Advancing a Virtual Home Hospital: a Blueprint for Development and Expansion

Background: The rising demand for hospitals has spurred increased interest in adopting virtual home hospital (VHH) care models. Development in this area often uses rigid research methods. This study describes a dynamic approach to constructing a VHH and outlines the progress over 5 years.

Methods: In 2018, a multicentre VHH was developed in Edmonton, Alberta, Canada, using an innovation lab approach, fostering collaboration among healthcare stakeholders for design, prototyping and testing. Over a 5-year period (2018-2022), the VHH underwent trial and adaptation using the Model for Improvement and the Dynamic Sustainability Framework, refining integrated care for a broader patient population. Within the VHH, patients received acute, hospital-level care at home, using technology, existing services and hospital and community personnel. Outcome measures included number of patient cohorts, staffing numbers, patients served, capacity and hospitals/health centres supported.

Results: Over 5 years, the VHH expanded from 2 to 15 staff members, from 14 to 25 physicians, from 45 to 870 total patients served, from 10- to 75-patient capacity and from serving 1 hospital to 6 hospitals and 1 health centre. The VHH advanced by transitioning from telehealth to digital remote patient monitoring, involving additional community partners, extending operating hours, diversifying admission and referral pathways and improving patient monitoring.

Conclusion: A VHH has the potential to bridge the gap between hospital and community care and to become a permanent healthcare delivery model that supports continuity of patient care.