by Kedar Ganta, Chief Product and Engineering Officer, Caregility
This is my final post of the year, and I would like to take a moment to share some key highlights that reflect our commitment to innovation and continuous improvement.
In 2024, we successfully rolled out 20 releases including 6 major updates and 14 minor ones. These releases were designed to improve your experience and keep us moving forward. We also launched a new status page (https://status.caregility.com) to provide real-time updates on the status of the Caregility applications to always keep you informed about our platform’s reliability.
With the November 2024 release, we introduced a new virtual background feature in iConsult. This enhancement minimizes distractions by removing irrelevant background elements during virtual sessions. For now, you can blur or set a neutral color as your background, and in future releases, we will offer the ability to choose and personalize your background for a more tailored experience.
In iObserver, we made significant improvements to the way observers interact with live sessions. The recent release enables multi-camera streaming with independent 5x and 40x options on the APS 200 Duo and APS 100 Pro + Flex Cam endpoints, offering greater flexibility and detail. We also enhanced the Discharge List to provide increased visibility by tracking when and by whom patients are discharged. Color-coded tooltips and additional language phrases improve usability and accessibility.
iObserver 3.0 also introduces Admitted Patient Statistics to the Program List, offering quick insights into patients on the list and those under observation. Look out for even more enhancements, including real-time reporting on active sessions, device availability, and assignment metrics in future updates.
Meanwhile, the Admin Portal is evolving into a central command hub, making device management more intuitive. With new features like scheduling soft reboots on APS endpoints, we aim to streamline operations and minimize downtime to better support your needs.
As 2024 draws to a close, I want to thank you for your feedback and engagement throughout the year. Wishing you all a happy holiday season, and I look forward to continuing our conversation in the new year!
Author: Kedar Ganta, Chief Product and Engineering Officer, Caregility
In my last post, I introduced our new family of dual-camera telehealth devices. Today, I want to share about additional workflow enhancements made possible through our ongoing platform innovation and integrations with new ecosystem partners.
iConsult
Our recent partnerships with Sonifi and Cyracom significantly enhance inpatient workflows with iConsult. Integration with Sonifi’s interactive patient engagement solutions offers patients a more comfortable and satisfying experience directly in their rooms. Meanwhile, Cyracom’s on-demand language interpretation services within iConsult effectively bridge language barriers and improve overall quality of care. iConsult now makes it easier to identify the location of patients using interpreter services, simplifying the internal billing process and improving overall efficiency.
iConsult P2P
In our outpatient iConsult P2P solution, the new polling feature enables group outpatient visits to become more dynamic and interactive. This allows healthcare teams to collect real-time feedback on patient needs, concerns, and preferences.
Also, don’t miss out on experiencing the AI-driven vitals scanning available within our P2P application. Using non-invasive computer vision technology, P2P analyzes a video stream of a patient’s face to measure vital signs such as heart rate, blood pressure, and respiratory rate.
iObserver
With the September 2024 release, iObserver has been enhanced with a new session transfer feature that maintains the same layout and patient tile location, providing a familiar and intuitive experience for virtual observers. These design improvements reduce cognitive overload and guide observers seamlessly through program list loading and session termination. Additionally, iObserver now provides insights into observer performance with metrics on virtual observer shift options, including intervention types and phrases.
Admin Portal
The success of your virtual care programs relies on visibility into your telehealth wall systems and carts. Our Admin Portal now serves as a command center, providing this visibility while facilitating fleet management. Admins can manage devices and perform soft reboots and seamless upgrades while filtering user accounts and devices by their associated programs.
Stay tuned for more updates as we continue to innovate and enhance workflows!
Clinical Program Manager Spotlight: Peter Strecker
Peter Strecker’s healthcare story began in high school. With exposure to pre-hospital care as an EMT in his late teens, Peter ultimately chose nursing school and gained invaluable experience in critical care and ED nursing. However, it wasn’t long before Peter’s passion for improving healthcare access led him beyond the bedside.
Peter Strecker Clinical Program Manager, Caregility
As an educator, Peter quickly realized he could have a greater impact by helping other nurses provide better care. “On a unit, I could impact a handful of patients,” Peter recalls. “But in education, I was teaching hundreds of nurses across the country how to provide better care for their patients.” This shift from direct patient care ignited a passion to improve access to the best possible care for as many patients as possible.
