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Telehealth News Roundup: Policy Updates Impacting Virtual Care

Legislative activity related to telehealth and AI picked up during the fourth quarter of 2023. Several new developments could have far-reaching implications for healthcare stakeholders. Here is a recap on some of the policy updates impacting virtual care.  

Gavel And Stethoscope On Table

White House Executive Order on AI

On October 30, 2023, the White House released an Executive Order (EO) on the Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. The EO seeks to make sure AI systems are safe, secure, and trustworthy as users flock to the technology, presenting guidelines on:

In the EO, the Administration addresses both the transformative potential and risks of AI, outlining broad actions to govern the development and use of the technology. Legal consultants with McDermott Will & Emery (MWE) offered a great deep-dive into the healthcare-specific points in the EO, including these important milestones:

Protecting Consumers, Patients, Passengers and Students

Promoting Innovation

As MWE put it, “This is a pivotal moment for AI governance. Many of the key, material details and AI governance standards will be developed during the next six months to one year. For organizations interested in developing or using AI or machine learning tools in healthcare, there will be far-reaching implications as new standards, compliance expectations, and other guidelines emerge.”

Controlled Substance Flexibilities

Also of note in October 2023, the Drug Enforcement Agency (DEA) and the Department of Health and Human Services (HHS) once again extended flexibilities related to the prescription of controlled substances via telehealth through the end of 2024.  

As reported by Healthcare Dive, this marks the second extension of relaxed prescribing rules, making it possible for clinicians to prescribe drugs like opioid use disorder and ADHD medications without first conducting an in-person evaluation.

With many of the telehealth flexibilities enacted during the pandemic set to expire at the end of next year, 2024 is “shaping up to be the Super Bowl for telehealth,” as Kyle Zebley, the American Telemedicine Association (ATA) senior vice president for public policy and executive director of ATA Action, put it.

Telehealth Permanency Hearing

On November 14, 2023, the Senate Finance Committee’s Subcommittee on Health Care held the “Ensuring Medicare Beneficiary Access: A Path to Telehealth Permanency” hearing to discuss the fate of Medicare telehealth flexibilities slated to expire on December 31, 2024.

During the hearing, four healthcare providers working in telehealth offered expert witness testimonies outlining essential flexibilities to make permanent:

  1. Allowing video visits for all conditions for all Medicare beneficiaries.
  2. Allowing physicians to provide care and services to patients via audio-only modalities.
  3. Expanding beyond qualified healthcare centers to allow licensed physical therapy, occupational therapy, and speech-language pathology practitioners to utilize telehealth services.

Opinions still differ on the future of telehealth payment parity. Some recommend reimbursing telehealth services at a lower rate to avoid market distortions while others argue that providers will cease offering these services without parity. As the Center for Telehealth and e-Health Law (CTeL) put it in a recent summary of the hearing, “Oftentimes, without the option of services provided via telehealth, patients are left with the “choice” of no care at all. Which isn’t really a choice at all.”

The Creating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Act bill was re-introduced in June 2023 in a renewed attempt to make COVID-19 telehealth flexibilities permanent. Meanwhile, the clock is ticking as we inch closer to the 2024 expiration date.

Dr. David Shulkin Joins Caregility’s Board of Directors

The Former Secretary of the U.S. Department of Veterans Affairs brings a wealth of experience in healthcare administration and policy to the virtual care company.

EATONTOWN, NJ (November 29, 2023) – Caregility, a leader in enterprise telehealth solutions, proudly announces the addition of Dr. David Shulkin to its Board of Directors. Dr. Shulkin, renowned for his tenure as the Secretary of the U.S. Department of Veterans Affairs, has been instrumental in transforming healthcare through his innovative policies and initiatives. His tenure was marked by significant advancements in patient care and the modernization of healthcare systems, reflecting his deep commitment to improving the lives of veterans and their families.

In his role as Secretary, Dr. Shulkin championed several key initiatives aimed at improving healthcare delivery and access, including the expansion of telehealth services for veterans, enhancing mental health resources, and streamlining services to improve efficiency and patient outcomes. His leadership in these areas demonstrated his forward-thinking approach and dedication to embracing technology for better healthcare.

