The "virtual ward" model did not reduce readmission or mortality rates among high-risk patients, according to a study published in the Journal of the American Medical Association.
The model relocates aspects of hospital care into a community setting, incorporating features such as single points of contact for patients and assessments conducted in a central location or by telephone for several weeks post-discharge.
Although the model is intended to reduce costs and improve patient outcomes, researchers, led by Irfan A. Dhalla, M.D., of the University of Toronto and St. Michael's Hospital, Toronto, did not measure any significant decline in readmissions or deaths up to one year after discharge from a virtual ward, according to the study.
Dhalla and his team assigned 1,923 patients discharged from four Toronto hospitals to traditional or virtual ward care at random. Of the virtual ward patients, 21.2 percent were readmitted or died, compared to 24.6 percent in the traditional care group, a difference of barely 3 percent.
Communication difficulties, which already cost hospitals $11 billion a year, may account for some lack of improvement, according to the authors. They were often unable to get in touch with patients' primary care physicians by telephone or email, and the various electronic health record (EHR) systems used complicated the process of determining which patients received which care.
Insights from the research on obstacles such as primary care physician integration problems and EHR compatibility make the study valuable for future research, Peter Boling, M.D., of the Virginia Commonwealth University Department of Medicine, wrote in an accompanying opinion piece.
"Moreover, it is still likely that in this era of exponential development of technologically supported solutions to complex problems, elements of the 'virtual ward' may have a place, perhaps linked with more robust in-home care delivery," he wrote.