The Acuity Pyramid: A New Framework for Remote Care

Remote care’s potential becomes clearer when we examine the "Acuity Pyramid," which organises care across three levels:

1. High-Acuity, Hospital-at-Home - Provides acute-level care in the home, including IV medication and daily clinical monitoring, typically as a substitute for hospitalisation.
2. Medium-Acuity, Virtual Wards (VW) - Patients at risk of readmission are closely monitored, enabling early intervention if their condition deteriorates.
3. Low-Acuity, Long-Term Care - Supports preventive care for chronic conditions through remote monitoring, medication optimization, and patient education. This level encourages self-management to prevent disease progression.

A key objective is to develop an integrated system that supports patients across all acuity levels, optimising resources while providing timely interventions at each stage.

Defining Hospital-at-Home vs. Virtual Wards vs. Long-Term Remote Patient Monitoring

While all three models deliver care outside the hospital, they serve distinct purposes. Hospital at Home aims to prevent hospitalisation by delivering acute care in a patient's home, reducing strain on hospital resources. Virtual Wards focus on post-discharge monitoring to prevent readmissions and detect clinical deterioration. For patients with chronic conditions, Long-Term Remote Patient Monitoring provides ongoing, non-acute monitoring to detect early signs of deterioration. Tools like wearable devices, patient-reported outcome measures (PROMs), and digital rehabilitation programs empower patients to take charge of their health, facilitating a proactive, rather than reactive, approach to care. However, the lines between these models are often blurred due to a lack of standardised definitions. This can lead to inconsistencies in care delivery and patient pathways.

Creating a Seamless Digital Health Ecosystem

Ortus-ihealth goal is to build a digital platform that seamlessly integrates all three models enabling patient transitions between levels as their needs change. This unified system enhances interoperability, linking with electronic health records (EHRs), patient education tools, and risk assessments for a holistic approach. Patients benefit from a seamless care continuum, remaining connected to each level of support throughout their journey.

Case Study: Heart Failure Management with Virtual Wards

A successful implementation of this model and Ortus-iHealth digital platform can be seen in heart failure management, where virtual asynchronous clinics have demonstrated impressive outcomes. By enabling remote monitoring and rapid medication adjustments, this approach improved patient satisfaction and reduced clinician time by 75%, with a 0% readmission rate at 30 days. This underscores the potential of virtual care to enhance quality and accessibility in high-demand scenarios.

Building a Patient-Centred Future

A connected remote care continuum empowers patients and providers alike, ensuring proactive, patient-centred support across all acuity levels. By integrating these models, healthcare systems can reduce hospitalisations, enhance patient satisfaction, and improve long-term health outcomes, transforming how and where care is delivered.