David Shulkin, MD

With a career that spans both public and private healthcare sectors, Dr. Shulkin brings a unique perspective to Caregility. His expertise in healthcare administration, policymaking, and innovation aligns perfectly with Caregility’s mission to transform telehealth services. His insights and experience will be pivotal in guiding Caregility as it continues to innovate and expand its telehealth capabilities, making healthcare more accessible and efficient for patients and providers alike.

Ron Gaboury, CEO of Caregility, expressed his enthusiasm about Dr. Shulkin’s appointment. “We are thrilled to welcome David to our board. His deep understanding of the healthcare industry, combined with his extensive experience in both public and private sectors, makes him an invaluable addition to our team. David’s unique insights will be instrumental in steering Caregility towards groundbreaking achievements in virtual care,” said Gaboury.

Dr. Shulkin shared his excitement about this new role. “Caregility provides next-generation solutions for health systems by providing platform solutions that address the critical issues of workforce shortages and improving labor efficiency. I joined the Board because many systems are looking for the type of integrated cross-platform applications that Caregility has demonstrated a strong track record in implementing.”

Dr. Shulkin’s appointment comes at a crucial time as Caregility continues to pioneer innovative ways to deliver healthcare remotely, furthering its mission to connect care for patients and clinicians everywhere.

About Caregility
Caregility is dedicated to connecting patients and clinicians everywhere with its Caregility Cloud™ virtual care platform. Awarded the Best in KLAS Virtual Care Platform (non-EMR) in 2021, 2022, and 2023, Caregility Cloud™ powers a purpose-built ecosystem of enterprise telehealth solutions across the care continuum. Caregility provides secure, reliable, and HIPAA-compliant audio and video communication designed for any device and clinical workflow, in both acute and ambulatory settings. Today Caregility supports more than 1,000 hospitals across over 75 health systems with over six million virtual care sessions hosted annually. From critical and acute, to urgent and emergent, to post-acute and ambulatory, as well as hospital-at-home, Caregility is connecting care everywhere. Follow Caregility on LinkedIn and Twitter at @caregility.

Contact
Jess Clifton
Senior Manager, Marketing Communications
jclifton@caregility.com
(678) 360-9043

Empowering Compassionate Care: Caregility’s Journey with AI in Telehealth

Some years ago, while in a discussion about technology innovation, the CIO of a world-famous healthcare institution spoke about his focus on compassionate care. That conversation struck a chord with me. At its very core, healthcare delivery is a human undertaking that is skillfully tailored to meet the needs of the individual patient. We should never lose sight of that fact. Digital health solutions must be a means to that end: delivering high-quality, compassionate, efficient, and safe patient care across the continuum of prevention, diagnosis, treatment, recovery, and follow-up. Technology must blend into the background and silently help human caregivers do their best work.

With this mission in mind, our team at Caregility is now embedding AI technologies into our proven virtual care platform to bring individualized patient care to a new level. The compassionate care belief system is a driving force as we set about that work.

We recognize the immense potential for AI in healthcare, but the consequences of getting it wrong, even in a tightly defined domain such as virtual care, could be harmful to care teams and patients. We’ve seen AI applied in broad strokes – delivering a standard set of capabilities to every patient without consideration of their individual needs. We believe that approach is a mistake, and we are committed to applying AI in a responsible way that respects the needs of individual patients and adapts accordingly.

Steering Principles for AI in Telehealth

To ensure our introduction of AI creates value for care teams and contributes to individualized patient care, we’ve embraced a few key steering principles. We believe these principles will help us stay true to our compassionate care beliefs, focus our development work, and allow us to adapt quickly as the underlying technology matures and we receive real-world feedback from our customers. Those steering principles include:

Caregility’s AI Roadmap

At Caregility, we are providing an optional set of AI-driven services that enhance specific virtual clinical programs, such as Virtual Nursing and Continuous Observation. As we build out these and other AI solutions, in order to adhere to our guiding principles, Caregility is employing an agile software development approach to release AI enhancements for virtual care in phases.

The initial phase is a minimum viable product (MVP) that embeds selected AI capability into our platform, delivering a targeted subset of our overall AI vision to Caregility customers and their patients. We will deploy the MVP to early field trial customers willing and able to partner closely with our clinical solutions team. Together they will provide our development team with a feedback loop that answers essential questions: Are we heading in the right direction? Is our vision for AI enhancement something that solves problems that exist in this institution, or should we adjust? Do our customers trust that this technology shows promise?

