# Oncology hospital-at-home with remote monitoring for toxicity

Source: https://onco.cc/ideas/idea-moon-oncology-hospital-at-home/  
OnCo record `idea-moon-oncology-hospital-at-home` (Idea). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Manage fevers, dehydration and other treatment side-effects at home with visiting nurses, wearables and video, instead of admitting people to hospital wards.

## Summary

Hospital-at-home programmes for medical conditions reduce cost and complications with equal or better outcomes. Oncology pilots (including for neutropenic fever in low-risk patients and post-chemotherapy support) show feasibility. The proposal is a scaled model combining patient-reported outcomes, wearable vital signs, home intravenous therapy and same-day nurse response, integrated with the oncology team, evaluated for safety and patient preference.

## Fields

- Kind: Idea
- Last checked: 2026-09-08
- Hypothesis: Hospital-at-home reduces inpatient bed-days for toxicity by a third with no increase in mortality or intensive care admission and higher patient-reported satisfaction.
- Rationale: Most toxicity admissions are for monitoring and supportive therapy that do not need a ward; being at home preserves function and reduces hospital-acquired harm.
- Proposed test: Randomised trial of hospital-at-home versus admission for defined toxicity presentations in patients meeting safety criteria; primary endpoint composite of death, ICU admission and readmission at 30 days.
- Maturity: early-clinical
- Actor: clinic

## Sources

- Bottleneck evidence (Toxicity and quality of life are undervalued): Di Maio et al., Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting (JCO 2015): https://doi.org/10.1200/JCO.2014.57.9334

## Connected records

- bottlenecks: [Fragmented care and guideline gaps](https://onco.cc/bottlenecks/b-care-fragmentation/), [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)
- key papers: [Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials](https://onco.cc/key-papers/paper-di-maio-j-clin-oncol/)

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