economic Benefits of Electronic Meal Ordering

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