Virtual Observation: 8 Things to Look for in a Solution
Considering implementing virtual patient observation technology within your healthcare organization? Here are eight key features and capabilities to make sure you ask potential vendors about as you evaluate solutions.
Is the system flexible enough to support one-way and two-way audio and video capability? Video-based engagement can help care teams build rapport with patients, improving the overall experience. Other times you may want only one-way video capability – for example, if you want to observe the patient, but don’t need them to be able to see the remote observer.
Does the camera have pan, tilt, and zoom capability that allows the remote observer to virtually navigate the patient room?
Is there an alerting and notification system that allows virtual observers to deploy clinical staff to the patient bedside quickly when needed?
Does the camera have night vision capabilities so that staff can clearly observe patients when the room is dark?
Does the system support interpreter service integration to ensure equitable care for patients with limited English proficiency (LEP)? Look for solutions that support multiple languages and are available 24/7.
What types of reporting and analytics does the system provide to help you demonstrate ROI back to your organization?
Can the software be delivered with a mobile cart or wall-mounted system? Can the hardware be installed from the ceiling or the wall, based on your room configuration? If you already have camera capability in the room, can the software integrate easily into your existing telehealth system or will you need to use a different device for each application?
Is the technology scalable? What additional costs might there be if you want to leverage the solution across multiple facilities? What are the applicable licensing fees?
The award recognizes leading-edge ideas, research, products, and services that are empowering healthcare. Lee Health Advanced Application Analyst Kimberly Gault, RN, and System Director of Virtual Health and Telemedicine Jonathan Witenko were awarded the recognition based on the success of the health system’s virtual patient observation program.
The Problem: Limited Staff to Support Rising Demand for Patient Observation
Lee Health’s virtual patient observation program was developed to address a prevalent issue in healthcare: optimizing patient safety in the midst of clinical workforce shortages.
“We decided to pursue this initiative as we were experiencing staffing shortages with our bedside safety technicians,” explains Gault. As demand for observation of fall-risk and at-risk behavioral health patients rose within the health system, “we were having many patients go unwatched or having to pull clinical staff to accommodate requests.”
Patient fall scores were elevated and care teams were stretched thin as a result. That prompted Lee Health to look for a smarter way forward.
The Solution: Virtual Workflow Innovation
Lee Health turned to virtual observation as an alternative to its in-person sitter model. Using newly procured technology, including Caregility’s iObserver tele-sitting application and telehealth endpoint solutions, the team began developing innovative new workflows to create a sustainable solution that redefined how high-risk patients are monitored.
Running on the same platform the health system uses to support additional telemedicine initiatives, the new program enables two-way audio/video communication between virtual safety technicians, observation patients, family, interpreters, and clinical staff. Lee Health acquired 70 telehealth carts to support virtual observation at patient bedsides across the health system. A PRN-to-FTE model is used to staff the virtual safety technician role.
To implement the program, Lee Health made investments in:
Staff training
Technology (telehealth endpoints, workstation monitors, cameras, and headsets)
Software licensing
Wage increases to migrate virtual observation staff from PRN to FTE status
Internal clinical stakeholders collaborated with technical teams to build workflow and documentation processes. Educators from internal nursing units supported intervention and escalation process training for virtual safety technicians.
The Results: Quantifying the Impact of Digital Transformation
Prior to implementing virtual patient observation, Lee Health relied on baby monitors to support 1:4 observer-to-patient ratios. Under the new model, the health system was able to reach a 1:6 ratio, with plans to scale operations to support 1:8 observation.
“With this program, we are able to watch more patients per safety technician at a time,” says Gault. “We have expanded virtual patient observation to all of our acute care facilities and emergency departments and are now working on our Skilled Nursing and Rehab facilities.”
Minus implementation investments, the team reported a six-month program ROI of $280,260. That number is expected to blossom to $1,705,260 in the years ahead. The new approach allows the health system to leverage virtual staff resources instead of drawing from limited bedside staff.
Gault points to securing CNO executive sponsorship, up-front funding and project approvals, and comprehensive pilot program and go-live support as crucial elements of program success.
Pushback from nursing staff and lack of communication with ancillary departments created some friction during Lee Health’s initial pilot program. To address these issues, the team amplified training and communication efforts to build stronger staff awareness and education prior to implementing virtual patient observation at additional facilities.
Lee Health executives view virtual patient observation as something health systems of any size can benefit from but encourage healthcare organizations to adopt flexible solutions that are easy to use and easily scale depending on program needs.
Caregility congratulates the Lee Health team on their well-deserved SFLHIMSS Innovation Award win! The health system’s virtual patient observation program is a shining example of how hybrid care innovation is enhancing and empowering bedside care.
