Mr. Three was lying in a bed, his face contorted in frustration. He had come to the Emergency Department at the Hospital of the University of Pennsylvania (HUP) after passing out in his attic, and now the doctor just told him he had cellulitis and he would need to be admitted for 2-3 days. Mr. Three didn't want to be away from his dogs that long. A nurse approached his bed.
"Hi, Mr. Three, my name is Lakenia. I'm one of the nurses with Hospital at Home. It's basically a program-a creative and innovative program," Lakenia Miller, BSN, RN, said. Then she paused. "I'm sorry, I'm really nervous!"
A chorus of "that's OK, you're doing great!" came from the nurses standing behind her. Miller caught her breath and continued, not missing another beat as she introduced the patient to a new program that would allow him to receive hospital-level care from the comfort of his home.
Moments later, she reflected: "I was a little nervous doing that, but in the real world it will be easier for me to help the patient understand," Miller said.
Practice and readiness for the real world was exactly the point. Miller's conversation with Mr. Three (not a real patient) was part of a simulation exercise that stretched over four days in early April 2026, just a week before Penn Medicine officially launched its Hospital at Home program at HUP and Penn Presbyterian Medical Center. The rehearsal served as a low-stakes way for clinical teams to test run the process, work out bugs, and shake off nerves ahead of the enrollment of real patients in this newest mode of acute care in patients' homes.
"We've done a lot of work over the past year trying to plan how to build a virtual hospital, and that's a complicated process," said Hospital at Home Medical Director Robert Burke, MD. "It's really important for us to be able to do high-fidelity simulations before we enroll patients."
Now, patients like Mr. Three can get the same quality of care as they would in the hospital, but still have their pets at their side and sleep in their own beds.
