This Week Health

Sachin Jain shares a cautionary tale for moving care to the home.

Transcript

Today. In the health, it cautionary tale when moving care to My name is bill Russell. I'm a former CIO for a 16 hospital system. And creator of this week health, I set up channels dedicated to keeping health it staff. Current and engaged. We want to thank our show sponsor. So we're investing in developing the next generation of health leaders, Gordian dynamics, Quill health.

Tau site nuance, Canon medical, and current health. Check them out at this week. health.com/today. All right. One of the people I follow on social media on LinkedIn specifically is Sachin. Jane. Who is CEO, , for a health plan out of Southern And he has just great posts and

If you're not following them on LinkedIn, I highly recommend you

And just last week, he put a post out here which is just exceptional and got a lot of back and forth and a lot of good dialogue going on. Driving care to the home. And I'm just going to read some of it, and then talk about it a little bit. The healthcare industry is dominated by optimistic dialogue about moving care to the home. And while

I am as bullish as anyone about moving care out of facilities, some humbling cautionary notes. I recently had a frail older friend. With end stage renal disease, secondary to a long history of diabetes, transition to dialysis. He started with thrice weekly. Center-based hemo dialysis. But eventually the obvious question of the day was asked. Could I Alesis be performed at home. His family was committed to doing everything possible, to support him. So they underwent training

on home dialysis. What he and they quickly discovered is the added effort required to support dialysis in the home. First was the small business of supplies and storage. Every few weeks, a large pallet of heavy dialysis supplies. Would arrive at the home significant space was required

store all of the supplies needed.

Physical strength was required to move and store these supplies as well. Second was the added burden of initiating and ending dialysis daily. The family members had to be trained on sterile technique. They also had to be present every day at the same time to get dialysis started. In the evening and also end dialysis the next morning, home-based dialysis produces a physically heavy bag of urine that needs to be disposed of every morning.

Third was the added challenge of managing his blood sugars. Dialysis uses a dextrose based solution that can cause significant

fluctuations in one's blood sugar. My friend's blood sugars climb so high at times that his thinking became cloudy and his insulin regimen became difficult to manage.

In the end, he decided that center-based dialysis was better for him. And he has done better since returning to a stable regimen of local dialysis facility. A few lessons, the mantra move care to the home is much easier, said than done. And should be approached with caution, exclusively for the right patients.

And we talked to, , John Halabi earlier in the year about their move to the home. And a significant amount of the work is in determining if the patient's home environment We'll support the home care that is being delivered in that environment. And so how systems as they sprint in this direction needs to understand that there's a significant.

, upfront. , review of , if the care that's being delivered in those homes. Can be delivered with the same level of safety. And quality that you would get somewhere All right. So we have that, , other lessons. Moving care to the home requires a safe, spacious, clean home environment.

Something to which all patients may not have access. Maintaining heavy medical equipment and supplies is an added burden and challenging for many. , number three, moving care to the home may create distinct medical complexity. I E. Blood sugar levels that isn't easy for all patients to manage the number four, not all patients.

Want to turn their home into a secondary medical facility. Despite what we may think of the benefits of not being in facilities, many people understandably want their homes to remain. Their homes. That makes a lot of sense. Clearly. That makes lot of sense.

All right. I think you can understand why I follow such and Jane. There is so many great insights in this one post and he posts almost daily on what he's seeing. From his purview as CEO. Of this health plan.

So why do I call this article out? I call this article out because I I'm also bullish on delivering care into the home. I believe that we should have more sensors in the home. If you've listened to the show for any period of time, you've heard me talk about the fact that my car has more sensors on it than I do.

And my auto dealership is more responsive to my car's Then my health system is to my Based on the sensors that I'm currently, , carrying around. And that's why I was looking through these comments. I think one of the things that was captured really well. , Phil Mitchell. , Dr. Phil Mitchell. , I don't know much more about him other than his name, which is on the comment.

Says this. Agree with That said we have to continue to see what can be safely done in the home. It's easy to maintain the status quo, but we should continue the pursuit of care where patients want it most when it is safe to do so. The outcomes look very promising when care is managed correctly with patients, families, caregivers, and health professionals, all contributing.

And I think, this is a great cautionary tale. We should consider this. And we should build out programs. That look into the viability of the home that look into the care that's being delivered to the home that looks into the lift. The, complexity and the difficulty, it will be on the family. And if they choose to deliver that care to the home, to provide them support.

In doing that. So there are many things we can't just say, Hey, throw care to the home because it's the best alternative here. We have to carefully consider and plan effectively for how we're going to deliver out of the home.

And this includes the technology that we're using and how we're going to adapt that technology to be used in the home to deliver care at the highest quality level. So that's all for today. I am still full speed ahead for care at home. And I think a lot of other people are full speed ahead for care With the caveat of full speed ahead

Everyone at home, it means identifying the best cases, identifying the right care, identifying the right technology and putting it all in place with the right systems and processes to support that and make sure that we can maintain a high level of quality of care in the home. All right, again, that's all for today. If you know someone that might benefit from our channel, please forward them a note. They can subscribe on our website this week out.com or wherever you listen to podcasts, apple, Google, overcast, Spotify, Stitcher.

You get the picture. We are everywhere. We want to thank our channel sponsors who are investing in our mission to develop the next generation of health leaders. Gordian dynamics, Quill health. Tau site nuance. Came in medical and 📍 current health. Check them out at this week. health.com. Slash today. Thanks for listening that's all for now

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