Use of Passive Home Monitoring as a Way to Reduce Unnecessary Hospitalizations for Complex Care Individuals

Senior Whole Health, a wholly-owned subsidiary of Magellan Health, has a core mission of addressing the social and medical needs of individuals eligible for Medicare and Medicaid, with a special focus on putting services in place to allow elderly individuals to remain safely in their homes for as long as possible.

The average Senior Whole Health member is 76, female, has several chronic illnesses, and takes five or more medications. In spite of the fact that many members have home-based community services and regular nursing visits, a majority of the admissions for hospital and emergency department care are unexpected. While it is not feasible for all high-risk members to have a daily evaluation by a clinician, Senior Whole Health is implementing a program of passive home monitoring for select high-risk members allowing for early detection of changes in behavior that identify when an individual is at risk for hospitalization. With prompt interventions by clinical staff, trips to the Emergency Department and/or Hospital can be averted.

The program being used by Senior Whole Health is called Lively® Home, a GreatCall product offering. With advance permission of the member and their family, a suite of 10 passive sensors is installed in the home. Activities of daily living such as getting into and out of bed, using the toilet and opening the refrigerator are monitored, allowing for a normal pattern of activity for an individual to be modeled. In the event that the individual’s behavior pattern changes (such as staying in bed much longer than usual or using the refrigerator much less than usual), an alert is sent to clinical staff, allowing for a wellness call to the member to check on their status. Often a medical condition can be identified and treated in the outpatient setting, avoiding more serious outcomes including hospitalizations and/or premature nursing home admissions.

Seniors have listed losing independence as among their greatest fears of aging. The use of passive monitoring technology such as Lively® Home along with direct in-person support services is expected to further extend the ability of high-risk Magellan Health members to live safely and independently as long as possible at home.