To use resources more efficiently and improve the treatment of patients who do not require long-term hospitalization, the Riga East Clinical University Hospital (East Hospital) has launched an innovative pilot project called “Hospital at Home.” The aim is to provide necessary treatment and care in a home environment while maintaining the highest standards of medical care. Currently, procurements needed to implement the project are underway, ensuring the required IT infrastructure and competencies. Additionally, vacancies for medical staff are being announced for positions within the project. The pilot is expected to provide services to 300 patients, and its results will show whether such a model is cost-effective and acceptable to the Latvian population.
“Hospital at Home” is an innovative healthcare service that allows patients to receive high-quality and effective care in a familiar, comfortable setting, reducing the stress and discomfort often associated with hospital stays, while maintaining optimal medical quality and outcomes. The pilot project at East Hospital will offer treatment, care, and medical supervision to patients with chronic conditions who are at increased risk of rehospitalization. It will also be suitable for treating acute but stable patients at home in cases where effective treatment guidelines are available. The implementation of the Hospital at Home concept will include remote monitoring of patients’ health and 24/7 communication using digital tools and certified medical devices. In special cases, in-person visits from doctors or nurses to the patient's home will also be available.
This concept has been successfully implemented in Scandinavian countries, the U.S., Canada, and elsewhere—particularly during the COVID-19 pandemic—demonstrating how quality medical care can be delivered at home. Additionally, the growing integration of digital tools, artificial intelligence, and telemedicine in healthcare means that, as digital literacy increases, many patients would prefer to be treated at home if their overall health condition allows.
Dr. Rita Konstante, East Hospital’s expert in sustainability and development planning, explains that as life expectancy increases, the proportion of elderly individuals in the population is growing, along with the number of patients suffering from chronic diseases. This can put additional strain on the healthcare system and its budget, especially in situations where 24/7 access to healthcare services outside the hospital is limited, except for emergency medical services. This means that, in the near future, safe healthcare services that are equivalent in quality and outcomes to hospital care must be developed for certain patient groups.
“As Latvia’s largest hospital, we want to trial this project because our patient flow is very intense. The Emergency and Patient Admission Clinic is especially busy, admitting more than 250 patients per day on average. To use hospital resources more effectively and ease the burden on the clinic, we aim to identify patient groups who can be discharged earlier after stabilization and continue treatment at home, with the necessary medical supervision in place. This approach would allow us to optimize hospital capacity and improve the patient care process,” says Rita Konstante.
In practice, the Hospital at Home model in Latvia will work as follows: for example, a patient who needs regular monitoring of blood pressure will be discharged from the hospital. The patient will be given a specific medical device for taking measurements, medication if necessary, and an individual plan for reporting health data. The devices will be connected to a unified system: the hospital can monitor readings online, while the patient will use a special mobile app to submit data. Patients will be trained on how to use the devices and the app. No payment will be required for the equipment, but the patient contract will include clauses to prevent intentional damage. Doctors and nurses will be available to the patient around the clock. Communication will be possible via messaging, phone, or video call. Two medical teams—two nurses and two doctors—will take turns overseeing patient monitoring and treatment remotely. If needed, a team member can visit the patient at home.
One of the most critical factors for the success of the model is patient selection. For the pilot, it is expected to include patients with pulmonary diseases (e.g., chronic obstructive pulmonary disease), acute but stable patients from the Emergency Clinic who do not have life-threatening conditions but require health monitoring that can be done remotely, neurological patients with pain who have already been diagnosed and have a defined pain management plan, and chronic patients with cardiac issues (e.g., heart failure, blood pressure disorders). The service will be available to patients regardless of age.
Strict criteria will be defined for identifying suitable patients, minimizing potential risks such as complications or sudden deterioration. Patients must provide informed consent to receive care under this model. If successful, the service could be expanded to include patients with gynecological, urological, and other conditions.
“A report from Norway, covering 2018 to 2021 and reflecting data from various municipalities where patients were treated at home, shows that treatment quality is maintained, readmission rates decrease, and patient satisfaction increases,” says Rita Konstante.
The pilot will last 12 months: approximately six months for preparation, followed by six months of actual service provision—digital monitoring and home treatment of patients. The service will be provided to 300 patients in Riga.
The results of the pilot will show whether the model is truly cost-effective and acceptable to the people of Latvia. If successful, East Hospital may train regional hospitals in implementing the Hospital at Home model, sharing expertise and experience in organizing and providing the service.
The testing of the integrated healthcare model Hospital at Home is being carried out under the Recovery and Resilience Facility fund project No. 4.1.1.r.0/1/22/I/VM/001 “Development of Recommendations for Advancing Integrated Healthcare.”
