Caring Through Text: A Qualitative Study of Clinician-Patient Asynchronous Communication in Hospital-at-Home (Preprint)

<sec> <title>BACKGROUND</title> Hospital-at-Home (HaH) care models are increasingly adopted as a strategy to treat older adults with acute care needs and reduce strain on healthcare systems. Technological innovations, particularly digital communication platforms, have become essential in enabling care delivery beyond traditional hospital settings. Among these, asynchronous messaging tools have the potential to facilitate safe, timely, and coordinated interactions between healthcare providers, patients, and caregivers. Despite growing interest, little is known about how the content and relational dynamics of such exchanges influence care experiences in real-world HaH contexts. </sec> <sec> <title>OBJECTIVE</title> This study aimed to examine the content of text messages exchanged between healthcare providers and patients or caregivers within a HaH programme in Singapore. </sec> <sec> <title>METHODS</title> A descriptive qualitative design was employed to analyze retrospective WhatsApp messages exchanged between healthcare providers and patients or caregivers from August to October 2022. An inductive qualitative content analysis approach was used to systematically identify and categorize emerging patterns in the data. </sec> <sec> <title>RESULTS</title> Three main categories were identified: (1) clinical checks and advice, (2) administrative and transport arrangements, and (3) quality of interpersonal dynamics. These were further supported by 13 sub-categories. </sec> <sec> <title>CONCLUSIONS</title> This study underscores the multifaceted role of digital communication in HaH care, demonstrating its influence beyond clinical coordination to operational efficiency and the quality of interpersonal relationships. </sec>