Three Keys to a Successful Virtual Patient Observation Program
As hospitals and health systems strive to offer high quality patient care in an efficient, cost-effective manner, many are turning to virtual patient observation. In lieu of 1:1 in-room sitters, virtual sitter programs leverage 24/7 monitored cameras to provide real-time remote observation. And, with a platform that allows one staff member to see a dozen patients on a single screen, other uses that are less event-based, such as catching unforeseen deterioration/sepsis, assessing cognition, wound monitoring, and interval-based status notes, are more readily applied at scale.
Beyond preventing negative outcomes, virtual observation, of course, also helps floor staff be more efficient, reassures patients and family members, and ensures that hour-to-hour needs can be more quickly addressed. With this type of technology, hospitals can support more patients without overextending their resources —a critical need as hospitals continue to face ongoing staffing shortages.
However, adopting any new technology or transitioning from an older system requires careful planning. To ensure a seamless implementation, consider these three keys to success:
In-person go-live support: Throughout the implementation and go-live, on-site support should be available for all shifts and all program touch points, including bedside. This will allow just-in-time training and real-time problem analysis and resolution.
Clinical oversight: Beyond the technology components of the implementation, a critical success factor for rollout is a clinical team that can make recommendations around clinical workflow design.
Minimal downtime: Especially for healthcare systems with existing virtual patient observation systems, it’s essential to have a seamless transition from the existing application to the new system. By minimizing downtime, you can support positive staff expectations from day one, while mitigating the patient risks that could otherwise accrue.
Reduced direct costs: Organizations that replace in-room sitters with a virtual, camera-based solution can decrease FTEs while optimizing patient safety and clinical monitoring. In addition, just one hospital-related fall injury can cost up to $30,000 (not to mention legal and reputational exposure). Thus, even one prevented fall has both direct and downstream cost implications, while multi-patient monitoring that requires only a single staff member has immediate top line impact.
Timely opportunities for intervention: If a patient simply needs reassurance and orientation, the observer can provide that in a timely, effective manner. If a patient at fall risk attempts to leave bed, the observer can ask the patient to remain in bed until clinical staff can assist, while immediately alerting staff who can intervene. Other changes of note that might not be immediately visible via telemetry include restlessness, altered mental state, skin or wound color changes, security concerns with a visitor, and many more.
Potential facility-wide applications: Virtual observation technology can be used in a wide variety of applications. Extending use cases well past the ICU and general acute care, applications include confirmation of status while contemplating or awaiting transfer or discharge, newborn and infant monitoring, and ensuring that ED patients pending test results or an available clinician have “eyes on them” at all times. Long-term, transitional/rehabilitation, and home care have obvious applicability as well.
For a closer look at the implementation process and benefits of a virtual sitter program, download the case study that details Caregility’s work with OhioHealth. With Caregility, OhioHealth was able to transition rapidly and seamlessly from a previous system to the new one in a single day with minimal downtime – and ultimately take an important step toward scaling telehealth services.
Six ways to ensure staff and patients have a better—and safer—virtual sitter experience
Virtual patient observation, conducted by virtual patient sitters, is an innovative response to hospitals’ ongoing staff shortages, helping them do more with less.
Traditional patient sitters provide in-room or curtain area support to patients at risk of falling, injury, or self-harm. But providing a physical sitter to occupy each room can add up to hefty expenses. With virtual patient observation, hospitals have a cost-effective alternative that helps them improve patient safety and reduce costs.
In previous posts, we have highlighted the many benefits of virtual patient observation and outlined the questions you should ask when you are shopping for a solution. Once you have invested in a system, here are some best practices that can ensure your hospital’s staff and patients have the best — and safest — virtual patient observation experience possible.
1. Implement rigorous procedures to protect patient privacy
Caregility Senior Vice President Wendy Deibert touched on this topic in an article for HealthCare IT Today. Among her recommendations, Deibert included the following:
Do not record or store virtual patient observation video
Require a badge to be scanned before the camera in the patient’s room can be turned on
Secure patient and/or caregiver consent via the standard hospital admission forms
2. Provide approachable training opportunities for staff
The introduction of any new technology can be daunting for hospital staff, so give them an opportunity to practice and build their confidence with your virtual patient observer solution. “A lot of times the clinical staff will think ‘This is a big project that’s going to take up a lot of my time and bandwidth,’” Devin Johnson, national account manager for NOVA Health, said to Intel’s “inside.tech” in July 2021. “We’ve tried to make deployment and training as simple as possible so that the nursing staff is more inclined to embrace the change.”
