Nirit Putievsky Pilosof 1,2, Rakefet Yoeli-Ullman 3, Esther Galler 3, Galia Barkai 4, Eyal Zimlichman 2,5, Abraham Tsur 2,3,4,6
1 Coller School of Management, Tel Aviv University, Israel.
2 ARC Innovation at Sheba Medical Center, Tel-Hashomer, Israel.
3 Department of Obstetrics and Gynecology, Sheba Medical Center, Ramat Gan, Israel
affiliated with The Faculty of Medical and Health Sciences, Tel Aviv University, Israel
4 Sheba Beyond Virtual Hospital, Sheba Medical Center, Tel-Hashomer, Israel
5 Central Management, Sheba Medical Centre, Ramat Gan, Israel
6 The Dina Recanati School of Medicine, Reichman University, Herzliya, Israel
Background and Aims
This study investigates a novel hybrid model of Hospital at Home (HaH) for high-risk pregnant women with severe maternal or fetal complications, replacing traditional prolonged hospital admissions for intensive monitoring until delivery. The HaH model, operated in Sheba Medical Center since October 2023 with 93 patients by February 2025, integrates daily remote visits by physicians and midwives, tele-home monitoring, and bi-weekly physical hospital visits.Remote cutting-edge technologies enable remote assessments of vital signs, glycemic control (Datos Health), fetal heart tracing (INVU by Nuvo), and fetal ultrasound (Pulsenmore).
Methods
The ongoing qualitative study involves observations and interviews with patients and staff to examine the design of the new healthcare service and learn from the women’s perspective.
Results
Preliminary results show potential for significant transformations of intense high-risk pregnancy care. The new model shifts relations between women and caregivers, alters professional practices, and empowers women through increased involvement, responsibility, and a sense of choice. Telemedicine technologies for self-monitoring, which requires learning and patience, gave women greater control over their situation. HaH allows women to maintain family life and motherhood, continue their work or studies, reduce stress and improve sleep quality compared to hospital stays. In some cases, women reported that HaH also enhanced their ability to manage Post-Traumatic-Stress-Disorder symptoms related to previous pregnancies and develop a stronger emotional connection with the fetus.
Conclusions
HaH for High-Risk Pregnant women offers a promising alternative to prolonged hospital admissions, empowering women while maintaining quality of care. Further research is needed to explore the scalability and management challenges of the new model.
