Appalachian Regional Healthcare starting hospital-at-home program

The Kentucky-based system is partnering with Biofourmis, a digital health company, to serve patients and participate in a study of acute care at home in rural areas.

Appalachian Regional Healthcare of Kentucky is preparing to launch a hospital-at-home program and says it hopes to significantly improve care in rural areas.

The non-profit health system, which operates 14 hospitals in Kentucky and West Virginia, is utilizing technology from Biofourmis, a digital health company based in Boston. The health system and tech company made the announcement Tuesday.

In addition to offering acute-level care at home, the partnership will also include a clinical trial examining the effectiveness of home health programs in rural areas.

More hospitals have been expanding their services to offer acute-care services at home. As of June 8, 239 hospitals in 36 states are offering hospital-at-home programs, according to the Centers for Medicare and Medicaid Services.

Due to the COVID-19 pandemic, CMS has issued waivers allowing more hospitals to offer acute care at home. In such programs, patients are monitored by wearables or other devices allowing health systems to monitor patients remotely. Under federal regulations, hospitals with home-based acute care services must send clinicians to visit patients in person at least twice per day.

Appalachian and Biofourmis touted the new venture as a critical way to expand healthcare options in rural communities. Maria B. Braman, Appalachian’s vice president, medical affairs and chief medical officer, said in a statement she sees great potential in the program.

"Home hospital is a care model that has seen encouragingly positive outcomes and satisfied patients, and we believe it could make a true difference in rural Appalachia," Braman said in the statement.

"Biofourmis' technology, which has been demonstrated to improve outcomes and decrease costs, has been successfully deployed in urban and rural home hospital programs,” she said. “The solution will give us the digital health and remote clinical support we need to help make our program a success so that we can eventually expand to more hospitals and patients."

Appalachian said it is starting the program with 10 “virtual beds,” so the system plans to treat about 30 patients per month at home. Patients will be given wearable biosensors, blood-pressure cuffs, pulse oximeters and weight scales, according to a news release on the venture.

Appalachian is one of two rural healthcare providers selected to take part in the clinical study dubbed the Rural ​​Home Hospital project.

The project is a collaboration of Brigham and Women’s Hospital in Massachusetts, one of the first to launch a hospital-at-home program, and the Harvard T.J. Chan School of Public Health. Blessing Health System in Quincy, Ill. is the other provider selected, and that system is also using Biofourmis’ technology.

Patients in rural areas have long struggled with getting access to quality healthcare, and the problems appear to be growing.

Between 1990 and 2020, 334 rural hospitals across the country shut their doors, according to the North Carolina Rural Health Research Program. During that 30-year span, rural hospital closures occurred more often in counties with above-average populations of Black, Hispanic and American Indian residents, compared to typical rural counties, according to a study by the North Carolina program.

Many rural hospitals are battling serious financial pressures. Nearly 900 hospitals in rural areas - 40% of the nation’s rural hospitals - are facing a serious risk of shutting down, according to a report from the Center for Healthcare Quality and Payment Reform.

Kuldeep Singh Rajput, CEO and founder of Biofourmis, said he’s looking forward to helping Appalachian build its hospital-at-home program.

"Appalachian Regional Healthcare can trust that they will have a virtual care partner that will support not just their digital health needs, but also clinical needs with our experienced, qualified remote care team,” Rajput said in the statement.

“Our end-to-end solution shrinks geographies so that patients in their homes will always feel close and connected to their providers no matter how physically far away they may be," he said.