Virtual Hospital
There are three types of Virtual Hospitals. The original virtual hospital model utilizes modern technology to deliver virtual house-calls to patients in remote locations from medical teams located at central locations. Often these centralized command centers are located in traditional hospitals. A second virtual hospital model uses the same connectivity approach to allow medical teams at hospitals to manage larger populations at permanent and temporary remote locations associated with the hospital. A third virtual hospital model taking shape in the United States is focused on delivering hospital-level care for high acuity patients in the safety and comfort of their own homes. These virtual hospitals are temporary hospitals delivered directly to the patient's home.
History
Virtual hospital, or hospital-at-home, models have been in place outside the U.S. for some time. In the last ten years they have become more prevalent with some form of virtual hospital in place at Johns Hopkins, Intermountain Health, Mercy Hospital, Mount Sinai, and the Medically Home Group in Boston. The virtual hospital model in the United States is largely credited to Dr. Bruce Allen Leff of Johns Hopkins University of Medicine. Dr. Leff introduced the concept of the hospital being delivered to the patient's home including all the technology, services, and clinicians associated with the patient's care. This novel approach to health care is known as patient-centric telehealth. In Boston, the Medically Home Group, Inc. has partnered with Atrius Health and VNA Care to deliver the world's first virtual hospital company. Operating statewide in Massachusetts and with additional locations on the West Coast, in the South, and in the Upper Midwest of the United States expected by 2021, Medically Home's virtual hospital model delivers patient-centric care for high acuity patients.
How Virtual Hospitals Work
Virtual Hospitals work by utilizing technology and personalized care to deliver high acuity patients, hospital-level care, in a remote setting. In the Medically Home virtual hospital model, the entire medical team is connected to the patient's home and a combination of remote patient monitoring, personalized care, and telemedicine provide for increased levels of comfort, improved healing times, lower risks to the patient, and lower expenses system-wide including to the patient, the hospital, and the payer. The three pieces of Medically Home's virtual hospital model are technology driven:
1. They transform the patient's home into a temporary hospital.
2. They connect the patient's virtual hospital bed with a clinical command center which coordinates the patient's care 24-7-365 from a team of doctors, nurse's, and nurse practitioners.
3. They implement a supply chain that includes a network of partners that use the technology to connect with the clinical command center and then deliver care, (physical therapy, occupational therapy, etc.), to the patient's home.
Benefits of the Virtual Hospital
The benefits of a virtual hospital model where all of the technology, services, and care are delivered to the patients home are many. For the patient they're in the comfort of their own home among familiar people and surroundings. That comfort translates into less anxiety, less delirium, fewer risk of falls and infections, and ultimately faster recovery times. Additionally, without the overhead of the brick and mortar hospital and with a faster recovery time comes lower expenses. The benefits to the clinicians are reestablishing the doctor/nurse-patient relationship, increasing frequency of contact, and improving access to care. Hospitals benefit from virtual hospital partners because each established bed in the home becomes a new "virtual hospital bed" allowing for swift growth of the hospital population without the capital expenditures of new construction.
Patient Experience
The patient experience with a patient-centric virtual hospital model begins with admission by their existing primary care physician. This often occurs upon discharge from a traditional hospital for a high acuity patient. Once approved, all of the technology is delivered to and set up in the patient's home as a temporary hospital. A robust network and backup system provides continuous patient monitoring while a supply chain of services and medications is coordinated through a clinical command center off site.
Influence on Virtual Hospital
The Virtual Hospital, also referred to as the "Hospital at Home" or "HaH", has an international body known as the [[World Hospital at Home Congress]] founded in 2019. The annual conference was launched in Madrid, Spain in April 2019 and featured Dr. Bruce Leff along with doctors, directors, and CEOs from virtual hospital though leaders from around the globe including Israel, Spain, and the United States. Brigham and Women's Hospital, Harvard Medical School, and Mount Sinai were among the groups that participated.