That passion evolved to virtual care about 10 years ago. Leveraging experience from roles with both vendors and health systems, Peter helps healthcare systems develop, implement and ultimately drive adoption of their virtual care strategy. “I love that every day I get to use technology to improve access to quality care for patients, anywhere, anytime.”
As the newest Clinical Program Manager at Caregility, Peter supports integrating virtual care into hospital workflows with a focus on leveraging the Control Hub to monitor and quantify the benefits of the Caregility Cloud™ virtual care platform. Drawing on his clinical background and experience in business development and healthcare IT working with many of the top health systems in the nation, Peter brings a unique perspective to his role.
Peter emphasizes that “patients want to see clinicians and clinicians want to see patients. The more conveniently we can facilitate that connection, the more likely we are to achieve successful and sustainable adoption.”
Looking ahead, Peter envisions a healthcare landscape that continues to move beyond the hospital walls to offer patients and care teams more flexibility.
“As reimbursement models and incentives continue to evolve, healthcare will naturally gravitate to providing the right level of care to the right patients at the right time.”
– Peter Strecker
Peter sees a future where care is delivered more efficiently and conveniently outside of the 4 walls of a healthcare facility in 8-minute appointment blocks. “With the explosion of chronic health issues, particularly in the US, wellness is largely about human behavior and helping individuals make better choices,” Peter notes. “While AI and ML improve by leaps and bounds every day, comforting patients and families, changing behaviors, and reinforcing long-term accountability will largely rely on human interactions for the foreseeable future.”
For healthcare organizations looking to implement virtual care programs, Peter offers practical advice. First and foremost, he emphasizes the importance of having stakeholders clearly define and articulate the problems they want to address. From there, robust ideation led by those stakeholders and end users will yield the most sustainable results. Peter also encourages organizations to be open to leveraging outside expertise.
Demonstrating meaningful outcomes—clinically, operationally, and financially—is critical; establishing benchmarks and baselines to measure success is essential. Develop a solid plan and strategy that meets those explicit objectives and goals.
In a field as dynamic and complex as virtual care, credibility is paramount and something Peter takes very seriously. Peter’s lifelong dedication to healthcare—from EMS to bedside nursing to being a trusted guide, helping navigate the evolving landscape of virtual care—is a testament to Peter’s commitment to bringing positive change in healthcare.
Interested in connecting with a Caregility Clinical Program Manager to discuss your virtual care strategy? Contact us today!
What’s New: Caregility July 2024 Update
Author: Kedar Ganta, Chief Product and Engineering Officer, Caregility
Today’s care delivery has evolved in ways unimaginable just a decade ago. During this period, technology and innovation advanced to offer a unique way to deliver more efficient and personalized care by aligning with constantly evolving healthcare needs.
In our July release, Caregility unveiled a new family of hardware devices and a host of innovative solutions that continue that trajectory. Read on to learn more about the latest advancements in the Caregility July 2024 update!
Reimagined Devices
Introducing the APS200 Duo
Our next-generation room device, the new APS200 Duo, is designed and engineered for diverse care needs. The first-of-its-kind dual camera device is a powerful addition with advanced capabilities such as a built-in beamforming microphone array, wide-angle lens, and zoom lens for a flexible and feature-rich experience.
The groundbreaking features in the APS200 Duo support simultaneous, independent camera streams with individual pan, tilt, and zoom controls, allowing remote clinicians and AI systems to access video and audio streams independently while maintaining full control over camera settings.
APS100 Pro with FlexCam for Versatile Care
We introduced the flexibility to add a FlexCam camera to our APS100 Pro devices, which allows external camera integration for versatile positioning. With two cameras at their fingertips, care providers can either scan an entire patient room for comprehensive views or zoom into a specific area for detailed observation as necessary.
