Ambulatory In-Home Services in the US Healthcare System : A Case Study in Adoption of the Mobile Integrated Health Program

Abstract: Overcrowded emergency departments (EDs) are a critical problem in healthcare, and emerging technology presents new solutions to this problem. One solution is ambulatory in-home services, like Mobile Integrated Health (MIH) programs, offering care to patients inside of their homes using telehealth technology. For an ambulatory in-home service to cross the chasm and be accepted by a larger population, two aspects have to be investigated and developed for an earlystage implementation: 1) The product offering, and 2) stakeholder attraction. A case of a newly developed MIH program has been studied with the purpose to understand what aspects should be prioritized in the development of an ambulatory in-home service, such as the MIH program. Firstly, the product offering should have a niche approach using early triaging, to ensure that its selling promise gets fulfilled. Secondly, the generic product should consist of basic services that can be expanded after the service has proven trialability. However, the potential of the product should be researched and presented to the management with a realistic selling promise commitment. Lastly, the complexity, mostly associated with administrative tasks, should be minimized. To further increase the adoption rate, knowledge exchange with other programs should be utilized. Moreover, the study shows evidence that both patients and providers have a high satisfaction associated with ambulatory in-home services, and that they have a relative advantage in comparison to an ED visit. The diffusion will mostly be through word-of-mouth, making the product offering even more important. To achieve maximum diffusion the patients and providers have to know that the service is available to other individuals in their social system. During the early stages of adoption, external influence will also play an important role in creating awareness. Moreover, loyalty and continuous use of the service have to be promoted.