3. Define what patients are — and are not — eligible for virtual observation
Virtual observation can be used in many patient cases, but not all. Generally, patients with dementia or a history of falls are good candidates to be monitored virtually. However, patients who cannot fully interact with the technology, including those with sight or hearing impairments, or those whose do not have the cognitive ability to follow directions, should be monitored in person instead.
4. Familiarize patients with virtual patient sitters before turning on the camera
For many patients and their caregivers, the concept of being monitored 24/7 via video will be disconcerting. Whenever possible, provide an in-person orientation for the patient and their caregivers to:
explain why a virtual sitter is being used
outline the privacy safeguards in place to protect the patient
introduce the different parts of the technology
show them how to interact with the platform
5. Keep the patient load manageable
Although virtual patient observation technology makes it easy for one person to tend to multiple patients in theory, in practice, that number should be limited so the observer can devote appropriate attention to each patient. The typical load for each virtual sitter varies depending on the capabilities of the hospital’s observation solution and its organizational policies, but usually falls between 10 and 15 patients per observer.
6. Provide clear direction on how — and when — staff should request physical intervention
Because time is of the essence in an emergency, virtual patient sitters must know exactly when they should ask for help in a situation where patients who do not respond to their instructions through the system. The escalation policy should name the colleague or supervisor they should enlist for physical assistance and identify the point at which they can recommend that a patient be removed from virtual observation.
Take care of the humans behind the technology
Although virtual sitter solutions are powerful, at the end of the day, they are just tools – so it is imperative to take care of the human beings at the control. As Deibert said in her HealthCare IT Today article: “Ergonomics, shift coverage and rotations, and easing monotony should all be factored into the implementation” of a virtual patient observation solution.
Telehealth News Roundup: The Benefits of Virtual Sitters
Today, it’s no secret that hospitals are overstretched when it comes to resources. They must innovate and embrace new solutions to ensure quality care, while also mitigating burnout and reducing costs.
Virtual patient observation, also described as using “virtual sitters,” is one innovative solution that is helping hospitals do more with less. By enabling nurses to observe multiple patients simultaneously, this tech can reduce the costs associated with in-person patient sitters which can add up quickly and go into the millions, according to Healthcare IT Today. It can also reduce patient safety risks by preventing or mitigating patient falls and self-harm.
More recently, current outlooks have emphasized how virtual patient sitting will benefit from Artificial Intelligence (AI), not only to reduce false alarms and associated “alarm fatigue,” but also to provide better predictive analytics over time to further increase patient safety.
Read on for our monthly news roundup showcasing the benefits of virtual patient sitters:
From observing patients with short-term memory to those at risk of harming themselves, virtual sitters are improving patient care. Additionally, these technologies open hospitals up to huge savings, as Caregility Clinical Program Manager Donna Gudmestad says, “There’s quite a bit of potential savings when looking at virtual observation versus physical sitters in the room.”
The nursing shortage has been persistent for a long time. But the pandemic has certainly amplified the situation—creating an unprecedented demand for nurses and nurse practitioners. This places a strain on overburdened hospital systems who are already near capacity. However, virtual sitter technologies are reducing the need for a 1:1 nurse to patient ratio, freeing up nurses to monitor multiple patients simultaneously while mitigating the effects of the nursing shortage.
Artificial Intelligence (AI) is now capable of supporting proactive care and enhanced monitoring capabilities tailored to meet the healthcare demands of hospitals, long-term care facilities and home care patients, without intrusive devices or complex deployments. The next level of solution providers will be capable of capturing quality predictive analytics as well. For example: predicting a fall before it even occurs and triggering a timely alert to prompt staff to take preventive action.
Lower Costs with Virtual Observation of High-Risk Patients
Essential around-the-clock observation of high-risk patients represents a major expenditure for providers. Since payers don’t cover the costs of continuous observation, these investments can top $1.3 million per facility per year, the International Association for Healthcare Safety and Security Foundation reports.
Patients who might need continuous observation include the acutely ill or medically unstable, patients who could fall, dislodge medical equipment, or try to leave the hospital, and individuals with dementia, delirium, substance abuse disorders, schizophrenia, and mania. It can be utilized in acute care hospital settings, behavioral health facilities and transfer centers, as well as in post-acute settings, such as skilled nursing facilities, long-term care facilities, or long-term acute care hospitals.
Continuous observation requires staff. But a rapidly aging population, chronic critical care worker shortage, and growing pressure to make better use of healthcare labor forces require organizations to find more efficient ways to deliver these services.
