Analysis of the Virtual Acute Care at Home Experience

NCT05952999 | Enrolling By Invitation

• 1 other identifier: 2015255
• Study Type: observational
• Target: 9,654
• Locations: 1 country
• Sites: 1

Brief Summary

The purpose of this study is to examine the implementation, intervention effectiveness, and dissemination of a digital acute care delivery model for improving selected health outcomes in the Hospital at Home population.

Conditions

Conditions; Infections; Heart Failure; Renal and Urinary Disorders; Diabetes; Hypertension; Fever; Bronchitis; Asthma, Chronic Obstructive Pulmonary Disease (COPD)

Keywords

home hospital; hospital at home; hospital in the home

Outcome Measures

Primary Outcomes (4)

• Composite of all-cause mortality for patients admitted to digital hospital

  Total number of deaths over total number of patients admitted to the digital hospital.

  Up to 30 days, (date of death from any cause, whichever came first, assessed up to 30 days)

• 30-day readmission rate

  Number of 30-day readmissions as defined by Organization using preset criteria

  Up to 30 days (date of readmission from any cause, whichever came first, assessed up to 30 days)

• Patient Satisfaction at discharge

  1-item measure: I would recommend this \[insert program name\] to others, assessed at discharge name\] to others.

  up to 1 week

• Patient Perception of Digital Care at discharge

  Results of Digital Care - Likert Scale (very satisfied to very dissatisfied)

  up to 1 week

Secondary Outcomes (4)

• Escalations (for management and treatment of early decompensation)

  up to 2 weeks

• Unplanned readmission within 30-days of discharge

  up to 30 days

• Length of Stay

  assessed up to 2 weeks

• Number of participants with Hospital Acquired Infections

  assessed up to 1 week

Other Outcomes (9)

• Number of participants with discharge disposition at time of discharge as one other than home

  assessed up to 8 weeks

• Qualitative interviews

  through study completion, an average of 2 years

• Number of readmissions between discharge and during next 6 months.

  Up to 6 months (Re-admission from any cause, assessed up to 6 months)

Study Arms (2)

Hospital at Home Care

The population for this study includes adult patients who are acutely ill and presenting to the emergency room, and are discharged to their home for hospital-level care in the home setting. The patients in this cohort may also include those who are discharged from the hospital early, but receive hospital-level care in the home setting.

Other: Digital Care Solution as supportive personalized care

Traditional Hospital Care

The population for this study includes adult patients who are acutely ill and presenting to the emergency room who elect not to be discharged, choose to be cared for in the hospital setting.

Other: Traditional Hospital Level Care

Interventions

Digital Care Solution as supportive personalized care OTHER

Patients will need to meet screening and inclusion criteria at time of enrollment. As a pragmatic study, researchers will not determine criteria or management of care aspects for patients.

Also known as: Traditional Hospital Level Care

Hospital at Home Care

Traditional Hospital Level Care OTHER

Patients will be cared for in the inpatient setting for management of diseases that meet screening and inclusion criteria at time of enrollment for hospital at home. As a pragmatic study, researchers will not determine criteria or management of care aspects for patients.

Traditional Hospital Care

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population will consist of individuals who are receiving care in the hospital at home program and those who are hospitalized but choose to receive hospital care in the home setting after a short period in the hospital. All those enrolled in the Hospital at Home Program will be strategically identified and used as the population for the quantitative and qualitative portions of the study.

You may qualify if:

• Patients 18 years and older who are admitted into the Hospital at Home program after presenting to the emergency department or who are inpatients that can be cared at home for hospital level needs
• Patients meeting the hospital's criteria for admission by diagnosis type (e.g., heart failure, respiratory infections and inflammations, renal failure, diabetes, pneumonia, bronchitis, chronic obstructive pulmonary disease, fever and inflammatory conditions, viral illnesses, other disorders of the nervous system). Diagnoses are determined by clinicians not researchers.
• Patients will need to reside within 30 minutes' drive time from the hospital
• Age \>= 18 years old
• as capacity to consent to study
• Any member of the home hospital clinical team (a healthcare professional who providing care or equipment for use in the home) who will be participating in delivery of healthcare services,
• Any member of the hospital care teams, including the screening and recruitment of patients for the home hospital intervention and/or providing care to patients that enroll in the intervention that is provided
• Any member of the leadership team who are involved in the operational aspects of program delivery

You may not qualify if:

• Need for long-term facility level care or current residence in a facility of this type
• No one will be excluded on the basis of sex or race

Sponsors & Collaborators

• OSF Healthcare System: lead

Study Sites (1)

OSF HealthCare

Peoria, Illinois, 61602, United States

Location

Related Publications (11)

• Arsenault-Lapierre G, Henein M, Gaid D, Le Berre M, Gore G, Vedel I. Hospital-at-Home Interventions vs In-Hospital Stay for Patients With Chronic Disease Who Present to the Emergency Department: A Systematic Review and Meta-analysis. JAMA Netw Open. 2021 Jun 1;4(6):e2111568. doi: 10.1001/jamanetworkopen.2021.11568.

