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Accepted for/Published in: JMIR Human Factors

Date Submitted: Jun 25, 2025
Open Peer Review Period: Jun 27, 2025 - Aug 22, 2025
Date Accepted: Sep 17, 2025
(closed for review but you can still tweet)

The final, peer-reviewed published version of this preprint can be found here:

Designing for Patient-Centered Care and Equity in Virtual Hospital-at-Home Models: Quality Improvement Initiative Using Experience-Based Co-Design

Kandola M, Wong E, Paquin R, Arora K, Sharda H, Deol R, Jung M, Montenegro M, MacPherson M

Designing for Patient-Centered Care and Equity in Virtual Hospital-at-Home Models: Quality Improvement Initiative Using Experience-Based Co-Design

JMIR Hum Factors 2025;12:e79679

DOI: 10.2196/79679

PMID: 41191859

PMCID: 12588588

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

Designing for Equity in Virtual Hospital at Home: A Quality Improvement Initiative Using Experience-Based Co-Design

  • Mahabhir Kandola; 
  • Emma Wong; 
  • Robert Paquin; 
  • Kamal Arora; 
  • Harroop Sharda; 
  • Roman Deol; 
  • Mary Jung; 
  • Maria Montenegro; 
  • Megan MacPherson

ABSTRACT

Background:

Virtual Hospital at Home services have the potential to improve care access and outcomes, but rapid implementation during COVID-19 lacked patient-centered development, raising concerns about equity and engagement.

Objective:

To co-design solutions that support equitable, patient-centered Virtual Hospital at Home services using an Experience-Based Co-Design (EBCD) approach.

Methods:

We conducted a five-stage improvement process in Fraser Health Authority, British Columbia, including (1) forming a multi-disciplinary steering committee; (2) reviewing provider experiences; (3) interviewing South Asian patients and caregivers; (4) hosting a co-design workshop to develop solutions; and (5) sharing back findings.

Results:

Participants identified barriers including digital literacy, language, and trust in virtual care. Co-designed solutions focused on culturally tailored education, hybrid digital training, caregiver inclusion, and community-driven engagement strategies.

Conclusions:

EBCD enabled the development of inclusive and actionable strategies to improve Virtual Hospital at Home services. Findings highlight the importance of ongoing community collaboration to ensure equity in virtual care innovation.


 Citation

Please cite as:

Kandola M, Wong E, Paquin R, Arora K, Sharda H, Deol R, Jung M, Montenegro M, MacPherson M

Designing for Patient-Centered Care and Equity in Virtual Hospital-at-Home Models: Quality Improvement Initiative Using Experience-Based Co-Design

JMIR Hum Factors 2025;12:e79679

DOI: 10.2196/79679

PMID: 41191859

PMCID: 12588588

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