Scalable hospital at home with virtual physician visits: pilot study

Am J Manag Care. 2015 Oct;21(10):675-84.

Abstract

Objectives: To evaluate the safety, feasibility, and efficacy of a substitutive Hospital at Home (HaH) model where physician care was provided via 2-way biometrically enhanced tele-video for a 34-day care episode.

Study design: Prospective, nonrandomized, quasi-experiment.

Methods: Using medical record and patient survey data, we compared patients cared for in HaH (n = 50) versus the traditional acute care hospital (n = 52).

Results: Patients in HaH had substantial contact with the HaH physician, as well as in-person visits with nurse practitioners and other care providers. HaH patients were more satisfied with their care in multiple domains and met illness-specific quality standards at similar rates to hospital comparison patients. Functional outcomes were notable for a trend toward improvements in activities of daily living among HaH patients. Compared with hospital patients at 90 days after discharge, HaH patients were less likely to experience a hospital readmission (adjusted odds ratio, 0.39; 95% CI, 0.21-0.72).

Conclusions: This pilot study suggests that a scalable substitutive model of HaH using biometrically enhanced 2-way tele-video, virtual physician visits, and caring for patients over a 34-day episode is safe, feasible, highly satisfactory, and may be associated with substantial reductions in hospital readmissions.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Adult
  • Aged
  • Aged, 80 and over
  • Analysis of Variance
  • Feasibility Studies
  • Female
  • Home Care Services, Hospital-Based / organization & administration
  • Home Care Services, Hospital-Based / standards*
  • House Calls
  • Humans
  • Illinois
  • Inpatients*
  • Male
  • Middle Aged
  • Monitoring, Physiologic / instrumentation
  • Monitoring, Physiologic / methods
  • Outcome and Process Assessment, Health Care
  • Patient Readmission / statistics & numerical data
  • Patient Safety / standards*
  • Patient Safety / statistics & numerical data
  • Patient Satisfaction*
  • Pilot Projects
  • Prospective Studies
  • Telemedicine / methods
  • Telemedicine / standards*
  • Time Factors
  • Videoconferencing