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Taking the

LONG VIEW

Why longitudinal care is the future of homecare—and of healthcare in general

By Hannah Wolfson

Healthcare has a new buzzword: longitudinal care. HomeCare asked Matthias Baumann, the AI Center of Excellence leader, sleep and respiratory care at Philips, to explain the turn toward longitudinal care and why homecare providers are well-positioned for it.

HOMECARE

Your focus is on longitudinal care—what does that mean, and how might it change how home medical equipment (HME) providers and home health agencies work with patients?

Baumann: Longitudinal care means looking beyond a single appointment or night of therapy to understand a patient’s health trends over time as well as their general quality of life. Clinicians and patients gain actionable insights on care from continuous monitoring of the patient’s condition. For example, with obstructive sleep apnea (OSA), that means connecting nighttime treatment data from monitoring devices with daytime performance, symptoms, quality of life and other health conditions. This empowers physicians with more information about their patients and enables them to treat their patients with more precision.

For HME providers and home health organizations, this could mean being more proactive in addressing patient care concerns and connecting them with the right treatment to improve their sleep therapy adherence and outcomes. Providers and care teams face a significant attrition rate in sleep therapy, but with longitudinal data, they could more easily identify early signs of adherence struggles. The goal is not simply to improve compliance metrics, but to help patients find the right therapy for them.

HOMECARE

Could you see homecare acting as a model for the larger healthcare ecosystem?

Baumann: HME and in-home care are well suited to longitudinal care because they show how treatment fits into a patient’s everyday life. Challenges that may not be visible during a clinical visit often emerge when patients begin using therapy at home.

Clinical and consumer connected devices, remote monitoring and patient support applications can help providers identify issues, inconsistent use or continued sleep disruption. Those insights help alert clinicians to issues and give them information they can act on more quickly than traditional in-person care.

For example, if a patient is struggling with consistently using their prescribed sleep therapy, they could use a coaching module to help them modify their day-to-day behaviors and improve their adherence. Through using a coaching module, the patient receives the timely, consistent care they need outside of just meeting with their clinician.

HOMECARE

Do you think Americans are ready to be under constant monitoring?

Baumann: Patients are increasingly comfortable using technology to understand their health, which we can see with the rise in popularity of consumer wearables. The data from 24/7 consumer wearable devices can provide crucial insights into a patient’s well-being and empower clinicians to make better-informed decisions.

In the case of OSA, consumer wearables can serve as an initial warning system, identifying warning signs and prompting physicians to use clinical monitoring to evaluate patients. While the strength in the data of consumer wearables varies, and is not on par with clinical monitoring devices, consumer wearables can still help illustrate how sleep therapies are impacting a patient’s quality of life, enabling better identification of therapy failures and comorbidities. Patients increasingly understand this monitoring not as surveillance, but as tools they can trust to provide insights on their overall health.

HOMECARE

How do you see AI changing the way care is provided short term and long term?

Baumann: In the short term, AI can help providers manage large patient populations more efficiently. Conversational AI can answer routine questions, provide basic education and triage patients, escalating more complex issues to a respiratory therapist, sleep technician or physician. AI can also analyze therapy data and identify patients at risk of discontinuing treatment, allowing providers to intervene earlier. This frees up care teams to focus on those with complex needs as well as other direct patient interactions, helping to improve clinical workload while maintaining the provider-patient relationship.

Over the longer term, phenotyping and endotyping, identifying patient trends at a population level and developing specific care pathways for patients with similar characteristics, could play a far greater role in patient care. AI-driven phenotyping can pick up on trends that physicians are not seeing and prompt earlier detection of conditions. With earlier detection can come earlier treatment, helping to improve patient outcomes.

HOMECARE

How do we ensure that both patients and providers are comfortable in the ethical usage of AI?

Baumann: Comfort begins with education and transparency. Providers need to understand what an AI tool does, how the algorithm has been validated and where its limitations lie. Patients need transparency about what data will be collected, how their data will be used and what the benefits will be to them for allowing that data to be shared with their care team.

The quality of the data is also key to establishing trust in AI for both patients and physicians. Clean, structured, organized patient data in one centralized place is essential to enable the actionable insights clinicians need to make confident care decisions. Poor data quality leads to poor AI outputs; high data quality can establish a strong foundation for accurate, actionable insights.

Additionally, AI should support, not replace, clinical judgment and the patient-care team relationship. Strong guardrails, clinical validation, privacy protections and human oversight are essential. Trust is built from relationships between humans, not chatbots. AI can enable physicians to spend more face time with their patients, foster trusted relationships, rather than taking time to combine disjointed data.

Ethical AI means using algorithms responsibly to augment human judgment while keeping patient safety, privacy and health outcomes at the center.

HOMECARE

Are there technologies or care approaches that you feel are much closer in reality than most people expect?

Baumann: As consumer wearables become more advanced in their ability to gather accurate data, they are increasingly able to contribute to longitudinal, medical-grade insights. Now, consumer wearables can serve as an initial warning system for conditions like OSA, prompting home sleep testing to evaluate their condition.

However, in the future, these consumer devices may be able to act as simplified diagnostic tools when paired with AI algorithms, potentially allowing clinicians to rule in and rule out sleep apnea without requiring home sleep testing. Notably, making this a reality will require Food and Drug Administration approvals and for data-sharing partnerships to be established.