He talks with Chief Healthcare Executive about the growth of hospital-at-home programs, Best Buy’s purchase of Current Health, and how leaders can help make home-based care succeed.
Christopher McGhee says hospitals shouldn’t fixate on the past.
McGhee is the CEO of Current Health, a technology company which helps health systems provide healthcare at home, including hospital-at-home programs. The Scottish healthtech leader sees a great deal of promise in offering acute care at home, but he also understands why some healthcare leaders may be tempted to focus on care within the hospital.
“I think hospitals are in a difficult spot right now,” McGhee says. “They’ve seen their volumes and their revenue go down, their costs are higher, a lot higher. So I think a lot of leaders are saying, ‘We’re going to focus on what we know best, which is in-patient, heads in beds.’”
“We’re also seeing a lot of hospitals recognize the future is going to be different, and we can’t just invest in what we’ve done in the past,” he continues. “We have to invest in the future.”
And that means looking at offering more care at home, including more acute care, he says.
“The future isn’t just going to be inpatient,” McGhee says. “Everyone agrees that part of the future of care is going to be care in the home. So we have to think about that future.”
McGhee spoke with Chief Healthcare Education during the HLTH Conference in November. He shared his thoughts on the changing healthcare landscape, how he feels Best Buy’s acquisition of Current Health has primed the company for growth, and how healthcare leaders can ensure home-based care can succeed.
There will always be a place for the hospital, but he says some patients can receive excellent care at home.
“For me, it’s how do we deliver, without being cliche, the right care in the right place at the right time for those individual populations,” McGhee says. (See part of our conversation in this video. The story continues below.)
During the COVID-19 pandemic, more hospitals have been offering acute care in the home, because the federal government gave health systems more flexibility in offering acute care at home. Congress and President Biden agreed to a two-year extension of those flexibilities in the $1.7 trillion omnibus spending package, which Biden signed in late December.
Home hospital programs are “one of the most innovative test programs that have come out during the pandemic,” Kyle Zebley, senior vice president of public policy for the American Telemedicine Association, told Chief Healthcare Executive in December. He called the extension of hospital-at-home waivers “a huge victory.”
To date, 260 hospitals (114 health systems) in 37 states are offering hospital-at-home programs, according to federal government data.
With more systems launching or at least exploring such options, McGhee says, “We’re really, really positive about our current growth trajectory.”
Current Health is working with more than 20 health systems.
“We work with many of the nation's leading health systems, people like Geisinger, UMass, NYU, Mount Sinai,” McGhee says. “We work all across the United States, supporting hospital-at-home, all the way down to chronic disease management. We are trying to be one single solution, regardless of whether it’s an acute patient in hospital at home, or whether it’s a chronic disease management patient.”
Joining Best Buy
Best Buy’s purchase of the company bodes well for its long-term prospects, he says. The retailer known for computers and electronics moved into the healthcare space when it acquired Current Health in a $400 million deal in 2021.
With the acquisition, Current Health’s technology is coupled with Best Buy’s strengths in logistics and supply chain management. Health systems “are excited about those capabilities,” McGhee says.
Best Buy brought in experienced healthcare leaders, he adds. Deborah DiSanzo, president of Best Buy Health, has been in healthcare for 30 years, he notes. Best Buy built “a proper healthcare team,” McGhee says.
“I think they came into it with a very thoughtful and in my opinion, a mature and intelligent perspective,” McGhee says. “They knew that they needed a company like ours, and went out and looked in the market, and thankfully thought we were the best. It was timed very well for us. We thought that being successful in this space required some of the things Best Buy had. So it came together really nicely.”
Looking to the future
While many healthcare leaders see more treatment being shifted to the home, McGhee sees the future as a hybrid of home-based care and treatment inside hospitals.
“A lot of people are saying home is going to be a replacement for the hospital. I think that’s incorrect,” McGhee says. “There are lots of people who need to be inside hospitals. The inpatient environment is always going to be a location where care needs to be delivered.
“The thing for me is, is there a percentage of care that’s in-patient today, that could be delivered in the home,” he adds. “I think we’ve seen definitively over COVID, that is true.”
Part of Current Health’s focus is going beyond acute care to chronic disease management at home, and post-acute transitional care.
“Health systems don’t want niche solutions for individual populations,” McGhee says. “They want one solution that can support them across the enterprise."
"Patients don't just live in these silos,” he says. “We want to follow them when they go from hospital at home to chronic care, and back to hospital at home, and give the consumer one integrated experience, not a bunch of fragmented experiences, but one experience that follows them through their journey.”
Proponents have pointed to encouraging studies showing good outcomes for patients in hospital-at-home programs, including reduced readmissions.
Nonetheless, some healthcare leaders have been reluctant to invest in hospital-at-home programs and other technology initiatives based in the home. While many healthcare leaders see the potential of such initiatives to improve patient care, many don’t identify expanding offerings to the home as a top priority, according to a recent survey of healthcare executives by Sage Growth Partners. Some are also waiting for more assurance about long-term federal reimbursements.
Still, patients are indicating they want more care options at home, and healthcare leaders should consider patient preferences, McGhee says.
“In the future, consumers are going to select their providers based on who offers these services and who doesn’t,” McGhee says. “You have to do it now, because otherwise, you’re going to be five years behind.”
Making programs work
While there are technology demands in implementing hospital-at-home programs, they aren’t the most formidable challenge, McGhee says.
“I say this as a technology leader, the technology is not the most important part of this,” McGhee says. “It’s making sure you have broad buy-in across the organization.”
Hospital executives need to make sure home hospital programs are a key priority and not just a side project, he says.
“It needs CEO-driven buy-in,” McGhee says. “It needs clinical leaders, it needs nursing leaders, it needs IT leaders and they all have to be bought into it together.”
Hospitals have to establish clinical workflows and select the right patients. Some patients may be too ill and need to be inside the hospital.
The most successful home hospital programs also have strong leadership from nurses, McGhee says.
“They are playing a really significant role in running the programs at the management level, helping identify patients … and spending a lot of time in the home with those patients,” he says.
Nurses who participate in home hospital programs have reported greater job satisfaction, which McGhee calls a welcome surprise.
“They’re actually able to go in and deliver care in the way that they can,” he says. “If they have eight patients on a floor, and they’re getting paged every two minutes, and they’re being called away, they can’t spend significant time with that patient.”
McGhee says the programs won’t lead to nurses being replaced, saying they are critical to making hospital-at-home work.
“These programs are only successful with amazing nursing and medical teams,” he says.
“We have to kill the phrase ‘virtual care’,” he says. “It’s not virtual, it’s still physical care. And we need nurses to go into the home and deliver care. It’s not ever about replacing the staff.”
Ultimately, McGhee says Current Health’s success will be built on showing health systems the clinical and economic case for hospital-at-home programs and their success in patient care and satisfaction.
But he says the other key ingredient comes in satisfying a constituency that is often overlooked: the providers.
“The experience for them has to be amazing,” McGhee says. “It has to be easier for them to do this than put a patient on the floor, or they won’t do it.
“We have to make the provider and the clinician experience incredible, and I don’t think there’s been enough focus on that last part,” he adds. “They’re kind of left out, and I think that’s a mistake.”