Opportunity

Inpatient and emergency department (ED) bed capacity is strained at many hospitals, partly because there aren’t alternatives to care for patients who need admission-level care. That bottleneck can lead to long ED waits and delays getting patients to the right level of care.  

Hospital-at-home programs aim to “bring the hospital to the patient,” delivering hospital-level services safely in the home while improving flow across the health system. Published comparisons suggest care at home can be both safer and more comfortable: such programs have been linked with fewer medical complications, shorter hospitalizations, and higher patient satisfaction. They can also reduce avoidable testing, imaging, and consults.  

At Penn Medicine, CHTI previously collaborated on a program called PATH to provide acute care in home settings – a forerunner of Hospital at Home but more limited in scope of services. During a nine-month pilot from 2024 to 2025, PATH had a hospital admission rate below 10 percent, had no unexpected mortalities, and saved around 350 hospital days, supporting the case that this model can expand capacity while maintaining high-quality care. 

Intervention

Hospital at Home is a safe, patient-centered alternative to traditional inpatient care in which Penn Medicine provides high-quality acute in the patient’s home. Here’s how it works: 

When a patient who is hospitalized or has been evaluated in the ED is identified a candidate for the program, a nurse navigator works with the patient, their care team, and their family to determine whether Hospital at Home is a good fit based on both their clinical disposition and home environment suitability. If so, and the patient decides to enroll, the patient is transported home and is met by a nurse who will set up the patient for the stay.  

During at-home hospitalization, patients receive care through twice daily in-person nursing visits, daily virtual calls with the overseeing physician, and 24/7 remote monitoring of vitals. Hospital services such as labs, X-rays, IV medication, physical therapy, pharmacy, and meals are provided in the home, and a virtual “call button” is always available. Rapid care escalation pathways are in place to ensure additional care is provided when needed. 

Finally, the patient is discharged and set up with a care plan in coordination with their primary care physician.

Impact

Hospital at Home launched in April 2026 at the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center for adult patients with a limited set of clinical conditions. Once the program is established, we intend to expand Hospital at Home to more Penn Medicine hospitals and a wider set of conditions.