AI Equipped Devices
Our new APS devices come equipped with advanced intelligence built-in, transforming video and audio capabilities. With smart infrared processing for night vision, far-end camera control, and multi-streaming video capabilities, the devices provide clear visuals in all conditions. On the audio front, we provide multi-streaming audio, noise suppression, adaptive gain control, far-end audio control, and a beamforming microphone array for precise sound capture. This is all possible as we power our new generation devices for edge computing with an 8-core CPU, dedicated GPU and NPU, up to 32GB of RAM, and hardware encoding and decoding up to 8K at 30 fps.
Together, the APS200 Duo and APS100 Pro with FlexCam are redefining hybrid AI workflows, making it easier and more accessible than ever for clinicians to provide exceptional care tailored to unique workflow requirements. This future-proofs your investment, ensuring our devices can handle the ever-changing demands of AI workloads while delivering exceptional performance in diverse care settings.
New Device Integrations
Integrate with TVs in the Patient Room
Caregility device integration with existing TV hardware in hospital rooms through RS-232 cables preserves hospital infrastructure investments and optimizes resource allocation. This integration enhances patient experience by improving communication via large TV screens, making care team engagement more effective and inclusive. Furthermore, the seamless, robust video call integrations with partners such as Aceso, Avidex, eVideon, Get Well, Oneview, and pCare provide a cohesive experience for both clinicians and patients via the TV.
Connected Ecosystem Enhancements with OneView and Social Mobile
Enhancing bedside experience plays a crucial role in patient care, as it influences comfort, improves communication, and shapes the perception of care quality. In partnership with Oneview, Caregility introduced two-way calling between clinicians and patients via the Social Mobile tablet, improving communication while protecting patient privacy. Much like our television integration, embedded intelligence seamlessly connects patients to clinician calls and effortlessly returns them to their previous activities once consultations are complete.
As we continue to innovate and adapt to the evolving needs of healthcare, we are committed to bringing more groundbreaking capabilities that make your clinical workflows smoother and interactions with patients more meaningful through the latest in healthcare technology. The improvements we’ve introduced this July are just the beginning of the journey. Stay tuned for more updates!
Empowering Compassionate Care: Caregility’s Journey with AI in Telehealth
Author: Paul Oliver, CRO, Caregility
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:
Partnering our clinical and development teams closely on product direction. Our clinical solutions team, comprised of licensed healthcare practitioners with decades of experience in bedside nursing and virtual care program rollouts across leading healthcare institutions, plays a significant role in ensuring that the new AI enhancements we bring to market will positively impact the day-to-day experience of bedside clinicians and their patients.
Responding to every patient as an individual. The more an AI-driven service is customized to the individual patient, the more meaningful the clinical insights that AI helps reveal are. Striving to achieve this level of personalized care delivery helps ensure actionability without introducing nuisance alarms.
A focus on Return-on-Investment. We are committed to being clear-eyed about the financial and clinical outcomes new AI enhancements must deliver to justify the resource investment in time, money, and opportunity.
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:
Patient rooms are often noisy environments. Caregility audio processing is purpose-built to perform well in this environment so that remote clinicians can pick up on alarms and hear patients and bedside teams clearly. That same capability can be dual-purposed to feed AI language processing components that enable ambient listening and documentation.
To support patient observation at night, Caregility cameras are purpose-built with infrared night vision. That capability also ensures that computer vision-based AI performs well under low-light patient room conditions.
Our point-of-care devices can send audio and video streams to multiple locations simultaneously to support simultaneous workflows. That means a remote doctor can consult with a patient at the same time the video stream is feeding our AI engine to monitor for patient safety issues such as the bed rail positioning.
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.
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.
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
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.
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.
Interested in connecting with clinical experts to discuss your hybrid care strategy? Contact us today!
Nurse Spotlight: Irene Goliash, RN
For some, the call to care for others is a lifelong passion. One such individual is Irene Goliash, RN. Drawing inspiration from a nurturing home environment, including a mother who often cared for family members and an aunt who was a nurse, Irene always knew she wanted to be a caregiver.
She began her journey into healthcare at an early age. A neighbor who recognized Irene’s intrinsic desire to support others suggested she try her hand at a nursing home role, noting that if she could manage that, she could likely handle any challenge a career in nursing might throw at her. And Irene did just that. “Working as a nursing home CNA gave me my start in nursing, which I found deeply rewarding,” she says.
