The Influenz-er model - a telemedicine supported virtual Hospital at Home model: Methods for assessing cost-effectiveness.

Abstract
Introduction: The issues arising in peak periods during pandemics and epidemics calls for improvement in efficiency of care by creating new health care models. However, to prioritize scarce resources efficiently, decision makers need proper documentation on costs and effects. We suggest changes in the current design of health care provision in Denmark. Hospitalized patients requiring medical supervision for an extended period could be admitted to their own home after a short period of observation at the hospital. At Nordsjaellands Hospital, an innovative telemedicine supported virtual HaH-model, the Influenz-er model, has been developed.

Aims, Objectives, Theory or Methods: The Influenz-er model provides care at home for patients through a mobile application and a surveillance system for clinical staff. The mobile application allows home-admitted patients to report self-monitored health data and request contact to staff. Clinical assessments are made each time data is reported and at least once daily via a video link.

Development involved clinical staff and patients. A preclinical test of technology is followed by a feasibility study. The model will be improved before implementation and evaluation in a randomised controlled trial.

To our knowledge, economic aspects of a HaH-model for acutely ill patients utilizing modern telehealth technologies for remote monitoring are not yet described. The aim of this study is to provide evidence on the cost-effectiveness of the Influenz-er model.

Highlights or Results or Key Findings: We do not have final or preliminary results. Influenz-er is a scientific project and data are collected systematically. Our end goal is value-based healthcare provision, and endpoints will include patients (patient safety, patient experience, clinical outcomes), next-of-kin (experience and strain) and economic aspects.

The Influenz-er model might be a solution to issues following overcrowded hospitals during peak periods of pandemics and epidemics. We hypothesize that the Influenz-er model can provide a cost-effective alternative to usual hospital care. The economic evaluation will provide transparent documentation for decision makers to decide if and when to apply the Influenz-er model.

Conclusions: The initial project vision was improving performance of the overall health care sector in peak periods, by using digital solutions to enable provision of better and more efficient care and support.

Implications for applicability/transferability, sustainability, and limitations: The evidence collected in this study is relevant for patients, next-of-kin, researchers, policymakers and service providers. It will deliver information about cost-effectiveness of Influenz-er at different organizational levels. Users were involved in development of Influenz-er. Patient and next-of-kin are included in the economic evaluation by assessment of productivity costs.