Karen has 22 year’s experience of developing and implementing 5 Hospital at Home programs in both urban and rural setting for the NHS in the UK s and more recently in the USA for the Huntsman Cancer Institute University of Utah. Hospital at Home is now an internationally recognized solution to helping with demand management for acute hospitals. As an international speaker on Hosptial at Home, her expertise is in developing and operationalizing new Hospital at Home programs with the emphasis on strategic and clinical engagement, developing clinical pathways, and working in an integrated and collaborative way. The largest program to date that she established in London had over 85 staff with around 3000 patient admits in an operational year. She was awarded a Winston Churchill fellowship in 2016 which she used to travel to Australia and New Zealand to study their Hospital at home programs.