We’ll then make modifications and improvements to deliver subsequent phases, using customer feedback to drive value at every stage: Does it increase efficiency? Does it improve care quality? Does it positively impact patient and staff safety?

Our goal is to create additional value for our customers through the Caregility point-of-care telehealth systems that they have already deployed and are planning to deploy. With powerful edge computing and high-resolution cameras and microphone arrays that simultaneously support live two-way audio/video sessions and multimedia streaming, the Caregility Cloud™ platform was built with medical-grade AI integration in mind.

Intelligent Telehealth Endpoints

Each Caregility point-of-care system we deploy today is equipped with sophisticated, purpose-built microphone arrays and HD cameras that can introduce both remote clinician support and AI-enhanced monitoring to care teams. Here are a few examples that illustrate what purpose-built means:

The question we seek to answer through AI enhancement is: What tasks can AI help us automate to augment the work of care teams?

AI-Enhanced Audio, Video, and Radar for Virtual Care

As we set out to introduce clinical AI to our virtual care platform, we’re focused on three key areas.

Computer vision enhancements will analyze patient room video streams to look for safety risks, best practice adherence, and workflow optimization opportunities. If the engine detects something that requires human intervention, our intent is to flag it for the right member of the care team. We will leverage our existing iConsult and iObserver applications as the main way to surface useful AI-driven insights to care team members, with incremental updates expected. We want insights to be actionable, not disruptive. Customer feedback from early field trials will inform our roadmap.

In the outpatient context of telehealth, we plan to extend video stream processing to virtual visits to gather patient vital signs (i.e., respiratory rate, heart rate, blood pressure, and body temperature) from facial video analysis. We’ll present this live data to the remote clinician so they can see it as part of their remote consultation.

Acoustic-based AI will listen to audio streams for patterns that can alert staff to patient stress or behavioral issues. In the inpatient context, we are researching embedded AI to identify medically relevant parts of conversations between clinical staff and patients to relieve some of the clinical note-taking burden for care teams. Ambient listening will inform structured clinical data capture for nurses to review before being documented in the EHR.

We are also working to integrate an optional radar sensor with our point-of-care devices to support contactless vitals streaming in inpatient care. Trending heart and respiratory rates over time could signal deterioration or changes in the patient’s condition. Our goal is to support personalized compassionate care and alert the appropriate clinician if vital signs diverge away from that patient’s baseline. Sepsis is a major patient safety factor in our hospitals, and we believe widespread adoption of this type of technology will help attack that problem and others.

The AI journey ramps up for Caregility in 2024, when we release our first commercial offerings addressing two of our key focus areas: Augmented Observation and Vitals Trending. We will partner closely with our early field test customers to measure the impact those solutions have on key performance indicators. Customer feedback will fuel our next wave of intelligent telehealth enhancements aimed at advancing compassionate, personalized care.

Bridging IT and Clinical Worlds for Virtual Nursing Success

In the dynamic landscape of healthcare, the integration of virtual nursing programs is paramount. Learn from industry experts who have successfully navigated the challenges of deploying virtual nursing programs & gain actionable strategies to create a program that not only meets clinical needs but also aligns seamlessly with IT infrastructure.

Virtual Nursing’s Reach Within Hospitals

In a recent HealthLeaders article, “Hospitals are Looking for Hard ROI in Virtual Nursing,” author Eric Wicklund confers with healthcare executives on the difficult task of pinning down value for the nascent care model. Given the multitude of ways that Virtual Nursing can be deployed, one of the most challenging aspects of rolling out a program is identifying where virtual nurse resources can make the most impact. This will inevitably vary from facility to facility.

“Each hospital is approaching the issue from a different direction, ranging from basic [virtual] sitter programs targeting patient monitoring and fall prevention to platforms that support new nurses to more complex telenursing platforms that combine monitoring with administrative functions,” Wicklund observes.

Although determining where virtual nurse resources can deliver the most significant benefits can be a complex task, one of virtual nursing’s most remarkable attributes is its adaptability and versatility, enabling its deployment across various units within the hospital. Here are several illustrative examples of how virtual nurses can be leveraged to improve patient care across the inpatient enterprise.

