Home is Where Health Is

By Dr. Michael Aragon

If we bank, shop, work, play, and socialize from home, why can’t we also receive our healthcare where we live? Now, with advanced technologies and flexible care delivery options, this option is becoming a reality.

Home healthcare, a $336 billion global industry in 2021, is projected to grow at an 8% combined annual rate through 2030.

What is driving the trend? The pandemic, for one, an event that’s made it safer to stay home than risk virus exposure. Other factors are comfort, convenience, and the wide availability of emerging health tech such as heart rate monitors, glucose meters, breathing aids, and at-home tests.

Home healthcare can be more cost-effective than in-hospital care, saving patients as much as 30%. Providing patients care in the comfort of their own homes has prompted governments, private insurers and retail giants to support the trend. For example, Walgreens finalized its $330 million investment of CareCentrix for home healthcare options last year. Smartphone manufacturers such as Apple are adding new features for home health tracking, making it easier for users to track medications and add alerts for when it is time to take their medicine.

Increasingly, home is where health is, you might say.

Home dialysis makes sense

Home healthcare is getting more sophisticated everyday thanks to new technology and innovation. Dialysis for kidney patients is a great example. Although the blood-cleansing process has technically been possible at home for years, it has been exceedingly expensive and difficult to implement. In fact, of the 570,000 chronic dialysis patients in the U.S., only 2% are doing it. People of color, who have been disproportionately affected by end-stage renal disease (ESRD), have had even less access to home dialysis.

Because of the traditional complexity of dialysis, ESRD patients have typically traveled to clinics three or more times per week for scheduled four-hour sessions, making it challenging to maintain employment, spend time with family or enjoy something as simple as a birthday or holiday. COVID-19 further complicated in-clinic treatment by creating shortages of staff and dialysis-fluid (dialysate), which was hung up in disrupted supply chains.

Fortunately, dialysis technology has rapidly evolved in the past few years so that it is simpler than ever and a good fit for most patients to treat at home. We’ve driven a lot of that innovation. Outset Medical’s Tablo® Hemodialysis System requires only taps on a touchscreen versus dealing with dials and gauges; a standard electrical outlet; and tap water, which is automatically purified on demand, instead of bottled dialysate. The device is also connected to the cloud so that clinicians can remotely monitor multiple home hemodialysis patients.

Not only does the new technology help safeguard immunocompromised patients from crowded clinics, it offers physicians and patients the opportunity for more personalized treatment, including custom ultrafiltration rates, dialysis durations, and treatment frequencies. Equally important, home hemodialysis can restore precious independence, dignity, and time for patients to enjoy life instead of being forced to adhere to a clinics’ schedules and processes.

It is working now

Patients and clinicians appreciate this new technology as a breakthrough. In a recent survey of more than 200 U.S. dialysis patients with experience using our device, 77% said its features would make them more likely to try home hemodialysis. In a survey of 184 nephrologists, 98% said its features would make them more likely to recommend home hemodialysis to their patients.

Home hemodialysis is the future of kidney care, and home in general is the venue for a rapidly expanding range of treatments that have traditionally been delivered in hospitals or clinics. As regulators deem more treatment safe for the home, patients and providers can expect new convenience, comfort and cost-effectiveness.  

Dr. Michael Aragon is chief medical officer of Outset Medical.