Table 1

Challenges and solutions to rural home hospital care delivery

Internet connectivityPoor cellular and wired infrastructureTiered approach to connectivity, including portable satellite
Geographical accessibilityLengthy travel times between patientsOptimise use of remote visits for in-home clinician; physician only remote
StaffingLimited availability of physicians and in-home cliniciansPhysician remote only; use novelty of programme as selling point for in-home clinician
Clinical workflowsNot optimised for remote physicianOptimise through rapid cycle feedback
Laboratory and imagingLengthy travel timesPoint of care ultrasound and laboratory technologies
Specialty expertiseLimited availabilityProvide remote physician consultation
  • *Challenges identified from prior work.19 Solutions developed through scoping, testing, and rapid cycle feedback.