Analysis of the Virtual Acute Care at Home Experience

• Conditions: Conditions; Heart Failure; Fever; Diabetes; Hypertension; Bronchitis; Infections; Renal and Urinary Disorders; Asthma, Chronic Obstructive Pulmonary Disease (COPD)
• Interventions: Other: Digital Care Solution as supportive personalized care; Other: Traditional Hospital Level Care

• Registration Number: NCT05952999
• Lead Sponsor: OSF Healthcare System

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.

Detailed Description

The investigators will conduct a mixed-methods quasi-experimental research study that will explore the effectiveness of the Hospital at home programs using qualitative interviews and quantitative data as a means to also conduct a process evaluation related to the implementation and efficacy of Hospital at Home programs. The purpose of this pragmatic study is to inform scalability beyond the initial site for implementation within a large healthcare system with a diverse patient population located in various communities, including rural and urban locations.

Study Timeline

• Study First Submitted: 2023-06-28
• Study First Submitted QC: 2023-07-11
• Study First Posted: 2023-07-19
• Study Start: 2023-08-15
• Status Verified: 2025-04
• Last Update Submitted: 2025-04-25
• Last Update Posted: 2025-04-29
• Primary Completion: 2025-12-31
• Study Completion: 2026-12-31

Recruitment & Eligibility

• Status: ENROLLING_BY_INVITATION
• Sex: All
• Target Recruitment: 9654

Inclusion Criteria

• 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

Patient caregiver inclusion criteria: (not required for patient participation):

• Age >= 18 years old
• as capacity to consent to study

Clinician or stakeholder inclusion criteria:

• 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

Exclusion Criteria

• 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

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Hospital at Home Care	Digital Care Solution as supportive personalized 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.
Traditional Hospital Care	Traditional Hospital Level 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.

Primary Outcome Measures

Name	Time	Method
30-day readmission rate	Up to 30 days (date of readmission from any cause, whichever came first, assessed up to 30 days)	Number of 30-day readmissions as defined by Organization using preset criteria
Patient Satisfaction at discharge	up to 1 week	1-item measure: I would recommend this \[insert program name\] to others, assessed at discharge name\] to others.
Composite of all-cause mortality for patients admitted to digital hospital	Up to 30 days, (date of death from any cause, whichever came first, assessed up to 30 days)	Total number of deaths over total number of patients admitted to the digital hospital.
Patient Perception of Digital Care at discharge	up to 1 week	Results of Digital Care - Likert Scale (very satisfied to very dissatisfied)

Secondary Outcome Measures

Name	Time	Method
Unplanned readmission within 30-days of discharge	up to 30 days	Number of 30-day readmissions over total number of discharges
Length of Stay	assessed up to 2 weeks	Day of admission to day of discharge, assessed up to 2 months
Number of participants with Hospital Acquired Infections	assessed up to 1 week	Number of hospital acquired infections reported (CAUTI, CLABSI, etc.)
Escalations (for management and treatment of early decompensation)	up to 2 weeks	percentage of patients escalated over total hospital digital encounters

Trial Locations

Locations (1)

OSF HealthCare; 🇺🇸 Peoria, Illinois, United States