Irene Goliash, RN Clinical Program Manager, Caregility
After graduating from Alexandria Hospital School of Nursing, Irene stepped into her first registered nurse role at Washington Hospital Center, a 900+ bed tertiary care facility in D.C. “I started on the medical telemetry floor,” shares Irene. “I always knew I wanted to be in critical care. After gaining experience and becoming comfortable with cardiac rhythms, I moved into the ICU, primarily working in surgical, critical, trauma, neurosurgery, and cardiac surgery care.”
From there, Irene transitioned to a role as a Cardiovascular ICU nurse at Georgetown University Hospital. She spent the next seven years providing comprehensive nursing care, patient education, and discharge planning for cardiovascular surgical patients on a combined ICU/Stepdown unit. During her tenure at Georgetown, Irene served as a charge nurse for the entire unit, acted as a preceptor for nurses during orientation, and developed and implemented a unit-based Peer Review system.
Along the way, Irene’s robust nursing experience attracted the interest of health IT stakeholders. A significant turn in her career came when Irene joined Apache Medical Systems (acquired by Cerner) to oversee the development of clinical end-user training programs. Irene was later recruited by VISICU (acquired by Philips) where she would spend the next 16 years managing the clinical transformation process for clients adopting the eICU program.
Irene’s work and connections eventually led her to Caregility, where she currently serves as a Clinical Program Manager working to alleviate the burdens of bedside teams and ensure a smoother healthcare process for patients through telehealth enablement.
“I know from first-hand experience that sometimes at the bedside you feel like you’re just running around putting out fires,” Irene shares. “It’s easy to get burned out thinking of the list of things you didn’t do. I’m all about helping the bedside team. It’s about alleviating their pain points and making the job more satisfying. Both clinicians and patients should feel the benefit.”
“You can significantly improve patient, family, and staff satisfaction just by shifting clinical workload to someone who has time to devote to the specific activity.”
– Irene Goliash
For those looking to implement a virtual care program, Irene stresses the importance of multidisciplinary involvement. “Pull your direct caregivers into the process from the very beginning,” she advises. “Without their buy-in, no matter how good your program is, it will fail. One of the biggest challenges I’ve seen is when customers think it’s an IT project because of equipment procurement and installation, but it’s not. It truly is a clinical project.” Irene recommends involving clinicians when determining program goals, where to focus, and where you grow from there.
Irene sees tremendous potential in emerging virtual nursing programs. She encourages healthcare organizations exploring the hybrid care model to “start small and take baby steps. You don’t have to come in and save the world. Maybe the best thing I can do as a virtual nurse is record your code for you or do the documentation or page people. Let me do the more mundane things so you can focus on hands-on patient care.”
“All it takes is one big win to prove the value,” Irene elaborates. “This can be particularly beneficial in areas where there is just not enough time to devote to things like patient education. We’re often dinged there by patients and families. Having a remote nurse resource who can teach without interruption is a great way to improve that.”
Irene envisions a future where every care team encompasses both bedside and virtual nurses. “Virtual roles can be a great way to harness the experience of nurses who have the knowledge but may not be physically up to a 12-hour shift, which is harder as you get older, keeping 20 to 30 years of nursing experience in my health system to support my bedside team.”Virtual roles can also be outsourced in rural areas where staffing shortages may leave facilities hard-pressed to pull from existing staff.
Irene’s journey is a testament to the limitless potential and adaptability of nursing. She continues to hone her skills as a member of the American Association of Critical Care Nurses and in her work with ATA developing TeleICU nursing guidelines.
As healthcare pivots to a more integrated approach to virtual care, the experiences and insights of nurse professionals like Irene will continue to illuminate the path to better supporting our patients and bedside teams, retaining experienced clinicians, and innovating care delivery.
Interested in connecting with a Caregility Clinical Program Manager to discuss your hybrid care strategy? Contact us today!
Nurse Spotlight: Sarah Lake, MS, RN, CCRN
Many would agree that the nursing profession isn’t for the faint of heart. RNs see it all. Although Sarah Lake, MS, RN, CCRN, didn’t initially set out to be a nurse, her early years working in the criminal justice system offered plenty of parallels.
