Guest: Maria Normann Larsen, Medical Doctor & Researcher, Herlev Hospital (research conducted at Nordsjaellands Hospital) Host: Joachim Almdal Recorded: June 2026

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Joachim: Hello and welcome to The Sustainable Healthcare Podcast, the podcast where we bring in smart people who are working on sustainability in healthcare and pharma and help share their insights. Today I have Maria Normann Larsen with me, who recently finished her PhD in remote care. While there was no direct sustainability or climate work in that research project, moving care from the hospital out to the patient, or from high intensity to lower intensity in an ambulatory setting, is something that we often see has good effects on reducing resource consumption in the research. So thank you for coming on, Maria.

Maria: Well, thank you for inviting me.

Joachim: First of all, who are you, and what got you excited about remote care and telemedicine?

Maria: As you mentioned, my name is Maria, and I’m a medical doctor. Currently I’m employed as a researcher at Herlev Hospital here in Denmark. What got me interested in remote care? I got fascinated by the possibility to be part of designing how our healthcare system should look in the future. We know that there is this movement towards moving patient care closer to the patient, and even into the patient’s home. And we know that for the right patient, it will possibly be a better solution than being admitted to the hospital. I got intrigued by the possibility to be part of that development and that process. So that’s what got me into it.

Joachim: I can definitely see that and why that would be intriguing. Both in your PhD and in the general, larger research project that you were a part of, what were you trying to find out, if you had to explain it to a kid, or someone who’s not a medical doctor?

Maria: The goal of the larger project that I was a part of was to design, evaluate and implement the first hospital-at-home care model in a Danish context.

Joachim: What is a care model? Sorry to cut you off.

Maria: A treatment course, how we treat patients. So if a patient falls ill and is in need of hospital care, then the process from the patient coming to the hospital until that patient is healthy again, or is not ill anymore, that would be the care pathway, or the care model.

Joachim: Perfect. Yep.

Maria: That was the overall goal of this larger project that I was a part of. The project has had several consecutive studies embedded in it, and the randomized trial was the main part of my PhD. So that’s what my work evolved around. What we wanted to find out was if this hospital-at-home model was actually better for the patient than being admitted conventionally to the hospital when they feel ill.

Joachim: And then the drum roll. What did you find out, and how did you go about investigating that?

Maria: As I mentioned, when you move the patient care from the hospital into the patient’s home, it’s not just a shift of location. It’s more complex than that. And therefore, when we talk about concepts like this, we talk about what we call complex interventions, and therefore we need to evaluate it stepwise. What we found, first and foremost, was that we could actually do it. It was actually possible to deliver hospital-level care in the patient’s home, even though the healthcare providers and the patient were not necessarily at the same location.

When we had proven that it was possible, we went on to the randomized trial, where we had two groups. One group went home to get their treatment in the home, and then one group stayed in the hospital to receive standard in-hospital care. The main purpose of the study was to see if the patients who were treated at home were more physically active than patients in the hospital, and they were. That’s a very positive finding, because we know that when you fall ill, many people tend to become very sedentary. And we know that this fall in physical activity will lead to functional decline and worse health outcomes. So when we can prove that patients are actually more physically active when they are at home compared to in the hospital, we can also assume that they will recover better and faster than patients in the hospital.

We also evaluated, through questionnaires, how the patients perceived the treatment. Overall, patients in the hospital-at-home care pathway were more satisfied with the treatment compared to patients in the hospital. So we were really happy with the results, to see that the patients were both more physically active and at the same time more happy with the treatment.

Joachim: That sounds super interesting, and of course really nice that the patients had a good experience. Were there any findings or anything you discovered around what it takes to make a good experience, if other parts of the hospital system wanted to implement this? Or was that out of scope for the research?

Maria: It was not a direct part of my project, but as I mentioned, the larger project has looked at several different aspects of this care model. As I just mentioned briefly, one important thing to remember is that these care pathways are what we call complex interventions. That means you will need several different stakeholders to do things in a specific way in order to make the model work. You have different collaborators both within the hospital, but also in the municipalities. And of course, you also have a very important actor in the patient and the patient’s relatives. So all these stakeholders will need to work together in order to make sure that this treatment course is successful. I think that was one of the most interesting parts of this project. It also really proved that just because we have shown that we could do it at Nordsjællands Hospital, it does not necessarily mean that everyone else can just take this product from the shelf and then implement it at their own department, because it will require so much work and effort to make it work in a new context.