Tele-ICU Support: One of the most well-known applications of virtual nursing is in the intensive care unit (ICU), where virtual nurses provide round-the-clock monitoring, early intervention, and clinical support to high-risk patients. They work in conjunction with intensivists and on-site staff to enhance patient care and safety, assisting with real-time data analysis and intervention.

Emergency Department (ED) Assistance: Virtual nurses can play a crucial role in the ED, supporting triage, patient assessment, and timely decision-making. By providing remote guidance and expertise, they help alleviate the pressure on ED staff, ensuring efficient care delivery, especially during high-demand periods.

Cardiology Care Coordination: In cardiology units, virtual nurses can assist in monitoring and managing care for patients with heart conditions, including angioplasty and stent procedure recovery. They help ensure timely detection of patient deterioration, medication adherence, and ongoing patient education, promoting better outcomes for cardiac patients.

Sepsis Care: Virtual nurses are well-suited to monitor patients at risk of sepsis. They can continuously assess vital signs and clinical data, identify early warning signs, and alert care teams to intervene promptly, potentially preventing this life-threatening condition.

Neurological Care: Patients in neurology units, such as those recovering from strokes or traumatic brain injuries, often require close monitoring and frequent interventions due to memory impairment. Virtual nurses can provide consistent support, reminding patients about instructions and interventions, and helping reduce the burden on in-person staff.

Skilled Nursing Facilities (SNFs): Beyond the hospital, virtual nurses can extend their reach to post-acute care settings like SNFs. They assist with patient assessments, medication management, and rehabilitation programs, ensuring that patients continue to receive high-quality care even after discharge.

This diverse landscape of use cases underscores the flexibility of Virtual Nursing. Healthcare organizations can tailor their adoption journey to meet specific goals, introducing virtual nurse resources to units most in need of additional support and units most likely to correlate to patient outcome improvements.

When expanding virtual nursing programs to additional units, it’s essential to start small and grow incrementally. As you implement your initial program, you’ll likely find that clinical staff closest to patient care delivery will generate new ideas and identify opportunities for improvement. Their feedback and insights can drive innovation, unlock additional ROI, and shape the future of virtual nursing within your organization.

Many see Virtual Nursing as a natural next step in the evolution of patient care models, proposing that there will come a time in the not-too-distant future when virtual nurses are an essential part of every hospital care team. In addition to helping health systems offset chronic staffing problems, looking ahead, Virtual Nursing models can introduce new pathways for providers to extend care into patients’ homes to support chronic care management and preventive medicine on a broader scale.


Interested in exploring Virtual Nursing solutions for your team? Set up a discovery call today!

Nurse Spotlight: Wendy Deibert, EMBA, BSN, RN

As a teen, Wendy Deibert experienced a near-death healthcare episode that resulted in an eight-week hospital stay punctuated by four surgeries. That harrowing experience became an enlightening window into what patients go through, igniting a fire in her to be on the other side of the bed taking care of those in need.

Wendy Deibert, EMBA, BSN, RN
Chief Nursing Officer, Caregility

As a young adult, Wendy dove headfirst into nursing, specializing as a neurologist ICU nurse. She would go on to spend two decades at the bedside at Barnes-Jewish Hospital, eventually managing the ICU. Along the way, her exposure to the whirlwind of emotions surrounding patient care allowed her to see healthcare engagement from multiple angles. When personal experience saw her husband and father become patients, inefficiencies in the healthcare journey sparked a new mission in Wendy to help make care more accessible and easier to navigate for patients.

Determined to make a difference, Wendy took a leap of faith and transitioned into the realm of healthcare technology at St. Louis-based Mercy health system. From ensuring patient medication safety to learning the intricacies of interfacing and formulary building, her IT journey began. But it wasn’t just about incorporating new tools; it was about understanding how technology could serve patients better.

Wendy’s most transformative phase was a tele-ICU project where she oversaw the implementation of e-ICU across 350 beds. This venture brought together diverse care groups, introduced Wendy to the magic of virtual care, and showcased the technology’s potential to bridge the gap between remote areas and big cities. From there, Wendy played an integral role in rolling out more than 70 telehealth programs across six states with Mercy, ultimately culminating in the creation of Mercy Virtual – a mammoth hub of 160 virtual caregivers.