Sarah first pursued undergraduate studies in political science and criminal justice, earning her bachelor’s degree at the University of South Dakota (USD). The Sioux Falls native then held positions as a correctional officer and a court services officer, doing what she describes as “the equivalent of felony probation and supervision for community members who don’t go to prison.”
Sarah Lake, MS, RN, CCRN Clinical Program Manager, Caregility
Like the clinical work she’d eventually embark on, Sarah’s Corrections roles operated under a paradigm that put emphasis on prevention through early intervention. The challenge was that she oversaw a population that was profoundly underserved with no access to social services. Sarah recognized that the lack of support services was an impediment to her ability to adequately help those in her community. This point of frustration led her back to school to find a different way she could help.
Sarah earned her nursing degree at USD intending to go into community, public, or mental health. After a preceptorship at the Department of Health setting up points of distribution during H1N1, she landed a critical access nursing role in Chamberlain, SD, at Sanford Chamberlain, ultimately returning to Pierre, her home community, with a role in Avera St. Mary Hospital’s ICU. That role introduced Sarah to a relatively new theory of care. Avera St. Mary’s eICU program allowed patients to receive services from remote clinicians while remaining close to home and family.
“The hospital had an eICU system that allowed clinicians to push a button to get instant access to intensivists and critical care nurses to help take care of critical patients whom we would have otherwise had to transport to tertiary care,” Sarah explains. “When I pushed the button for the first time [to get help] on a drip I was unsure of, I was sold.” Sarah immediately recognized the potential that virtual care posed to broader use cases.
“The thing I am the most passionate about is improving the delivery of patient care.”
– Sarah Lake
“During my career, I did temp work outside of hospitals and worked as a flight nurse, but I always came back to the eICU at Avel eCare (then Avera eCare) because I liked virtual care’s ability to give folks world-class care in their home community. When I came back to work full time in the Sioux Falls area at Avel eCare, one of the service lines was a multi-specialty clinic offering specialties to IHS. Sixty percent of the services we were supporting were mental health or psych related – precisely the kind of services I thought we needed when I was in Corrections.”
When COVID-19 hit, Sarah and her team again turned to telehealth to remotely support patients isolated at home. It wasn’t long before Sarah was recruited by Caregility to put her virtual care experience to work supporting hospitals across the nation looking to follow suit. Today, Sarah helps health systems hone their telehealth strategy, design virtual clinical workflows, and stand up EMR-integrated programs that improve care delivery for patients and providers.
Sarah sees hybrid care fueling what’s possible in healthcare. That includes the ability to support remote family involvement or group visits, patient and staff education, and patient monitoring as an added safety layer and another way to build relationships with patients.
“Post-COVID, patients are sicker and there aren’t as many clinicians available to take care of them,” Sarah notes. “Adopting a virtual nurse is one way teams can meet in the middle. Medicine is also getting much smarter. Wearables and home-based apps have tremendous potential to further personalize care and proactively improve outcomes. Increased use of AI will not only enhance care delivery but also optimize operations. It will account for things people don’t think about when they’re putting patients into beds – like higher fall risk if the patient is placed at the end of the hall – to support the best utilization of space. What locations are best for the recovery of specific conditions? What staff do we have to take care of them? We’ll see the use of AI in those operations.”
For those looking to implement a virtual care program, Sarah offers five points of advice:
Work with a multidisciplinary team including clinical, administrative, and IT stakeholders to define your goals and objectives based on your unique pain points.
Conduct a feasibility study to determine what it will take to launch your program. Consider time and resource requirements, seeking outside expertise as needed.
Define your clinical protocol. Demonstrate ways the solution will benefit patients, lighten staff workload, and foster new professional development skills among staff who will use the tools.
Select technology that supports your identified workflows. Will telehealth endpoints be cart-based or wall-mounted? What integrations are desired? Be mindful of regulatory compliance and network factors.
Iterate and re-iterate constantly.
“Virtual care and telehealth bring us to a whole new level of being able to deliver care to absolutely everybody in a quick, cost-effective manner, even in geographically isolated communities with socioeconomic struggles,” says Sarah. “Today we can have a diabetes patient see a world-class endocrinologist at home on an iPhone. Virtual care lessons I’ve learned along the way have only broadened what I see as the future potential.”
