TAKE A LOOK | What it is like being a Discovery Hospital at Home patient

Business Insider SA
Discovery Hospital at Home has had around 150 patients so far. (Image: Ntando Thukwana/Business Insider South Africa)
Discovery Hospital at Home has had around 150 patients so far. (Image: Ntando Thukwana/Business Insider South Africa)
  • Discovery’s new Hospital at Home has already been able to admit about 150 patients since its launch in January.
  • It allows its members to receive treatment at home for acute illnesses that ordinarily require a hospital stay.
  • It uses wearable digital devices to track patients’ health and feedback information about their progress to a monitored dashboard.
  • The device can pick up the patient’s physiological signs and sound off alerts should the patient’s vitals go out of range.
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Since its launch, health scheme Discovery has admitted more than 100 patients to its ‘virtual hospital’, a new offering named Hospital at Home, which allows people who would have otherwise been admitted to a traditional hospital to receive care from their homes.

The Discovery Hospital at Home has been able to treat about 150 patients in their homes by a network of almost 100 doctors and nurses across the country.

The virtual hospital has already tackled some complex conditions, such as respiratory tract infections and pneumonia, which have also been the most common, Dr Ronald Whelan, Discovery’s chief commercial officer, told Business Insider South Africa.

“We have a very specific pneumonia protocol; Hospital at Home is very well suited for pneumonia treatment. [It] typically requires a course of intravenous antibiotics; it requires respiratory monitoring. It also keeps patients of pneumonia away from the hospital,” Whelan said.

It’s also dealt with cellulitis and more complex conditions like congestive cardiac failures.

“We’re gradually increasing the acuity of care. We’re starting with low non-complicated conditions; as we expand the system, we’ll have higher acuities of care,” said Whelan.

Members 18 years and older qualify for the programme, and the option is available under all Discovery Health plans with hospital benefit where there is a valid pre-authorisation in lieu of hospitalisation,” the company said.

The Discovery Hospital at Home programme is led by Dr Botho Mhoyza, the health scheme’s head of professional risk.

This is how the patient journey unfolds under Discovery’s Hospital at Home programme, from when they get admitted to what treatment is provided at home.

The Hospital at Home journey starts in the doctor’s room or at casualty, with the clinician deciding that the patient is eligible for at-home treatment. The patient will then have to confirm whether they have a suitable home environment to receive care.

virtual hospital
The clinician applies for the patient to be admitted to their home on Discovery's platforms. (Image: Ntando Thukwana/Business Insider South Africa)

The patient is admitted in a seamless process, where the clinician applies for at-home admission on behalf of the patient on one of Discovery’s monitoring platforms, Health ID. The doctor will then outline a treatment plan and submit a script for the patient. In addition, doctors can also apply for their patients via email or telephonically.

“If required, once we’ve had all the paperwork and approved the admission, we can then transport your patients via ambulance or a medical taxi service directly into the home," Mhoyza said.

Once admitted into the home, a dedicated home care nursing team is dispatched to the member’s house, and the medications, equipment, and devices required for the patient are brought to the home.

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The nurse arrives at the patient's home, gains consent and explains how the Hospital at Home programme works. (Image: Ntando Thukwana/Business Insider South Africa)

The registered nurse will then discuss the programme, gain consent from the patient and explain how they will engage with the care team.

“To supplement the engagement with the nurse and the patient, we have developed a patient and caregiver welcome pack. It articulates the whole Hospital at Home experience to the patient. It documents who the care team is, how to contact us, what to expect from the admission, [and] what type of services we’ll be able to bring for you,” Mhoyza said.

The team then does a medical reconciliation with the patients, making them aware of when and how to take their medications.

The nurse then sets up an Everion wearable device, developed by global digital healthcare solutions company, Biofourmis. The digital device gets wrapped around the patient’s arm and can transmit the patient’s vital signs to a dashboard in a 24-hour clinical command centre.

virtual hospital
The nurse will wrap the Biofourmis digital device around the patient's arm. (Image: Ntando Thukwana/Business Insider South Africa)
virtual hospital
The nurse will wrap the Biofourmis digital device around the patient's arm. (Image: Ntando Thukwana/Business Insider South Africa)
virtual hospital
The Biofourmis wearable device is able to pick up up to 22 signs of physiological distress. (Image: Ntando Thukwana/Business Insider South Africa)

The device enables a real-time view of the member’s health status with up to 22 physiological signs.

“To supplement this wearable biosensor, we have powerful dashboards, which enable our care teams to monitor our patients 24 hours a day, real-time, and react to those alerts. Should a patient’s vital signs be out of range, there will be an audible alert on the dashboard,” she said.

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The dashboard, situated in a 24 hour monitored command centre, communicates the health status of the patients. (Image: Ntando Thukwana/Business Insider South Africa)

If an alert sounds, the team “will immediately reach out to the patient, so you’re able to have a video chat with the patient and ascertain if the patient is clinically stable,” and if any issues of concern present, care is quickly escalated.

“We have powerful AI analytics powering this dashboard… [it] is continuously risk stratifying patients, bringing to the forefront those patients that we should be concerned about. They’re able to pick up very subtle physiological signs of distress, way before us as clinicians will be able to pick it up, and even before the patient becomes unwell,” said Mhoyza.

Each patient is provided with a companion device, a Samsung smartphone loaded with a sim card and data.

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The companion Samsung smartphone is loaded with a sim card and data. (Image: Ntando Thukwana/Business Insider South Africa)
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The companion device given to patients allows them to also acknowledge that they are taking their medication. (Image: Ntando Thukwana/Business Insider South Africa)

“This device enables real-time communication between the patient and any member of the care team. Additionally, it’s important because it engages the patients, [and] they’re able to acknowledge they’ve taken their medications. We can send reminders, [and] questionnaires to ask the patient how they’re doing,” said Mhoyza.

The company has contracted emergency service providers who know how many patients are admitted to their homes and where they are located. If care needs to be escalated, they transport the patient to a traditional hospital.

Patients receive daily home care nurse visits, and physician consults to track progress. The patient gets daily treatment from a physiotherapist and is supported with a daily meal delivery service where appropriate.

The patient is then discharged from Hospital at Home if they respond well to their treatment, and the nurse then assists with the delivery of take-home medicines and discharge planning services. Discovery will arrange for a pick-up of the Samsung device once discharge has been finalised.

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