On the occasion of World Health Day (April 7), we spoke to Runam Mehta, CEO, HealthCube on the role of home healthcare in maintaiing health equity. Excerpts from an interview:
What is the role of home healthcare in revolutionising the healthcare industry?
As someone who started her career as a physiotherapist over 15 years ago, I have been associated with home-based care delivery since the outset. Unlike the perception that it is a novel approach, I believe that it is, in fact, the original healthcare delivery practice that is now being rediscovered and revolutionised with the help of technology. Right from historical times, we had caregivers and doctors who would visit the homes of the patients, treat them, prescribe medication etc.
Somewhere in the journey, the approach shifted from a patient-centric to an expert-centric process where the experts are at the core of the service, and patients need to visit them to get treated. This approach is essential when we look at tertiary care. For instance, surgeries can’t be done outside specialised facilities and ICUs, so we need an expert-centric model for such critical care. However, whichever part of healthcare services can be delivered at home will now go back to the original practice.
People get better and faster recoveries when they are treated within the comfort of their homes. They are also able to avoid infection risks when they remain in the safety of their homes since most antibiotic-resistant bacteria are found in hospitals. With the rise in demand, even healthcare providers have now become open to delivering care at home, and the technology is ready to support such initiatives through telemedicine and remote monitoring tools. From an operational perspective, home healthcare services are also more efficient, economical, and customizable which will surely make adoption increase steadily in the years ahead.
How has it grown in the last 10 years. How did Covid impact it?
About 15 years ago, home healthcare was perceived to be a luxury that only the rich could access and afford. People as well as doctors considered home-based care for a specific type of illness and only in certain scenarios. However, in the last 10 years, there has been significant growth in this segment and it is being led by companies like Portea and others that have been streamlining and consolidating a predominantly unorganized section of healthcare delivery.
Modern home healthcare companies have expanded their coverage and brought a number of services under their coverage. I believe factors like awareness, access, and affordability need to be further focused on. For instance, if insurance coverage can be introduced for home-based healthcare services, it would truly give a great boost to the industry.
As far as COVID is concerned, it has definitely made home healthcare services a lot more relevant and made people adopt them through awareness about the benefits. Now, insurance coverage for home healthcare services is going to give the next impetus to the segment.
In this digital age where we have hi-tech devices for monitoring parameters, how has the role of home caregivers changed?
One of the key reasons why the transition from home-based care to institutional care had taken place earlier was due to the caregivers’ needing complete and real-time control over service delivery. When patients are admitted to hospitals, they are constantly monitored by healthcare staff such as nurses and doctors who are always present there. This ability to 24×7 monitoring and instantly respond to any changes in patients’ conditions makes the doctors feel they have better control of the situation and superior chances of a positive outcome for each treatment delivered. However, this approach is not equally convenient or preferable to the patients or their attendants. They have to take time out from their regular life routines and are even exposed to potential infections in the hospital environment.
That’s where digital monitoring devices are helping bridge this gap in control. Through such hi-tech devices, doctors can have real-time access to information about the patient’s condition and lend control at par with what doctors usually have when the patient visits the hospital. As technology is rapidly evolving, I believe that in the next decade or so, the evolution of technology and these advanced devices will facilitate access, and give caregivers greater control over service delivery. As we have already seen during the pandemic, technology is also helping in scaling the services quickly and extensively and this evolution will continue in the years ahead.
What kind of future do you foresee in home healthcare, especially considering the increasing aging population?
Before the pandemic, the elderly were the primary consumers of home healthcare services and accounted for up to 70 per cent to 80 per cent of the demand. The pandemic has further underscored the relevance of home healthcare for them, and unlike the past when such services were sought only for specific diseases or in specific scenarios, now it will be accessible and suitable for all including the elderly, pregnant women, small children, or people suffering from weak immunity etc.
Technology is evolving rapidly, and today, there are advanced medical devices available to create a complete ICU-level home care setup. The elderly can be treated at home for increasingly complex healthcare problems including chronic and contagious physical health issues as well as mental health ailments. The world has rediscovered an effective, scalable, sustainable and easily accessible model of universal health coverage and things will only accelerate from here.
In fact, we will see the full-scale adoption and acceptance of home-based healthcare in another 10-15 years when those who are currently in the 45-50 years age bracket cross the 60-year mark and join the elderly population. They will already be well-versed with home healthcare services, and have greater confidence in the accuracy and trust in reliability of these services. Thus, unlike the current generation which is transitioning to tech-assisted home healthcare, the elderly in about 10-15 years from now will already be supportive of a home-based healthcare delivery model for all non-critical care needs.