{"entity":{"id":"idea-moon-oncology-hospital-at-home","kind":"idea","name":"Oncology hospital-at-home with remote monitoring for toxicity","aka":[],"tldr":"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.","asOf":"2026-09-08","links":[{"label":"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)","url":"https://doi.org/10.1200/JCO.2014.57.9334"}],"tags":[],"related":[],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol","b-care-fragmentation"],"keyPapers":["paper-di-maio-j-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"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.","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","cost":"medium","horizonYears":3},"route":"/ideas/idea-moon-oncology-hospital-at-home/","neighbours":{"bottleneck":[{"id":"b-care-fragmentation","kind":"bottleneck","name":"Fragmented care and guideline gaps","route":"/bottlenecks/b-care-fragmentation/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-di-maio-j-clin-oncol","kind":"paper","name":"Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials","route":"/key-papers/paper-di-maio-j-clin-oncol/"}]}}