New Research on the State of Virtual Nursing in 2025
Five years ago, Virtual Nursing was largely seen as experimental. But as Black Book Research recently put it, “healthcare’s shift to Virtual Nursing and allied virtual care has officially crossed the line from pilot projects into core infrastructure.”
Virtual Nursing: Why Now?
Three powerful forces are driving the acceleration of inpatient virtual care:
- Workforce pressures – Labor remains hospitals’ largest expense, representing 56% of costs in 2024. Virtual Nursing helps protect bedside capacity by shifting tasks to virtual RNs, who are often late-career nurses eager for flexible roles.
- Rural fragility – Nearly half of rural hospitals are operating in the red, with hundreds at risk of closure. Virtual command centers and teleICU co-management provide “second set of eyes” coverage that stabilizes patients locally and reduces transfers.
- Evolving expectations – Pandemic-era care models introduced the concept of always-on care, which consumers and providers alike now see as the new standard.
What the Research Says
Virtual Nursing adoption has since skyrocketed and is quickly evolving to include virtual command centers and AI capabilities in tech-enabled bedside care delivery. In an August 2025 survey of 554 clinical, financial, and IT leaders, Black Book Research found that 88% of hospitals are piloting or running multiple purpose-built solutions for virtual care (i.e., Virtual Nursing, Virtual Sitting, Tele-ICU, etc.). 73% of those surveyed expect their organization to expand virtual care services by 2026.
The survey results tell a compelling story for acute virtual care:
- 62% report stronger multidisciplinary collaboration following deployments
- 47% of rural leaders cite major reductions in transfer delays
- 44% of risk leaders report measurable improvements in adverse-event detection
- 64% of nurse managers report improved staff satisfaction, tied closely to time saved
Self-reported outcomes reinforce the impact:
- 20–45 minutes of RN time reclaimed per shift, largely through documentation assists and standardized education and discharge preparation
- 10–30% fall reduction on high-risk units within the first year
- 30–50% one-to-one sitter hours are replaced in mature observation programs
- 15–35% reduction in rural transfer delays with hub-and-spoke virtual models
How Hospitals Are Making It Work
According to researchers, successful programs engage staff early and often and “assemble modular, purpose-built services that align to the facility type (tertiary, community, rural/CAH, post-acute), nursing acuity and staffing mix, available funding/budgets (operational vs. capital, grants), and user experience levels.”
The study underscores that success depends less on gadgets and more on governance and design. High-performing organizations:
- Start with sitters. Virtual observation programs deliver early ROI and provide a scalable on-ramp to broader Virtual Nursing models.
- Define role boundaries. Units that publish a clear task taxonomy—what stays bedside vs. what shifts virtual—are 1.7x more likely to rate adoption as “very good or excellent.”
- Invest in training. 59% of nurses required additional education or peer support to accept remote models; peer champions helped boost unit adoption significantly.
- Wire it into the EHR. Virtual work documented in the same chart builds bedside trust and accelerates adoption.
Researchers warn against common red flags, including fuzzy task definition, clinical staff training gaps, bad AV that wrecks credibility, and unclosed loops between virtual and bedside teams.
A Maturity Model for Virtual Care
Black Book offers the following framework for scaling Virtual Nursing adoption:
- Start with one high-value use case (e.g., sitter) to prove ROI.
- Create a repeatable rollout kit (policies, training, checklists).
- Phase by unit and site; track adoption and time-to-value.
- Publish service-level objectives (answer times, escalation closure, hourly touchpoints).
- Tie to executive dashboards (quality, throughputs, labor, finance)
Each step in the adoption journey reflects a shift from novelty to necessity. And increasingly, the destination isn’t just more technology – it’s a model of care that protects bedside time, stabilizes rural hospitals, and improves outcomes.
The Bottom Line
Virtual Nursing isn’t about cameras on walls. It’s about redesigning workflows so bedside teams can focus on what only they can do. It’s a proven force multiplier for safety, staffing, and access, especially when organizations match the right tools to the right setting.
For hospitals navigating workforce strain, rural fragility, and policy uncertainty, Virtual Nursing has become not just a solution but a strategic imperative.
Microsoft Chief Nursing Innovation Officer Kathleen McGrow, DNP, MS, RN, PMP, FHIMSS FAAN
