By Dana Yaffe, PhD, Director of Clinical Research, MDClone
LinkedIn: Dana Yaffe, PhD
LinkedIn: MDClone
The rapid growth of the global population has led to an increasing strain on healthcare systems, with hospitals facing overcrowding and limited capacity to accommodate the rising number of patients. This surge in demand for medical care necessitates a transformative approach to healthcare delivery.
To this end, many health systems have explored the “virtual hospital” model, in which providers move beyond conventional models of telehealth to deliver hospital-grade care to populations of high-acuity patients in their homes.
Some virtual hospitals provide an enhanced, digitally enabled at-home alternative to emergency or inpatient acute care and offer the potential to unlock hospital beds and improve the patient experience and equitable access to care, according to a report from McKinsey & Company.
At Sheba Medical Center, Israel’s first virtual hospital emerged from the lessons learned during the Covid-19 pandemic when outpatient clinics were converted to isolation wards and telemedicine techniques were implemented to minimize physical contact. While telemedicine wasn’t new, the “care without an address” concept and the virtual hospital took people, process, and technology to an enhanced level.
Critical to this effort was a self-service data platform that empowers Sheba’s end users with synthetic data capabilities as well as real-world data for exploring hypotheses and tracking process improvement initiatives. With the self-service platform, Sheba performed important preparatory work to learn the market to establish the stages of development for its telemedicine services.
Overcoming virtual care challenges
Sheba, which is the largest hospital in Israel, designed its virtual hospital model to support unique programs that are the first of their kind in the country, with the goal of surpassing the limits and expectations associated with traditional telemedicine services.
The program provides patients with at-home hospitalization, psychiatric home hospitalization, customized with remote rehabilitation programs, home cardiac rehabilitation, high-risk maternal fetal telemedicine monitoring, diabetes management, remote patient monitoring (RPM) devices supporting algorithms for detecting physiological activity, and more.
Initiating Sheba’s virtual hospital program involved multifaceted challenges. For example, regulatory compliance was paramount, encompassing licensing, privacy laws, and data protection. Technological hurdles included creating user-friendly interfaces, ensuring interoperability, and maintaining robust security. Financial considerations spanned revenue models, payer acceptance, and cost management. Accessibility challenges arose from the digital divide and equity concerns. Additionally, driving adoption necessitated overcoming provider resistance and addressing patient hesitancy.
Sheba overcame these challenges by implementing several key measures, including:
Ensuring technological excellence: Sheba has established a rigorous process involving technical experts who meticulously evaluate each technology’s integrity, privacy safeguards, and cloud usage.
Enhancing adoption and trust: To address adoption challenges and skepticism among providers and patients, Sheba employed a multifaceted approach. A key component was a change management program that increased awareness with webinars and meetings within the hospital and with patients and their caregivers.
Maintaining quality and safety: Before any new service or pilot program is launched, everything must be meticulously reviewed and approved by a quality and safety committee, which ensures the highest standards are upheld.
Enhancing attractiveness towards payers: In order to develop telemedicine services that are needed by payers, Sheba has begun a process of dialogue with payers about their needs that also exposes them to the virtual hospital program’s capabilities.
Additionally, the justification for new virtual care services is supported by data generated from the self-service platform that offers data exploration options. By providing access to synthetic data and real-world data, the platform enables teams to look for care delivery models that provide the best care practices based on the needs of the population. For example, team members can create queries to assess how many patients will benefit from receiving immunotherapy at home, and consequently, how the new model will impact the workforce, the supply chain, and the payer group. This type of data allows Sheba visibility to market research so that leaders can base decisions on new services on areas of need and benefit.
The results
In the first quarter of 2024, Sheba facilitated nearly 24,000 telemedicine visits, demonstrating the growing impact of virtual care. For example, as a result of maternal fetal virtual care, over 50 high-risk pregnant women have benefited from a transformative antepartum high-risk admission. The hybrid admission program serves women with severe pregnancy complications such as pre-eclampsia and fetal growth restriction and has reached more than 650 admission days of intense remote care, in part by leveraging state-of-the-art technologies such as remote fetal monitoring and remote fetal Ultrasound.
The program promotes inclusivity, even reaching ultra-Orthodox Jewish women who used smartphones for the first time to enroll to this service. Remarkably, there have been no severe adverse events reported with maternal fetal health home monitoring. Only one case of non-compliance occurred, without clinical consequences.
Sheba’s virtual care model has matured over time, greatly due to necessity during the Covid-19 pandemic and has evolved into a transformative force in healthcare. The strategic use of data, including real-world insights, informs decision-making and drives innovation. By offering at-home hospitalization, psychiatric care, cardiac rehabilitation, maternal fetal telemedicine, and more, this “care without an address” approach redefines the patient experience.