New Workbook Supports Home-Based Cardiovascular Care

The American College of Cardiology (ACC) has released a workbook that provides guidance and resources to support cardiovascular care in the home.

The ACC Home-Based Care Workbook covers the pros and cons of home-based cardiovascular care, principles and objectives for developing a home-based care program, and key performance indicators to measure the success of these programs.

According to the workbook, home-based care is any form of medical care delivered in a patient's home, with or without additional in-person care provided in a medical facility. Numerous factors are driving the shift to home-based care settings, including growing consumer demand, focus on value-based care, and the vast array of available digital healthcare tools.

"While interest in and access to home-based care has grown considerably in the last few years, these services often remain underutilized, especially in the case of acute and specialty care," said Nivee P. Amin, MD, chair of the ACC Home-Based Care Workbook writing committee, in a press release. "However, given the rise of chronic diseases like heart disease and many elderly people's desire to remain in their own homes as they age, it is vital that we look at every possibility for how to appropriately provide care at home. The ACC created this workbook in hopes that all stakeholders in this space might see the possibilities and benefits of increasing home-based care."

Home-based cardiovascular care can be used to treat various conditions. The workbook notes several clinical cases where home-based care may provide benefits, like elective outpatient percutaneous coronary intervention and peripheral vascular intervention, cardiac implantable electronic device placement, chronic arrhythmia management, and heart failure treatment.

Some critical guiding principles and objectives of home-based care include providing easy access to healthcare and minimizing barriers, ensuring care delivery is flexible and seamless between virtual and in-person care, encouraging patient engagement, and empowering patients with digital tools that allow them to choose how and when they access care.

However, there are several challenges to implementing home-based cardiovascular care, such as technical issues, the need for other support services, and escalation of care when needed. The workbook provides mitigation strategies for the potential challenges, suggesting home-based cardiovascular care providers offer technical support, incorporate appropriate monitoring equipment, and ensure quick access to emergency care.

Further, the workbook provides key performance indicators to assess the success of home-based cardiovascular care. These include clinical outcomes like mortality, readmissions, and length of stay; patient experience measures like patient satisfaction scores and ease of patient portal use; clinician experience measures like clinician engagement; health system/operational factors like patient volume and return on capital investment; and payer-related criteria like total cost of care.

The workbook's release comes amid rising interest in at-home care. A survey by PA Consulting Group shows that 74 percent of US healthcare leaders are prioritizing solutions to support moving care delivery from the hospital to the home.

The survey polled 550 leaders across MedTech, pharma, and private and public healthcare. It also revealed that 43 percent of leaders said their organization already provided at-home care solutions for patients.

Home-based care efforts are growing outside of the cardiovascular specialty as well.

In August, Sylvester Comprehensive Cancer Center and collaborating organizations announced plans to study technology that could support cancer management at home. Backed by a $3.5 million, five-year grant from the National Institutes of Health, the study will examine the efficacy of a machine-learning platform that uses wearable device data and a voice-activated system to help cancer patients manage side effects and related stress from treatments.