Point-of-care ultrasound in hospital-at-home care: a scoping review

Hospital-at-Home (HaH) models are increasingly used to deliver acute hospital-level care in patients’ homes, but present challenges due to limited access to conventional diagnostics. Point-of-care ultrasound (POCUS) is a portable imaging modality with potential to support clinical decision-making in such settings. However, existing evidence is fragmented and no comprehensive synthesis of its clinical applications, outcomes, or implementation has been undertaken. This scoping review aims to map existing evidence on POCUS use in HaH across these domains. We conducted a scoping review using the Joanna Briggs Institute (JBI) scoping review framework and reported the review according to PRISMA-ScR guidelines. We searched five electronic databases using controlled vocabulary and free-text terms related to HaH and POCUS. Two reviewers independently screened records and extracted data using a standardised form. Findings were synthesised descriptively and organised into key domains. Fifteen sources of evidence were identified, including observational studies, conference abstracts, narrative and expert opinion articles, one guideline, one randomised controlled trial (RCT) protocol and one completed RCT. POCUS was most commonly applied in fluid status assessment and respiratory conditions, with multi-organ approaches frequently described. Where reported, POCUS influenced clinical management in 51.4–89.9% of cases, and one small RCT demonstrated reduced readmission and mortality with POCUS-guided care. No included source reported formal diagnostic accuracy metrics. Most sources were published from 2024 onwards, reflecting a rapidly emerging evidence base concentrated in Europe and Asia. Operator dependency and absence of a formal credentialing framework were consistent gaps. POCUS has shown potential to support clinical assessment and decision making in HaH, particularly for fluid status and respiratory presentations. However, the evidence base remains early, heterogeneous and largely descriptive with limited diagnostic accuracy data, inconsistent outcome reporting and no HaH specific credentialling or governance framework. Future prospective studies should define safe use cases, operator requirements, image quality standards and outcome measures for POCUS in home-based acute care. Not applicable.