CareRooms: the perils of “Silicon Valley hype” when your customer is the NHS

A cautionary tale of an innovator likely sidelined due to clumsy press talk. The NHS has a problem called bed blocking, where post-acute care patients cannot return home because no one is there to care for them. It was up 40 percent last year. One approach to it has been home/community care combined longer term with telehealth services to reduce unneeded re-admissions. Another is freeing up the bed by placing a patient who does not need direct nursing care in a supervised post-acute room in a setting which provides assistance services.

In the US, many large hospitals and clinics run or partner with hotel-like annexes for recovering patients, usually post-surgical, who need assistance but not direct nursing care or special medical monitoring. The patient remains overnight or for a few days, with or without a private duty nurse, until the person can be discharged to travel home. These recovery centers/hotels, plain to plush, are popular in ‘medical tourism’ cities such as Miami, Houston, and New York, but well-used by locals for many procedures including orthopedic and cosmetic surgery recovery. Regular hotels have also gotten into this act with special services marketed to surgical practices. Recovery hotels and services may or may not be covered by insurance as they are part of hospital or practice referral. 

CareRooms’ approach is closer to ‘Airbnb for post-surgical discharge care’. Here this startup, according to its website, arranges rooms in private homes for a fee, equips them appropriately, and the lessor can earn £50/night. The host stays on the premises, microwaves meals and serves drinks, and can be sociable. Other care is provided by CareRooms. The idea is simple, eminently pitchable, and may actually address this NHS problem usefully if supervised properly. The co-founder and medical director of CareRooms, Harry Thirkettle, is a part-time A&E registrar at Southend and was mentored in the NHS Clinical Entrepreneur program; the other co-founder was a program mentor. 

And therein lies the catch. The service has not been in trials yet, and here they are offering room lessors without care training £50/night right on the website, which gives the impression that this service is readily available (wrong). How do they provide their ‘other care’ and what is it? How do they equip the room? Recruit and train hosts? How will they scale three rooms to 30 and then 300? And payment–covered or private? All those problematic, unglamorous and sobering things founders learn in early days haven’t been experienced yet. (more…)

The ‘right package of care’ sought for ‘bed-blockers’, home care (UK/US)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /]’Bed-blocking’ as a signal failure of transitional care. Here is a term that may be unique to the UK, but not the problem: older people who cannot be discharged after an illness because there is no plan and no suitable place for transitional care and/or a safe return home with care. According to the Guardian, the term originated among UK healthcare managers and economists as early as the late 1950s as a marker of system inefficiency. The writer, Johnny Marshall, director of policy for the NHS Confederation, correctly notes that it should be a marker of “(a) system that has failed to move quickly enough to put together the right package of care to enable the person in the bed to return home” and that unfairly blames the patient. He gives examples of programs across Britain with home assessment and care, particularly for older people post-fall injury, that reduce or eliminate hospital days.

In the US, transitional care is pointing to a blend of home care tech/services. Some of the indicators for LTC support that Laurie Orlov points out in Tech-enabled home care — what is it, what should it be?

  • Assisted living growth is flat as this past weekend’s open can of soda–housing is chasing residents (though cost doesn’t seem to be following the usual supply/demand curve), the average resident is 87 years old and staying 22 months, and their net worth can’t afford present AL
  • There’s a huge and growing shortage of home care workers for an ever-increasing number of old and old-old
  • Yet finally big investment is taking place in tech-facilitated home care locating and matching: Honor.com, Care.com and ClearCare–a total of just under $150 million for the three

But can technology–front and back end–make up for the human shortage? And there’s a value in wearing the Quantitative Self hat here. (more…)