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Stepping Up to Better Care



A recent article by Dr David Oliver, visiting fellow of The King's Fund, drew attention to the increasingly problematic shortage of beds in acute care hospitals. Expressing his concern at the situation. Dr Oliver wrote that numbers of available beds in the UK have reduced sharply over the last 30 years – a problem exacerbated by the contrasting rise in the numbers of elderly people, and those living with serious medical conditions.


The shortage in acute bed space is, in part, due to difficulty faced by healthcare providers in being able to transfer care. The strain on follow-up facilities leads to many being kept under supervision in hospital after they are healthy enough to be discharged or alternatively, returning for emergency readmission after discharge. Consequently, fewer beds are available for new patients entering acute care facilities.


As such, further focus on step up/step down rehabilitation services after acute illness and injury is becoming imperative for hospitals and their healthcare partners. While moving people out of hospital to free up bed space is highly important, ensuring that transition is made with the adequate level of care is even more so. Unfortunately, this is a challenge exacerbated by the fact that many leave hospital weaker or less independent, as highlighted in Dr Oliver's article.


Encouragingly, the National Intermediate Care Audit, shows that those that have experienced personalised care services after discharge give glowing reports of the benefits. This is where Telemedicine can play a vital role, delivering a personalised method of healthcare delivery that can ease patient rehabilitation in the home while freeing up much needed beds in hospitals.


Telemedicine's potential to help address these issues has led to an exciting time in the market at present, with more and more organisations showing interest and beginning to invest in telemedicine as it continues to grow apace. Solutions to manage Long Term Conditions are developing particularly rapidly, and stakeholders are welcoming new solutions in an effort to reduce the impact of these chronic conditions, which costs the US healthcare system an estimated $1.5 trillion annually.


Among those solutions is The Bundle Payments for Care Initiative (BPCI). Introduced by CMS' Centre for Medicare and Medicaid Innovation (CMMI), BPCI delivers treatment to patients over a 90 day 'episode of care', including initial acute hospital treatments, inpatient and nursing facilities and continued care at home. The use of bundles is forecast to save $50 billion over 10 years and increase quality of outcome for patients.


It is possible that following the lead of the US, investing in and implementing  the most effective home care solutions, could lead to massive scale savings across other healthcare systems, relieving the pressure on bed space and providing better quality of care for all.


Find out more about first wave digital health here, and see how telemedicine solutions could help solve one of the primary healthcare challenges of our time.