As an employee at Mercy, Wendy was a Caregility customer, using the company’s telehealth solutions to support several of the health system’s virtual care initiatives. After parting ways with Mercy to launch her own consulting business, Wendy eventually joined the Caregility team, where additional resources could support shared growth. She currently serves as Caregility’s Chief Nursing Officer, where she supports clinical integrity on behalf of the virtual care company and its hospital and health system customers.


“My passion is getting care into the home or as close to the home as possible instead of having patients travel. Virtual care is also a wonderful early warning system in inpatient settings like the ICU, enabling faster, more proactive care interventions.”

– Wendy Deibert


Wendy has learned through experience the importance of tailoring tech solutions to organizational needs, emphasizing that it’s not about replacing current processes but optimizing them. Integration, she believes, is vital. Separate systems, she’s found, tend to create bottlenecks, while a universal platform offers streamlined care.

“One patient, one record,” Wendy stresses. “No one wants to use a secondary system. Leverage EMR integration to embed processes and boost adoption. One thing I learned at Mercy is that telehealth programs grow organically. Disparate solutions for different units can be terrible for IT to manage and clinicians really prefer to live in one environment. Get onto one platform you can use across settings.” She encourages care teams to identify telehealth solutions that support broad use cases to simplify program growth and technology management.

“Make the technology, the clinician, and the process equal parts of the process,” Wendy also advises. “Collaboration between clinical and IT stakeholders establishes common ground and common language. If you just drop technology in without formally defining virtual care workflows, roles, and protocols, your program won’t be sustainable.”

Wendy’s unique position as someone with both clinical and technical expertise has given her a holistic view of the healthcare arena. Her journey from an eight-week hospital stay to her leadership role at Caregility has been nothing short of inspiring. Today, Wendy continues to leverage her expertise, advocating for best practices and pioneering the seamless integration of technology in patient care delivery to improve both patient and clinician experience.


Interested in connecting with clinical experts to discuss your hybrid care strategy? Contact us today!

AI’s Potential in Inpatient Clinical Care

Traditionally, healthcare has been regarded as a laggard in embracing IT innovations, primarily due to the inherent complexity of care delivery and the stringent regulatory environment. However, this perception is undergoing a significant transformation. The widespread adoption of acute telehealth has played a pivotal role in this shift, providing care teams with valuable hands-on experience that has helped build trust in health technology. As a result, healthcare professionals have become more comfortable with and open to leveraging digital health tools in their daily practices.

This newfound receptivity to digital enablement has set the stage for a remarkable leap forward in the industry. This is evidenced by the recent surge of interest in artificial intelligence (AI) in healthcare. The proliferation of generative AI and the urgent need to find new solutions to the ongoing staffing crisis are further fueling interest in exploring AI’s place in clinical care.

AI-Enhanced Telehealth

Although headway has been made regarding operational use cases for machine learning-based AI in backend process improvements, healthcare teams are eager to identify and implement AI solutions that can enhance clinical workflows, produce more precise diagnoses, and improve patient outcomes. For the many hospitals equipped with synchronous, audio/video-based telehealth services at the bedside, infrastructure exists to introduce AI services at the point of care as well.

In the realm of virtual care, the evolution of intelligent telehealth endpoints has been remarkable. As telehealth has evolved from audio-only interactions to feature-rich video encounters, camera and microphone quality have improved to keep pace. One noteworthy development is the integration of edge computing capabilities into telehealth endpoints, enabling the support of AI applications. New multiplexing technology supports multiple cameras, allowing care teams to simultaneously support virtual patient engagement and video-based AI solutions.

In addition to high-fidelity camera and microphone arrays, new sensors such as radar technology are making their way into telehealth platforms. These sensors are capable of continuously capturing valuable clinical data while minimizing disruption to the care process. These advancements in telehealth are allowing care teams to infuse AI services such as Augmented Observation and Vitals Trending into bedside care processes, arming clinical teams with patient safety reinforcement tools that reduce pressure on staff and lead to better outcomes.

Contactless Patient Vitals Capture

Promise and Precautions in Clinical AI

While the adoption of AI in healthcare holds immense promise, it also comes with its set of challenges and precautions.

In a recent interview with Healthcare IT Today editor John Lynn at the 2023 HLTH conference, Caregility Chief Product and Engineering Officer Kedar Ganta lauded AI’s ability to bring in ambient intelligence from audio, video, and sensor feeds, “whether it’s collecting vitals or documenting notes for the clinician.” This technology operates in the background, collecting vital patient information and supporting care processes without causing disruption.

