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SHIFT-Hospital@Home pilot study

Knowledge database Organisation Structures & processes Technology Data management & digitalisation Integration & interoperability Patient-centred approach B.3: Hospital @ Home - smooth transition of patients from hospital to home through the use of telemedicine and technology

In order to ensure seamless care after discharge from hospital and thus achieve increased safety, innovative approaches and treatment pathways are required that reorganise the distribution of tasks between outpatient doctors and the hospital. As part of the "Hospital@Home" pilot study, we are testing such a new type of treatment process.

Problem description, research question and relevance

The current problem is that there can be a discontinuity in medical care when transferring from hospital to the home environment, particularly at weekends and on public holidays. This is often a critical phase in the treatment process.

In the SHIFT-B3 "Hospital@Home" pilot study, innovative telemedical treatment processes are being demonstrated to counteract this problem. The primary research questions being investigated are the health status of patients and the satisfaction of patients and doctors involved (Study NCT05617560, Clinicaltrials.gov). The study procedure is as follows:

The people identified by the University Hospital Basel (USB) for treatment will be offered participation in the pilot study in consultation with their GPs after receiving detailed information. If they agree to participate in the study, relevant information will be transmitted from the USB to Medgate. Medgate's telemedicine-trained doctors will contact the participants no later than the day after they leave hospital and look after them during the critical phase after hospital discharge. They enquire about the patient's state of health, resolve any uncertainties, record vital signs, adjust treatment if necessary or refer the patient back to hospital if the condition deteriorates. Participants have the opportunity to contact Medgate at any time during the telemedical care if their health deteriorates or if they have important questions about their state of health. At the end of the telemedical care, the participants are returned to the care of their general practitioners, who are informed in writing about the progress of the telemedical treatment.

 

Figure 1: In our Hospital@Home model, patients are supported between hospital discharge and GP care via telemedicine established in the healthcare system.

Initial results and recommendations

With the completion of our pilot study at the end of 2024, we expect to gain insights into the feasibility of our Hospital@Home model, the quality of care and patient satisfaction. Observations to date show that patients who use this model should have a certain affinity for digital technology. Another crucial point is the smooth exchange of medical information between the participating medical providers from the inpatient, telemedicine and outpatient sectors. Initial feedback shows that the continuous support provided by telemedicine with 24/7 consultation options has been very well received. We report the study results promptly on this knowledge platform.

Literature and other sources

Healthcare concept work area (2024), Swiss Hospital at Home Society https://shahs.ch/arbeitsbereich-gesundheitskonzept/ (as of 2024, 16 May)


Hospital@Home: Telemedical Care After Inpatient Hospital Stay, NCT05617560 (2022, 15 Nov)
https://clinicaltrials.gov/study/NCT05617560 (as at 2024, 16 May)


Simon Koechlin: The hospital comes home, Schweiz Ärzteztg. 2024;105(1-2):16-19 https://saez.swisshealthweb.ch/de/article/doi/saez.2024.1253151792/


Harkey K, Kaiser N, Zhao J, et al. Utilisation of telemedicine to provide post-discharge care: A comparison of pre-pandemic vs. pandemic care. Am J Surg. 2023;226(2):163-169. doi:10.1016/j.amjsurg.2023.03.007


Lindenfeld Z, Berry C, Albert S, et al. Synchronous Home-Based Telemedicine for Primary Care: A Review. Medical Care Research and Review. 2023;80(1):3-15. doi:10.1177/10775587221093043

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