Interested in connecting with a Caregility Clinical Program Manager to discuss your hybrid care strategy? Contact us today!
Nurse Spotlight: Donna Gudmestad, MHL, BSN, RN, CCRN
Donna Gudmestad, MHL, BSN, RN, CCRN, will tell you she “took the long road into nursing.” As a college student considering her career options, Donna opted to pursue nursing based on exposure to the profession she had gained interacting with home nurses who helped care for her grandfather.
Drawing from that experience, her work as a caregiver began as a Certified Nursing Assistant (CNA) in a nursing home. Donna would go on to work as a Licensed Practical Nurse (LPN) for six years, taking a break to start a family before ultimately going on to become a Registered Nurse (RN).
Donna Gudmestad, MHL, BSN, RN, CCRN Director of Clinical Solutions, Caregility
Roughly twenty years would pass between Donna earning her BSN in Nursing from Indiana Wesleyan University and going on to earn her Master of Health Leadership from Western Governors University. Along the way, she gained experience in virtually every facet of the patient care journey, holding nursing roles in academic, long-term care, sub-acute care, rehab, and hospital-based settings.
Perhaps most notably, Donna was among a small but growing constituency of clinicians actively working to modernize care by introducing virtual workflows at the bedside. Using the expertise she cultivated working as an ICU nurse at St. Louis University Medical Center and as a nurse manager at Mercy Virtual, Donna was offered a role as the Director of Operations leading six virtual service lines across a four-state region.
Donna currently puts her 30+ years of nursing and 14+ years of telehealth implementation experience to use as
Director of Clinical Solutions at Caregility, where she works with some of the nation’s leading health systems to bring clinically sound virtual care programs to life. That includes emerging virtual nursing models.
Although virtual nursing is rightfully generating buzz, Donna observes that the concept is not new. “TeleICU is one flavor of virtual nursing,” she notes. “We have been doing medication second signature and other workflows virtually for 15 years within the critical care space.” She sees the expansion of those practices into lower acuity hospital units as a natural next step in improving patient care delivery.
“Whereas before it was a battle, COVID really opened people’s eyes to what technology can do to help nurses at the bedside.”
– Donna Gudmestad
Drawing from her experience as a clinician and virtual care forerunner, Donna is a wealth of knowledge for care teams standing up virtual programs. Her number one recommendation is to do your due diligence upfront. “Don’t stand something up and think you’re going to come back and clean it up,” Donna notes. “Do it right the first time. Decide which workflows you want to start with. What are your goals? What’s your measure of success? Align your metrics up front so you can measure your performance.”
Donna encourages leadership teams to involve bedside staff in program development early on to fully understand their challenges and build a program that adequately addresses them. “Sometimes we do things we think are helpful because we’re not in the hot seat every day,” says Donna. “The devil is in the details and bedside staff hold valuable knowledge that’s needed to really streamline workflows.”
When asked where she sees healthcare in 10 years, Donna is resolute in her perspective that virtual nursing and telemedicine will be normalized as a standard, additional mode of care delivery. “A nurse or provider will be able to come into a patient’s room virtually to accomplish much of what is done in person today,” she explains. “Peripherals and AI-supported transcription will support them, so they won’t have to type anything into their computer.”
Though critical care is destined to remain in-house, Donna sees an increased need for nurses beyond the four walls of the hospital. “A lot of care will be pushed out into the home whenever it’s appropriate,” she elaborates. “Many things can be done within the home, which more often than not increases patient comfort and reduces care costs.”
She views virtual nursing programs as practice for that future state and posits that “nursing will look very different in a decade.” That will likely entail a virtual-first engagement strategy where hands-on teams are deployed as needed – the inverse of what we typically see today. Donna is also optimistic about the broader use of AI in care delivery to make that future state possible, but notes that “with power comes responsibility.”
“Nurses have a thousand things on their plate,” she points out. “At the end of the day, the goal is to make it easier for clinicians to deliver high-quality care that is augmented by technology.”
Interested in connecting with a Caregility Clinical Program Manager to discuss your virtual care strategy? Contact us today!