Ganta does note, however, that amidst the excitement surrounding AI, the topics of trust and accountability often receive insufficient attention. Establishing patient and provider trust in AI systems is crucial. “This is where regulation comes into the picture,” says Ganta. “It’s a balance between over-regulating something versus promoting innovation.” Reliable data and transparency in AI solutions are essential for building trust, and the inner workings of AI algorithms should be shared with providers to enhance visibility into these factors.

Additionally, “providers should have the ability to override the AI decision” Ganta advises. Creating a regulatory framework and an independent body to oversee AI in healthcare is vital to address these concerns. As AI continues to reshape the healthcare landscape, these discussions about trust, regulation, and accountability are essential for harnessing the full potential of AI while safeguarding patient wellbeing.

As the healthcare industry continues to embrace these advancements, the future holds exciting possibilities for improved patient outcomes and experiences.

Caregility Introduces New Integrations and Capabilities to Virtual Care Ecosystem that Streamline Clinical Workflows


New telehealth program management tools, connected device integrations, and HL7 capabilities add to the company’s growing list of hybrid care innovations purpose-built to help healthcare organizations increase efficiency while improving patient and clinician experience.

EATONTOWN, NJ (October 30, 2023)Caregility, an enterprise telehealth leader connecting care for patients and clinicians everywhere, announces the release of new capabilities as part of the company’s highly anticipated Cares 2.0 software series. The Cares 2.0 software enhancements introduce new telehealth program and device fleet management capabilities, peripheral device integrations, and interoperability standard options for more than 75 leading health systems that depend on Caregility Cloud™ (Best in KLAS virtual care platform; 2021, 2022, and 2023) to deliver their virtual care programs.

“Cares 2.0 marks the latest step in our unrelenting pursuit of virtual care applications that help healthcare teams improve process efficiency and positively impact care quality,” said Kedar Ganta, Caregility’s Chief Product and Engineering Officer. “We continue to explore new boundaries to offer patients and care teams innovative ways to transform inpatient care delivery in today’s changing landscape.”

Caregility’s iObserver application for continuous patient observation.

Caregility’s iObserver application for continuous patient observation.

Caregility Cloud™ customers can now:

The Cares 2.0 software enhancements add to Caregility’s unprecedented ecosystem of integrated virtual care offerings that empower healthcare organizations to implement telehealth programs tailored to their specific needs and use cases. Meanwhile, the company also continues its work to bring embedded AI capabilities into virtual clinical workflows through new Augmented Observation and Vitals Trending offerings.

The new capabilities build on the company’s award-winning solutions for virtual consults, continuous patient observation, virtual nursing, and more. The Caregility Cloud™ virtual care platform encompasses purpose-built telehealth endpoints, clinically vetted virtual engagement applications, sophisticated device fleet management and program administration, and an unparalleled array of innovation and service provider partners, all underpinned by reliable, cloud-based telehealth trusted by leading health systems.

Set up an exploratory call to learn more.

About Caregility
Caregility is dedicated to connecting patients and clinicians everywhere with its Caregility Cloud™ virtual care platform. Awarded the Best in KLAS Virtual Care Platform (non-EMR) in 2021, 2022, and 2023, Caregility Cloud™ powers a purpose-built ecosystem of enterprise telehealth solutions across the care continuum. Caregility provides secure, reliable, and HIPAA-compliant audio and video communication designed for any device and clinical workflow, in both acute and ambulatory settings. Today Caregility supports more than 1,000 hospitals across over 75 health systems with over six million virtual care sessions hosted annually. From critical and acute, to urgent and emergent, to post-acute and ambulatory, as well as hospital-at-home, Caregility is connecting care everywhere. Follow Caregility on LinkedIn and Twitter at @caregility or learn more at www.caregility.com.

Contact
Jess Clifton
Senior Manager, Marketing Communications
jclifton@caregility.com
(678) 360-9043

Hospital Leaders Weigh in on Virtual Nursing

Healthcare delivery is undergoing a transformation and virtual nursing is at the forefront. In a recent webinar co-hosted by Caregility and the American Telemedicine Association (ATA), healthcare leaders from institutions at various stages of implementing Virtual Nursing programs gathered to discuss their experiences.

