Why Improving Digital Literacy Is Crucial
Dallas-based Parkland Health is one of the largest public hospital systems in the country. Its at-home acute care program, launched in 2022, has already reached a major milestone.
“In a year and a half, we’ve created 1,214 additional bed days for the hospital,” says Alissa Tran, director of acute care at home for Parkland Hospital at Home.
Initially, Parkland Health staff screened patients manually for the at-home program, but quickly streamlined the intake process.
“We worked with the Epic team to develop screening tools to identify patients,” says Dr. Stephen Harder, medical director of Parkland Hospital at Home. “We look at the medical record in addition to their ZIP code, the payer mix and living conditions.”
Similar to UMass Memorial Health, Parkland Health cares for vulnerable populations, so the program takes patients’ specific needs into consideration.
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“Many of our patients live in digital deserts, where reliable and affordable internet is lacking and access to specific devices is problematic,” Tran says. “Some have relatively low digital literacy, which often coincides with lower health literacy. So, to really function, our program has to overcome those barriers.”
The program does this in a number of ways, from installing Wi-Fi in the home to providing simple tablet devices that are “as easy to use as a phone,” Tran says. Staff members provide training on the devices, particularly the tablets that patients use to connect with their care team.
“We’re educating our patients once or twice daily on how to use the device, how to answer video visits or initiate video visits. This may be the first time they’ve done that,” Tran says.
Working with patients inside their homes helps identify other problems that can improve quality of life. In one experience, Harder says, a care team that was managing a patient with multiple chronic conditions identified that he should get a special lift to help him get in and out of bed, and they worked with him to obtain that equipment.
“That one change probably saved about 30 hospital days,” Harder says. “He’s now able to go home and spend time with his kids instead of being in a hospital bed.”
Providers Gain Much-Needed Insight to support Holistic Health
On the West Coast, Dr. Vivian Reyes, an emergency room physician by training, initially wasn’t convinced that acute care at home was effective for patients. As her role expanded to include strategic operations at Kaiser Permanente in Northern California, her viewpoint changed.
“I was involved in several large-scale projects that enhanced the patient experience in the hospital space. My involvement moved my eye toward the hospital-at-home concept as we recognized that, not just at Kaiser Permanente but across the country, patients were getting sicker, their care needs were more complex and they wanted more on-demand care. They wanted to get care in their home,” says Reyes, who is now the national physician lead for Kaiser Permanente Care at Home.
After a small pilot program, Kaiser partnered with Medically Home to provide the operational and technology infrastructure to build an at-home acute care program. Patients receive biometric tools and an easy-to-use tablet. Cradlepoint hardware provides connectivity, if needed.
