Abstract
The Ayushman Bharat Digital Mission (ABDM) represents a transformative leap in India's healthcare landscape, aiming to create a national digital health ecosystem for universal coverage through interoperable, citizen-centric building blocks. This paper introduces the Hospital at Home (HaH) model, delivering any extended monitored care at home (e.g., acute episodes, chronic management, or post-operative recovery), as a natural extension to ABDM and explores the integration of the Hospital at Home (HaH) model of delivering extended monitored care in patients' residences, into the ABDM framework. HaH can encompass chronic disease management to post-acute recovery. This paper explores the architectural extensions required to support IoT devices, AI-enabled monitoring and alerting, and emergency escalations. Key integration points with ABDM components like ABHA, UHI, and HIE-CM are assessed, and improvements on the core stack (e.g., a federated Remote Monitoring Gateway) are discussed. Discussions highlight benefits such as reduced hospital burdens and equity improvements, while addressing challenges like digital divides. Findings underscore ABDM's federated design as a scalable foundation, positioning India as a leader in home-based care. This work offers a roadmap for policymakers, developers, and providers to realize HaH's potential within ABDM.