Patient referral form - My Home Hospital
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My Home Hospital patient referral form
My Home Hospital is a public hospital-level service that delivers medical care to patients in the comfort and privacy of their own homes. The service is available at no charge to eligible public patients 24 hours a day, 7 days a week across the metropolitan Adelaide area, Gawler and Mount Barker Regions and their surrounds. Further expansion is planned for additional selected areas of the Barossa Hills Fleurieu Local Health Network throughout 2022.
My Home Hospital is available for a range of conditions, for which in-home care is considered appropriate. My Home Hospital brings the care to the patient in the form of doctors, nurses, allied health practitioners, some x-rays and blood tests, medication and other support services such as meals and personal care, if necessary.
The service provides acute hospital-level care for the following conditions:
Patients can be referred to My Home Hospital by their GP, medical specialist, a nurse practitioner, a paramedic or from an emergency department or hospital.
The referral form (PDF 265KB) can be accessed below:
Referral templates can be downloaded for GP practice management software, including Best Practice, Medical Director and Zedmed, using the links below.
You can find instructions for how to import the form, developed by the Adelaide PHN, here:
My Home Hospital is a Wellbeing SA service, available at no cost to eligible public patients 24 hours a day, 7 days a week across metropolitan Adelaide, Gawler and Mount Barker regions and their surrounds..
To be eligible and suitable to receive acute hospital level care in their home the patient must:
Clinical advice and support for referrers about patient suitability for My Home Hospital, and diagnostic work-up that may be required is available from the Virtual Care Centre 24/7 (including weekends and public holidays) on 1800 111 644 (1800 111 MHH).
To see a detailed map of the eligible Gawler and Mount Barker areas and surrounds, you can view the maps and post code lists below:
To view more detailed information on patient suitability for My Home Hospital, you can also view the following Calvary-Medibank flow charts:
There is a simple process for referring a patient to My Home Hospital
If you have questions regarding eligibility or want to confirm any details of the service, you can call 1800 111 644 at any time, 24/7, 365 days a year.
If your patient is eligible and would like to receive their care at home, you will need to complete a referral form (PDF 265KB) and send it to My Home Hospital via fax or email. The contact details are on the form.
Once a referral has been received by My Home Hospital, we confirm the patient’s eligibility and then contact the patient to admit them to My Home Hospital. We will also contact the referrer for additional information if needed.
As soon as the eligibility check is complete, we will notify you of the outcome (within 30 minutes of receipt of your referral but usually sooner).
The admission process will commence and usually be completed within 60 minutes. We will notify you once the admission is complete and let you know who the admitting doctor is for the patient’s episode of care.
Clinical advice and support for referrers about patient suitability for My Home Hospital and diagnostic workup that may be required is available from the Virtual Care Centre 24/7 on 1800 111 644 (1800 111 MHH).
My Home Hospital brings the care to the patient in the form of doctors, nurses, allied health practitioners, some x-rays and blood tests, medication and other support services such as meals and personal care, if necessary. It is a medically-led service with a Medical Director and staff specialists providing 24/7 senior medical cover.
My Home Hospital uses remote monitoring technology that is easy to use. It allows our care team to stay in touch with patients at any time, and to review their pulse, temperature and blood pressure as soon as the patient takes them. Data collected via remote monitoring devices will be immediately available to Care Coordinators in the Virtual Care Centre, who can then respond to any issues.
My Home Hospital offers:
My Home Hospital patients will receive in-home visits as often as their condition requires, at least once a day. These visits will be provided by experienced registered nurses, doctors and allied health providers.
Care needs will match patient needs, with personalised care plans developed that are based on the information obtained from patients, their family and/or carer if appropriate, referrers and usual care providers. Regular review of care requirements will be conducted face to face and virtually with care tailored to meet individual patient needs.
While admitted to My Home Hospital, patients will also have access to a Care Coordinator, who is an experienced registered nurse, 24/7 to provide additional information or assessment as required.