title: Scalable hospital at home with virtual physician visits: pilot study.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Advocate Health Care, 3075 Highland Pkwy, Ste 600, Downers Grove, IL 60515. E-mail: william.summerfelt@advocatehealth.com.
authors.forename: Wm Thomas
authors.initials: WT
authors.lastname: Summerfelt
authors.forename: Suela
authors.initials: S
authors.lastname: Sulo
authors.forename: Adriane
authors.initials: A
authors.lastname: Robinson
authors.forename: David
authors.initials: D
authors.lastname: Chess
authors.forename: Kate
authors.initials: K
authors.lastname: Catanzano
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D005240:Feasibility Studies; D005260:Female; D018575:Home Care Services, Hospital-Based / Q000458:organization & administration / Q000592:standards*; D006792:House Calls; D006801:Humans; D007087:Illinois; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods; D010043:Outcome and Process Assessment, Health Care; D010359:Patient Readmission / Q000706:statistics & numerical data; D061214:Patient Safety / Q000592:standards* / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D010865:Pilot Projects; D011446:Prospective Studies; D017216:Telemedicine / Q000379:methods / Q000592:standards*; D013997:Time Factors; D049269:Videoconferencing