Virtual hospital services for adult patients: A scoping review

The COVID-19 pandemic expedited the use of virtual hospital services (VHS) and hybrid hospital-in-the-home (HITH) models. However, the current evidence base remains fragmented and heterogeneous in care model designs, terminology, and reported outcome measures. This scoping review maps the published literature on VHS models implemented or evaluated for adults aged 18 to 65 during and after the COVID-19 period.

Following the Joanna Briggs Institute (JBI) methodology and Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, a comprehensive literature search of four online databases was conducted, identifying articles published between March 2021 and July 2025, followed by screening of reference lists of included studies by two authors.

Of 1624 records identified, 28 studies met the eligibility criteria. Most studies were published in the last two years, reflecting accelerated interest in sustaining VHS models beyond the pandemic. Of these, 16 studies reported on fully virtual models, while 12 studies described hybrid HITH models. Most models utilised mixed synchronous and asynchronous communication, while mobile applications and wearables were uncommon. Respiratory conditions were the most common diagnostic group (n = 17/28), and heart failure exacerbation was the most frequently reported specific condition (n = 6/28). Patient satisfaction and experience were most frequently reported outcome measures (n = 17/28); qualitative evidence on clinician and caregiver experience was limited.

This review provides a structured map of VHS model components in the adult non-geriatric population, revealing substantial heterogeneity and inconsistent reporting amongst different care models. The evidence base remains dominated by pilot and single-site studies. Future research should prioritise standardised taxonomy and clear model descriptions to inform future effectiveness and implementation research.