In-patient service demands have increased during a time when patients have experienced reduced access to hospital care. Hospital-at-Home (HaH) solutions are a form of telehealth that provide an in-patient care experience in patients’ homes, offering the potential for improved outcomes. While these are desirable benefits, HaH involves privacy and cybersecurity risks by introducing hospital-grade medical or biometric devices and information systems outside the hospital’s direct control (i.e., the patient’s home). Patient homes increasingly feature Internet of Things (IoT) devices, such as voice assistants (e.g., smart speakers), as part of a broader “smart home” ecosystem. These devices may not have capabilities that support privacy and security practices and may be used as pivot points for attackers to gain access to a hospital’s information system. This paper introduces a notional high-level smart home integration reference architecture to better un