JMIR Publications

ABSTRACT

Background:

Hospital-at-home (HaH) programs supported by telemedicine and remote monitoring technologies are increasingly being adopted as alternatives to conventional hospitalization. Although clinical outcomes and patient satisfaction have been widely studied, less is known about healthcare professionals’ experiences in mature, digitally supported HaH models integrated into routine clinical practice.

Objective:

This study aimed to assess healthcare professionals’ perceptions of a mature digitally supported HaH program, focusing on usability, workload, organizational integration, perceived clinical impact, and overall satisfaction.

Methods:

We conducted a single-center cross-sectional study in the HaH unit of Infanta Leonor University Hospital (Madrid, Spain) between January and May 2025. All healthcare professionals assigned to the unit were invited to participate in an anonymous electronic survey composed of 14 Likert-scale items and 1 open-ended question. The items were designed to assess understanding of the program, perceived clinical impact, interaction with technology, workload, and overall evaluation. Nonparametric tests included Mann–Whitney U and Kruskal–Wallis tests. P values from each set of 14 item-level tests were adjusted separately using the Benjamini–Hochberg procedure.

Results:

A total of 30 professionals participated (response rate 63.8%), including physicians (43.3%), nurses (33.3%), and nursing assistants (23.3%). Overall perceptions of the digitally supported HaH model were generally favorable, particularly regarding perceived quality of care, perceived promotion of patient autonomy, and overall satisfaction. The most notable differences across professional roles appeared in items related to the perceived contribution of technology to quality of care (ε²=0.46, 95% CI 0.17-0.85), recommendation of the model (ε²=0.45, 95% CI 0.14-0.85), and perceived promotion of patient autonomy (ε²=0.41, 95% CI 0.15-0.78). No significant differences were identified according to years of professional experience. Optional comments were also provided by 20% of participants and were reviewed descriptively, highlighting several areas for improvement, including connectivity, platform functionality and workflow protocols.

Conclusions:

Healthcare professionals generally perceived the digitally supported HaH model positively. However, exploratory differences between professional groups suggest that usability, workflow, and perceived workload may not be experienced uniformly across professional roles. Long-term sustainability of HaH programs may benefit from role-specific organizational strategies, targeted training, and better workflow integration.