AUTHOR=Denecke Kerstin , May Richard , Borycki Elizabeth M. , Kushniruk Andre W. 

TITLE=Digital health as an enabler for hospital@home: A rising trend or just a vision?

JOURNAL=Frontiers in Public Health

VOLUME=Volume 11 - 2023

YEAR=2023

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2023.1137798

DOI=10.3389/fpubh.2023.1137798

ISSN=2296-2565

ABSTRACT=Abstract
Background: Hospital@home is a model of healthcare, where healthcare professionals actively treat patients in their home for conditions that may otherwise require hospitalization. Similar models of care have been implemented in jurisdictions around the world over the past few years. However, there are new developments in health informatics including digital health and participatory health informatics that may have an impact on hospital@home approaches.
Objectives: 
1.	To identify the current state of implementation of emerging concepts into the hospital@home research and models of care.
2.	To identify strengths and weaknesses, opportunities and threats associated with the models of care.
3.	To suggest a research agenda.
Methods: We employed two research methodologies, namely a literature review and a SWOT analysis (strengths, weaknesses, opportunities and threats). Literature from the last 10 years was collected from PubMed using the search string "hospital at home" OR "care at home" OR "patient at home". From the included papers, relevant information was extracted. 
Results: Title and abstract review was conducted on 1371 papers.  Full text review was conducted on 82 papers.  Data were extracted from 42 papers that met our review criteria. Most of the studies originated from the U.S. and Spain. Several medical conditions were considered. Use of digital tools and technologies was rarely reported. In particular innovative approaches such as wearables or sensor technologies were rarely used. The current landscape of hospital@home models of care simply delivers hospital care in the patient’s home. Tools or approaches from taking a participatory health informatics design approach involving a range of stakeholders (such as patients and their caregivers), were not reported in the literature reviewed. In addition, emerging technologies supporting mobile health applications, wearable technologies and remote monitoring were rarely discussed.  
Conclusion: There are multiple benefits and opportunities associated with hospital@home implementations.  There are also threats and weaknesses associated with the use of this model of care. Some weaknesses could be addressed by using digital health and wearable technologies to support patient monitoring and treatment at home. Employing a participatory health informatics approach to design and implementation could help to ensure the acceptance of such care models.