Joachim: Did that answer your question? Yeah, very well. You mentioned that these were complex diseases, so you’ve done it in places where it can be difficult. But are there any disease areas where you think this could work well, and where it might not work so well? You don’t have to have investigated this yet, but any care pathways, injuries or disease areas, or some characteristics of that?

Maria: What we found was that this care pathway is a good option for many different kinds of patients. We performed the study in a department for pulmonary and infectious diseases, so of course many of our patients were admitted with an infection. And what we also see internationally is that these solutions are most often provided to patients with infections. So patients with infections would definitely be a good option for care pathways like this, also because many of these patients typically have shorter hospital stays and are often healthy in other aspects apart from their sudden infection. But I know that the care pathway has also been provided to other patients. We also had a collaboration with the Department of Nephrology, the department for kidney diseases, and it was possible for these patients as well.

So I think the most important thing is that the patient is motivated. If the patient is motivated to go home, and of course they also have to be well enough to do it, but that would be a decision made by the clinicians. If the patient is well enough and the patient is willing to go home, that’s the most important thing for a successful trajectory. Because as healthcare professionals, we become dependent on what the patient does. We’re used to having the patients in a hospital room, and we can go to the patient and make different tasks happen. If we want something to be evaluated or something to be done in a specific way, we can do it. But if the patient is in his or her own home, we become much more dependent on the patient. And to make that collaboration successful, we need the patient to be willing to collaborate. I think that’s one of the most important things.

Joachim: That makes a lot of sense. I know the nephrology department in Herlev have done some good work on telemedicine. We worked together with them when we recently calculated the first CO2 emissions from a Danish chronic kidney disease care pathway. And I’ve also had some personal experience with something similar, actually, where my son was born almost six weeks early. So after a little week on a neonatal department for early kids, we were, I think, a month or so on home treatment, because he still had a tube to eat from. And that was just so good, coming home to calmer conditions. Of course, it also meant that he was in a better, more stable state, but also you just relax a lot more, and it’s just nicer to be at home. So if the treatment can be equivalent, I can definitely subscribe to it being really nice.

Maria: That’s also what we hear from the patients we have talked to who have been admitted at home: that they really like it. Of course, they need to want to go home, but if they want to go home, they really appreciate the opportunity to be treated at home instead of being in a busy hospital ward.

Joachim: I can definitely see that. We have a very broad audience of both clinicians and people from the industry and others. If there’s anyone out there who wants to explore moving more of a care pathway home to the patients, or closer to the patients, how would you recommend they get started? What could be a small first step to take? Equipment, or anything, because you made it happen here, you and a lot of other people.

Maria: It was definitely not a one-person job, I can tell you that for sure. So the first thing is that you need to get a team. You can’t do it all by yourself. And then the first thing I would do would actually be to involve the stakeholders that this thing you want to bring home to the patient is aimed at. It’s not enough that you get the good idea. You need to evaluate what the needs are of the patients and also of the healthcare staff. Because if you invent something that there’s no need for, it will not be implemented. It’s as simple as that.

Joachim: I think that’s a great place to start, just mapping out which stakeholders would be involved and what would make it easy and meaningful for them to participate, and what they need to function.

Maria: Yeah. I think you just have to remember that it has to be something simple. Keep it simple, you know. So it has to be not too advanced, and it has to be able to be incorporated into the daily work routines in the healthcare system. And the Danish healthcare system is a difficult size if you do not work there, I know that for sure. So if you are not within the healthcare sector, I would definitely recommend teaming up with someone within the healthcare sector to help navigate the system and the work routines, and to see where the solution might fit in.

Joachim: Great advice. Thank you so much for coming on, Maria. It’s just really exciting to see good research done in this field. If people want to read more about the project, and or you, where can they do so?

Maria: When the project was conducted at Nordsjællands Hospital, there will be quite a lot of information on their webpage. And we have also published our results in peer-reviewed journals. People are always very welcome to reach out on LinkedIn, connect there, if they want to talk more about moving care into the patient’s home.

Joachim: Great. So they can Google “Hospital at Home”, and we’ll put a link to you in the show notes as well. Thank you so much, Maria. It was really, really nice talking to you.