  PMID: 34100939 BACKGROUND

• Brody AA, Arbaje AI, DeCherrie LV, Federman AD, Leff B, Siu AL. Starting Up a Hospital at Home Program: Facilitators and Barriers to Implementation. J Am Geriatr Soc. 2019 Mar;67(3):588-595. doi: 10.1111/jgs.15782. Epub 2019 Feb 8.

  PMID: 30735244 BACKGROUND

• Chua CMS, Ko SQ, Lai YF, Lim YW, Shorey S. Perceptions of Hospital-at-Home Among Stakeholders: a Meta-synthesis. J Gen Intern Med. 2022 Feb;37(3):637-650. doi: 10.1007/s11606-021-07065-0. Epub 2021 Aug 6.

  PMID: 34363185 BACKGROUND

• Cooling M, Klein CJ, Pierce LM, Delinski N, Lotz A, Vozenilek JA. Access to Care: End-to-End Digital Response for COVID-19 Care Delivery. J Nurse Pract. 2022 Feb;18(2):232-235. doi: 10.1016/j.nurpra.2021.09.011. Epub 2021 Sep 25.

  PMID: 34608377 BACKGROUND

• Dismore LL, Echevarria C, van Wersch A, Gibson J, Bourke S. What are the positive drivers and potential barriers to implementation of hospital at home selected by low-risk DECAF score in the UK: a qualitative study embedded within a randomised controlled trial. BMJ Open. 2019 Apr 4;9(4):e026609. doi: 10.1136/bmjopen-2018-026609.

  PMID: 30948606 BACKGROUND

• Federman AD, Soones T, DeCherrie LV, Leff B, Siu AL. Association of a Bundled Hospital-at-Home and 30-Day Postacute Transitional Care Program With Clinical Outcomes and Patient Experiences. JAMA Intern Med. 2018 Aug 1;178(8):1033-1040. doi: 10.1001/jamainternmed.2018.2562.

  PMID: 29946693 BACKGROUND

• Leff B, Burton L, Mader SL, Naughton B, Burl J, Inouye SK, Greenough WB 3rd, Guido S, Langston C, Frick KD, Steinwachs D, Burton JR. Hospital at home: feasibility and outcomes of a program to provide hospital-level care at home for acutely ill older patients. Ann Intern Med. 2005 Dec 6;143(11):798-808. doi: 10.7326/0003-4819-143-11-200512060-00008.

  PMID: 16330791 BACKGROUND

• Savundranayagam MY, Montgomery RJ, Kosloski K. A dimensional analysis of caregiver burden among spouses and adult children. Gerontologist. 2011 Jun;51(3):321-31. doi: 10.1093/geront/gnq102. Epub 2010 Dec 6.

  PMID: 21135026 BACKGROUND

• Shelton RC, Chambers DA, Glasgow RE. An Extension of RE-AIM to Enhance Sustainability: Addressing Dynamic Context and Promoting Health Equity Over Time. Front Public Health. 2020 May 12;8:134. doi: 10.3389/fpubh.2020.00134. eCollection 2020.

  PMID: 32478025 BACKGROUND

• Yao X, Paulson M, Maniaci MJ, Dunn AN, Nelson CR, Behnken EM, Hart MS, Sangaralingham LR, Inselman SA, Lampman MA, Dunlay SM, Dowdy SC, Habermann EB. Effect of hospital-at-home vs. traditional brick-and-mortar hospital care in acutely ill adults: study protocol for a pragmatic randomized controlled trial. Trials. 2022 Jun 16;23(1):503. doi: 10.1186/s13063-022-06430-6.

  PMID: 35710450 BACKGROUND

• Dalstrom MD, Klein CJ, Rothrock-Magana M, Cooling M. Patient-Centered Care: A Qualitative Analysis of Patient and Caregiver Experiences in a Hospital at Home Program. J Patient Exp. 2025 Jun 2;12:23743735251347706. doi: 10.1177/23743735251347706. eCollection 2025.

  PMID: 40464036 DERIVED

MeSH Terms

Conditions

Disease; Infections; Heart Failure; Urologic Diseases; Diabetes Mellitus; Hypertension; Fever; Bronchitis; Asthma; Pulmonary Disease, Chronic Obstructive

Condition Hierarchy (Ancestors)

Pathologic Processes; Pathological Conditions, Signs and Symptoms; Heart Diseases; Cardiovascular Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Male Urogenital Diseases; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases; Vascular Diseases; Body Temperature Changes; Signs and Symptoms; Respiratory Tract Infections; Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Chronic Disease; Disease Attributes

Study Officials

• Colleen Klein, PhD, APRN

  OSF HealthCare

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Education & Research Scientist, Center for Advanced Practice, Principal Investigator

Study Record Dates

• First Submitted: June 28, 2023
• First Posted: July 19, 2023
• Study Start: August 15, 2023
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026
• Last Updated: March 17, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)