DESIGNING AND TESTING A RURAL HOME HOSPITAL MODEL

There is a critical need for better access to acute care in rural America. One in five Americans live in rural areas, yet nearly 80% of these areas are medically underserved. Since 2018, we have been creating new pathways to bring hospital-level care to rural Americans.

Our Rural Home Hospital model combines the people, technology, and workflows needed to bring safe, high-quality care to patients right in their homes. Early pilot testing showed that the model was feasible to implement and that it was acceptable to both patients and clinicians. The model was recently tested in a randomized controlled trial; results are forthcoming.

By bringing care to patients where they are, we are making care more equitable and accessible for all.

Designing a Rural Home Hospital Model

How it Works

Under our care model, patients receive twice daily, in-home visits from a trained clinician. Patients have 24/7 access to their care teams, and are continuously monitored using remote technology.

Once the course of care is finished, the patient is “discharged.”

1. A patient presents to the hospital with a health concern and is admitted.
2. They’re screened for eligibility and offered the opportunity to return home and receive the remainder of their care at home rather than in the hospital.
3. A specially-trained clinician visits them twice daily at home and uses portable, internet-connected diagnostic tools to take vital signs and perform diagnostic tests. Results are transmitted in real time to a physician at the hospital.
4. The in-home clinician uses video technology to remotely connect with the physician, who guides a medical exam and speaks with the patient about diagnosis, treatment, and follow-up.
5. Once the course of care is finished, the patient is “discharged.”

Testing the Model 

Randomized Controlled Trial

We completed the first-ever international randomized controlled trial of rural home hospital. Ariadne Labs partnered with the Thompson Family Foundation and three health system, Blessing Health System of Quincy, Illinois, Appalachian Regional Healthcare, which serves areas of Kentucky and West Virginia, and Wetaskiwin Community Health Centre, Alberta Health Services in Canada, to build, launch, and evaluate rural home hospital programs. 

Development of the model began in 2018 with funding from an Ariadne Labs Spark Grant. In collaboration with University of Utah Health, the Ariadne Labs team tested the model through mock admissions with patient actors, followed by a feasibility pilot study involving real patients to provide a proof of concept before launching the RCT. 

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