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The Future of Care at Home and Digital Health: 8 Takeaways from Team8’s Fireside Chat with Best Buy Health

Varda Shalev June 4, 2024

The American healthcare system is facing multiple challenges – rising costs, increasing demand, and difficulty maintaining care quality. At Team8, we believe that technology has the potential to reverse these trends and transform healthcare for the better. Digital transformation is at the heart of promising new care delivery and payment models, from employer-sponsored health plans to value-based care.

To explore the future of digitally-enabled care at home, we recently hosted a webinar featuring Prof. Varda Shalev, a primary care physician, a medical informatics expert and managing partner at Team8 Health; and Deborah DiSanzo, president of Best Buy Health and a veteran health tech executive. You can watch the full webinar recording here, or read on for a summary of our top takeaways from their fascinating discussion

1. Care is shifting from hospitals back into the home

“Care at home is not a novel concept,” noted Prof. Shalev. “In 1751, the nation’s first hospital was founded in Pennsylvania, and it was the beginning of the 19th century where hospitals really began to take off in the U.S. We are now coming full circle, back home.”

Several factors are driving this trend – from digital tools that have enabled many treatments to be delivered remotely, to an aging population that prefers to be treated in familiar surroundings, and health systems looking for more efficient care delivery models. McKinsey has estimated that up to 25% of total care delivery costs could shift to the home by 2025.

2. New technology infrastructure is needed to enable home-based care

To realize the full potential of home-based care, Prof. Shalev believes that a new generation of digital health technologies will be essential. “It’s not enough to give services at home without comprehensive technology, and the technology isn’t there yet,” she said.

In particular, she highlighted the lack of integration between the myriad point solutions on the market today, from remote monitoring devices to telehealth platforms. “One crucial aspect is the lack of integration of care at home solutions,” said Prof. Shalev. “All systems must communicate to allow data interoperability through features like single sign-on, decision support tools, and emerging technologies such as AI and LLMs.”

Developing these technologies will require close collaboration between providers, payers, and health tech innovators. Team8 is actively exploring opportunities to develop products in areas such as remote monitoring, telehealth, predictive analytics, and care coordination. However, any new offering will need to demonstrate a measurable impact on cost, quality, or experience to drive adoption.

3. AI and predictive algorithms must be optimized for the home environment

Artificial intelligence has the potential to help predict adverse health events and reduce false alarms from home monitoring systems. However, most current models are trained on hospital data and do not translate well to the home setting.

“What we’re seeing interestingly is the algorithms that work in hospital for prediction of adverse events are not working the same way in the home,” said DiSanzo. “And there’s lots of reasons for that. So this is another great AI model to get enough data of enough diverse patients to be able to really create AI models that are going to enable the prediction of an adverse event.”

4. Decentralized clinical trails are a major pharma use case for care at home tech

Pharmaceutical companies are increasingly interested in using remote monitoring and telehealth to enable decentralized clinical trials. This approach can help improve enrollment diversity, participant retention, and protocol adherence while reducing the burden on patients.

“This was a big pandemic thing – clinical trials at home,” said DiSanzo. “What we have found in clinical trials at home with remote patient monitoring is that patients are more compliant, they stay on the programs longer when they can be monitored at home. We are finding a lot of interest in oncology. CAR T-cell therapy patients do not need to spend 14 days in the hospital, but enable them to go home with monitoring- and in oncology clinical trials where it’s sometimes a burden for the patient to get to a healthcare facility.”


6. Creative new payment and business models are required

Perhaps the biggest obstacle to widespread adoption of care at home models is misaligned incentives between payers, providers, and patients. Both payers and providers must embrace the approach to make it economically viable. 

DiSanzo explained how Best Buy’s unique business model, which combines consumer electronics retail with health services, allows it to monetize some offerings without relying solely on reimbursement – while also developing partnerships with health systems. “There are programs for aging at home that are paid for under Medicaid and Medicare, and also by health insurers. But in our model, one half of all of our solutions are self-paid by consumers. We have a model where there are family caregivers who want to provide services for their parents to age independently at home, and those are all self-paid.”

7. Israel offers a unique environment for digital health innovation

Israel’s highly centralized healthcare system, with just four HMOs covering the entire population, creates an ideal testbed for digital health innovation. During her time leading medical informatics at Maccabi Healthcare Services, Prof. Shalev oversaw the implementation of a comprehensive EHR system and the creation of integrated databases covering 2.5 million patients.

“In a very short while, we started capturing digital data for medical records,” she said. “This was the first digital revolution in medicine, but it was not yet digital health. With time, we started creating health databases of the general population, connecting data like never before.”

This wealth of longitudinal, population-level data has enabled Israeli startups to develop and validate AI-powered diagnostic and treatment planning tools at a rapid pace. The country’s close-knit health tech community and strong government support for entrepreneurship have also contributed to its emergence as a digital health powerhouse.

8. Headwinds holding back wider adoption

Despite the potential benefits of home-based care models, Prof. Shalev noted that adoption has been slower than many experts predicted: “We are not there yet. There has been steady growth, but not the explosion one might expect.” This is due to challenges such as the high cost of round-the-clock professional caregivers, lack of technology infrastructure, and the major process changes required of health system operations.

One major barrier is the high cost of delivering comprehensive care in the home setting. “If extensive medical attention is required, costs can skyrocket,” Prof. Shalev explained. “Professional caregivers on site and operational overhead can quickly add up.” Reimbursement structures and incentives are also poorly aligned to support home-based care, requiring payers to fundamentally change their mindset to focus more on making healthcare easier and more available for patients.

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