Hospitals are moving into private homes – are homes and patients ready?

The article discusses the increasing trend of shifting healthcare, particularly hospital care, to the home environment in response to rising costs, healthcare worker shortages, and patient preferences. This model, known as Hospitals in the Home (HiTH), extends beyond traditional home healthcare by incorporating diagnostic, clinical, and monitoring tasks into domestic settings.

The adoption of HiTH is driven by factors such as cost reduction, decreased readmission rates, and improved patient outcomes. Convenience plays a significant role, as patients find it burdensome to visit doctor's offices, especially those with mobility challenges. The availability of affordable digital healthcare innovations and telemedicine further facilitates remote patient care.

However, the article highlights three critical aspects to consider in the transition to HiTH: ensuring social and health equity, safeguarding the privacy and sanctity of the home, and addressing physical and design challenges within existing living spaces.

Equity concerns arise from the digital divide, where access to digital tools and a reliable internet connection becomes crucial for HiTH participation. The article discusses the risk of creating inequalities in healthcare access, especially for socioeconomically disadvantaged individuals.

Preserving the privacy and sanctity of the home is emphasized, acknowledging that the home is a place of stability, tranquility, and privacy. The article suggests that introducing medical procedures and equipment into the home environment may disrupt patients' and caregivers' autonomy and privacy, impacting family dynamics.

The discussion also includes architectural and design challenges associated with HiTH implementation. The integration of diagnostic, rehabilitation, and monitoring devices into homes may lead to clutter and pose mental health challenges. Cooperation with experts outside the medical field, such as psychologists, architects, and designers, is deemed essential to optimize spatial design and maintain the dignity of the home.

To address these challenges and ensure the success of HiTH, the article proposes a set of guidelines. These guidelines cover topics such as patient population considerations, selection of hardware and digital solutions, staff training, patient education, preserving the sanctity of the home, and preparing the home as a place of healing.

In conclusion, while the HiTH model offers numerous benefits, careful attention must be given to the aforementioned aspects to achieve a sustainable and equitable healthcare delivery system in the home. The article encourages collaborative efforts with stakeholders and provides a set of guidelines as a foundation for the implementation of HiTH services.