Virtual care pioneer and Caregility CNO Wendy Deibert led the illuminating panel discussion featuring Tracey Kopenhaver, Operations Manager, Geisinger Inpatient Virtual Care; Christine Coriell, Director of Nursing Operations, OhioHealth Resource Center; and Debra Marinari, Associate Vice President, Hospital Operations, Mary Washington Healthcare.

2023-Virtul-Nursing-Webinar-Thumb-Caregility

Access the webinar recording here.


Here are some key takeaways from the discussion:

Adoption Drivers

All panelists pointed to nursing workforce challenges as key motivators to pursue Virtual Nursing, but technology and ROI had to line up.

Addressing Nursing Shortages and Burnout

The virtual nursing model allows healthcare organizations to tackle staffing shortages and burnout by distributing the workload more evenly.

“We were motivated by a few things – primarily the nursing shortage, nurse turnover, nurse burnout, and really looking at our care team redesign. Looking at current state, where we don’t have quite enough nurses to go around, and our nurses are overworked and busy and can’t get to all the things that they need to do in a day… How can we try to future-proof or buffer that?” – Tracey Kopenhaver

Technology Aligns with Strategic Goals

By leveraging existing technology that supports remote patient observation teams and tele-ICU programs, Virtual Nursing programs align well with strategic goals to centralize and scale virtual care.

“When we think about our Nursing strategic goals at OhioHealth, one is having a flexible workforce and second is maximizing the technology we have at OhioHealh. So, this was just a natural next step into the virtual world.” – Christine Coriell

Demonstrated ROI

Panelists addressed the importance of justifying costs, typically vetted through pilot programs.

“It had to be cost neutral – that’s the model that we took. So, we had to make sure that whatever we brought in was going to have a good return on investment – not just the quality metrics, but [improving] satisfaction and decreasing turnover.” – Debra Marinari

Strategy

While there is variation in how Virtual Nursing workloads are assigned within each organization, some standard practices emerged. Each panelist’s healthcare organization uses Epic’s EHR in different capacities for streamlining workflows. Each organization also staffs virtual nurses onsite, with Geisinger employing a hybrid model that also includes nurses working from home.

Getting Started

“The number one recommendation I would give to anybody who is thinking about starting a virtual nurse program is don’t let perfection get in the way of progress. We started very low budget. We repurposed carts. We hired per-diem staff to start with and borrowed some staff from our virtual ICU program. We really went in on a shoestring to get it off the ground. We’ve been able to demonstrate the return and we have the financial support to move ahead with a more permanent solution.” – Tracey Kopenhaver

Staffing Models

Virtual nurse staffing models varied across panelists. Coriell noted that, in their current phase, OhioHealth virtual nurses work Monday through Friday from 7 a.m. to 7 p.m., with plans to extend to 24/7 coverage.

“The virtual nurse will be assigned to patients that all will roll up to the many nurses overseeing that care at the bedside. We’re utilizing a flex team of nurses with knowledge across different care sites for now. A future focus is on having dedicated full-time employees (FTEs) for the program.” – Christine Coriell

Geisinger takes a slightly different approach, with Virtual Nursing overseeing specific tasks.

“There are no specific patient assignments for virtual nurses since they currently focus mainly on admissions and discharges.” – Tracey Kopenhaver

Meanwhile, Marinari and the Mary Washington Healthcare team elected to bring on additional FTEs for virtual nursing from the very beginning.

“The model had to be really such that the nurses at the bedside did not feel like they had less resources, but actually more. We had to balance the FTEs for each of the departments, and what that workload was going to be [in terms of] patient ratios. The virtual nurses are assigned to patients, currently managing around 15 to 16 patients during the day and up to 20 at night.” – Debra Marinari

Goals and Results

Positively impacting nurse and patient experience are core objectives for each organization.

KPIs

“Key outcomes that we really want from this program [include] retention of nurses, decreasing that workload and stress at the bedside, increasing time for the bedside nurses to be able to provide care for their patients, improving nurse satisfaction [and] patient satisfaction, and then some cost savings. Ultimately, we would look at time saved with length of stay and a few other metrics as well.” – Christine Coriell

“We’re looking at our HCAHPS – nurse responsiveness and communication with the nurse scores in particular.” – Tracey Kopenhaver

Time Management & Efficiency

All panelists agreed that virtual nursing significantly improves time management, reducing the workload of bedside nurses.

