Digital Considerations for Designing Hospital in the Home Services

Hospital in the Home (HITH) is an established model of healthcare delivery, providing hospital-level care outside the traditional inpatient setting. Care may be delivered in a patient’s home or another appropriate setting, with clinicians providing face-to-face care alongside virtual care and remote monitoring where appropriate.

Taking hospital care beyond the ward changes the environment in which the service operates.

Within a hospital, patients, clinical teams and many of the activities involved in an episode of care are organised around a defined setting. HITH can extend those activities across different locations, teams and modes of care.

For health services, the digital challenge is how to maintain a coordinated view of the patient journey and the activity around it as care moves across those settings.

Different pathways need different workflows

HITH services can support a range of clinical conditions and care pathways.

The assessments, clinical reviews, scheduled visits, communications and follow-up required can vary between patient cohorts and models of care.

Digital care pathways can help organise these different requirements. A pathway can define the activities that need to occur throughout an episode of care, including assessments, tasks, scheduled interactions, patient questionnaires and communications.

For health services supporting multiple HITH pathways, this provides a way to configure workflows around different models of care while maintaining a consistent approach to how activity is coordinated.

Maintaining a view across the service

Once care is being delivered across different settings, teams need visibility beyond an individual clinical interaction.

Which patients require review today? Which visits are scheduled? What activities are outstanding? Have required assessments been completed? Has new information been received from a patient? What needs follow-up?

The answers may involve different clinicians, locations and systems.

A digital environment that brings patient pathways and service activity together can give teams a clearer view of what has happened, what is planned and what still requires attention.

Coordinating care across settings

A HITH episode may include face-to-face clinical care, virtual consultations, patient-reported information and remote monitoring, depending on the model and the needs of the patient.

Each interaction can affect what happens next.

A home visit may result in a new task or change to the care plan. A patient response may require clinical review. A virtual consultation may lead to follow-up from another member of the team. Remote observations may require assessment or escalation.

The challenge is keeping these activities connected around the patient pathway, so teams can understand what has happened, who is responsible for the next action and where the patient is in their care journey.

This is where digital workflows become particularly relevant to HITH. They provide structure around the activity taking place across different settings and modes of care, rather than treating each interaction as a separate process.

Patients also interact with the pathway

Delivering hospital-level care outside the ward can also change how patients receive information and participate in their care.

Depending on the pathway, patients may receive appointment information, care instructions, education or reminders. They may complete questionnaires, report symptoms or provide other information between clinical interactions.

Building appropriate patient interactions into the pathway means information provided by the patient can sit alongside the other activities involved in their care, rather than being managed as a separate process.

Virtual care and remote monitoring are part of the model

Virtual care and remote patient monitoring can support HITH alongside face-to-face clinical care. Their role will differ depending on the patient cohort, clinical pathway and service model.

Where they are used, they need to connect with the wider HITH workflow. A virtual consultation may need scheduling and follow-up. Remote observations need processes for review and response.

Virtual care and remote monitoring will not be relevant to every HITH pathway in the same way. Where they are used, the important consideration is how they connect with the wider service and its workflows.

Connecting with the existing clinical environment

HITH remains part of the health service, even when care is delivered in another setting.

Existing clinical systems therefore remain an important part of the digital environment. At the same time, HITH can introduce additional workflows involving mobile teams, patient-facing applications, virtual interactions and monitoring technologies.

Integration allows relevant information to move between systems and be available across different parts of the care journey. The Australian Digital Health Agency’s work on interoperability similarly emphasises the importance of making relevant health information available when and where it is needed to support connected care.

The digital foundations for HITH therefore need to support the way care is delivered outside the traditional inpatient setting while connecting with the broader clinical environment.

Supporting different models of HITH

HITH services vary in how they are structured and delivered, and their technology requirements will vary too.

Different pathways may require different combinations of clinical workflows, patient interaction, virtual care, remote monitoring and integration. What remains consistent is the need to coordinate the people, information and activity involved in delivering hospital-level care outside the traditional inpatient setting.

CareMonitor supports health services to bring these elements together within configurable digital care pathways that can reflect different HITH models and service requirements.

Clinicians can use CareMonitor across mobile and web applications to manage patient pathways, tasks, assessments and care activity across settings, while the CareMonitor Patient App supports patients to access information, complete questionnaires and provide information from home. Virtual care and remote patient monitoring can be incorporated where required, with device connectivity and integration supporting the flow of information across the wider clinical environment.

CareMonitor’s evolving AI capabilities also support clinical and operational workflows, including documentation, scheduling, task management and care coordination. By bringing these capabilities into the wider care workflow, health services can configure the platform around how their HITH services are designed and delivered.

Speak with our team about supporting Hospital in the Home delivery through remote patient monitoring, virtual care, patient communication and configurable care pathways.