“The thing that we’ve been able to measure the most is the time saved for the bedside nurses.” – Tracey Kopenhaver

Marinari and the Mary Washington Healthcare team conducted time studies to demonstrate time savings, assessing the time from when the discharge order is written to the time the patient leaves as a metric. Coriell highlighted the role of existing relationships between virtual nurses and unit staff in speeding up tasks and improving efficiency.

Conclusion

Virtual Nursing programs are not just a trend; they are a substantial step toward enhancing healthcare delivery. These programs alleviate staff burnout, improve patient experience, and provide financial returns. With insights from leaders in the field mounting, it’s clear that Virtual Nursing is a viable and vital part of the future of healthcare.

Watch the full Virtual Nursing panel discussion with Geisinger, OhioHealth, and Mary Washington Healthcare here.


Looking for guidance on how to implement, optimize, or expand your Virtual Nursing Program? Set up a Virtual Nursing discovery call today.

Nurse Spotlight: Heidi Steiner, DNP, RN-BC, NE-BC

It’s not uncommon to meet professionals inspired by their family legacy working in healthcare. Although Heidi Steiner grew up surrounded by a family of nurses – including her mother, aunt, cousin, and godmother – she initially resisted the unspoken pressure to tread a similar path. Instead, Heidi was drawn towards community health education. Her dream was to promote health, prevent illness, and keep people out of the hospital.

Heidi Stiener, DNP, RN-BC, NE-BC
Product Manager, Caregility

However, life often takes us in unexpected directions. As Heidi navigated her early career, she conceded to nursing, working as a hospital aide and later as a nurse extern. She grew to appreciate the hospital setting but her core passion always remained: educating people to prevent illness.

This led her to the rehabilitation side of nursing, where she found immense satisfaction in guiding patients and their families through recovery. As Heidi puts it, “The nurse is the quarterback for the team, ensuring patients and their families are equipped with knowledge and care tailored to their needs.”

After relocating to Michigan, Heidi advanced to a nursing leadership role managing a 24-bed inpatient rehabilitation unit. Her interest in collaboration, patient education, and interdisciplinary teams stood out. When the hospital introduced Cerner, Heidi stepped in to represent the nursing department and found herself immersed in the world of informatics, changing the course of her career yet again.

After spending several years leading healthcare teams through the adoption of electronic health records, and then acting as a consultant for Cerner, Heidi ventured into developing a cross-continuum patient education strategy at Trinity Health. Working on a patient engagement portal, she emphasized that hospital care is only a fragment of the patient’s healthcare journey. The real challenge? Ensuring sustained care and knowledge once the patient returns home.

Heidi’s journey eventually brought her to Caregility and the realm of virtual care. As a Product Manager for the company’s virtual clinical consultation software, she influences tech design, features, and strategies that directly affect patient and clinician end-users. Her goal remains consistent: supporting patients, families, and clinicians throughout the healthcare journey. She believes that technology empowers clinicians to deliver their best care.


“Our job as a technology company is to provide tools that empower clinicians to give the best care they can deliver. This aligns with my passions, which have always been working as a team, collaborating in the best interest of the patient and their family, and supporting clinicians to deliver excellent care.”

– Heidi Steiner


When asked about her ideal vision for healthcare, Heidi paints a picture of seamless health information sharing, patient-driven care plans, and more holistic approaches to meeting patient needs. She sees virtual care bridging the gaps in episodic care, providing continuous insight into patients’ health patterns, and introducing new pathways for earlier intervention when necessary.

Heidi’s advice for anyone looking to venture into virtual care? “Walk, then run. Planning is essential, as is stakeholder involvement and a clear roadmap. ID your KPIs upfront and conduct routine milestone tracking to evaluate the success of your program. Evaluate as you go so you can change course as needed.”

With her certification in nursing informatics and a doctorate degree, Heidi exemplifies the importance of continuous iteration and learning. Her story serves as an inspiring reminder that while legacy can light the way, it’s our individual choices, commitment, and adaptability that truly shape our journey. Whether you’re a nurse pursuing your passion or a patient navigating your care plan post-discharge, that’s timeless wisdom.


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