Providers Turn to Video Monitoring in Hospital Rooms
In response, providers are turning to innovations in virtual technology to mitigate these challenges without compromising patient safety. Viable solutions are coming in the form of platforms that enable a single trained staff member to observe several high-risk patients safely and remotely on a single monitor via a live connection in each patient room. By reducing staff requirements from one person per patient to one person observing as many as a dozen or more patients, the use of virtual platforms can seriously whittle down the costs of continuous observation. These remote alternatives allow a staff member to monitor several patients and identify potential issues quickly, freeing nurses and other clinicians to focus on other responsibilities, with the assurance that their high-risk patients are being carefully watched.
Sushant Mongia, a video communications software architect and developer with Caregility, notes that the best of these platforms will incorporate multiple healthcare workflows, allowing the staff observer to observe the patient at high resolution, listen to, talk to, or initiate two-way communication with the patient, operate the video camera in the patient room remotely, and quickly and seamlessly alert nurses and other clinicians or staff if intervention is warranted.
Remote video-audio solutions “significantly reduce the costs associated with needing healthcare professionals to be physically present,” Mongia says.
If, for example, a patient becomes confused and removes their IV drip, the staff observer can alert the nurse. This use of remote technology reduces the provider’s dependence on people while letting nurses perform at the top of their license, focusing their time and energy on the delivery of more demanding and complex care.
Virtual Patient Observation for COVID-19
The approach is also showing value in the care of COVID-19 patients by enabling staff and clinicians to see and communicate with patients without having to don PPE for each interaction. Mongia advises providers interested in exploring the use of virtual care platforms for continuous observation of high-risk patients to look for the following:
Clinical adaptability. Platforms designed by people with clinical backgrounds and an in-depth understanding of clinical workflows, with input from clinical and other end-users. Providers should look for a platform that can be tailored to the needs of their organization and readily adjusted and fine-tuned as those needs evolve or as federal or state healthcare guidelines change.
Technical adaptability. Most providers have the internet connectivity needed to support a remote platform for continuous observation, but they’re often missing the fine-tuning required to accommodate heavy video traffic and support the reliable transmission of high-resolution video. Even the most basic video capabilities involve 10 times more data transmission than audio alone. Providers should look for a platform with the technical ability to support a multitude of networks and bandwidths and the flexibility to adapt to varying locations, conditions and network structures without sacrificing reliability or quality.
Operational support. An immediate response team that is available 24/7 to troubleshoot technical problems and minimize disruptions, regardless of conditions or environment.
What’s Next for Virtual Observation
Taking the next step in virtual care innovations will include the use of computer vision and machine learning technologies. Such solutions will be unavoidable in the future, as they improve care for residents and patients. At Caregility, we refer to this as Augmented Video Analysis (AVA). Incorporating AVA into virtual observation platforms can help:
Reduce patient risk management by detecting elopement risk, wandering patients, missed meals and missed medication
Monitor wellness and acuity levels by tracking resident ambulatory speed, posture, and head pose in the nursing home setting
Comply with COVID-19 safety protocols by alerting on facemask and social distancing noncompliance of visitors and staff
Mitigate patient risk by detecting equipment tampering, falls, and self-harm
You can watch our recent webinar on how augmented video analytics is transforming care for patients, residents and staff here.
Hospital-at-Home Programs: The New Frontier for Treating Chronic Conditions
With hospitals strained to their breaking points with COVID patients and people across the country wondering whether it was wise to go to the emergency room, many systems turned to hospital-at-home programs as part of the solution.
Remote monitoring and telehealth tools effectively extended the triage process for COVID patients into the patients’ own homes, easing the burden on hospitals and helping make sure only the patients who were most sick came in to get care.
Now, the growing hospital-at-home model is showing promise for addressing another critical health problem, one that is the single biggest driver of U.S. healthcare costs and mortality: chronic conditions.
Social determinants of health — the environmental conditions in which people live and work — play a much bigger role in causing and reinforcing chronic conditions.
By combining telehealth with a care-at-home program, hospital systems can begin to develop an awareness of and data on patients’ environmental circumstances.
“Normally it’s hard to uncover data on social determinants of health. But we think that telehealth will make collecting this data a little bit easier,” explained Peter McLain, Caregility’s Chief Strategy Officer and SVP of Business Development.
Vision for the future of care for chronic conditions
In the near future, care for those with chronic disease will rely not only on social determinants data but also patient data points that go well beyond the standard measurements of blood pressure, weight, and blood oxygen levels to include other relevant physiological data — all of these gathered from hospital at home products.
Meanwhile, telehealth home care will provide the connective platform to leverage that data through the patient’s entire care journey.
Using these health records and the information gathered during the initial consultation, providers will be able to create a personalized care plan for the patient, automatically generate customized workflows, and schedule video check-ins that correspond to the care plan.
Meanwhile, with the patient at home, remote telehealth devices or hospital-at-home equipment will be able to collect new patient data and automatically transmit it through the platform.
A combined hospital-at-home and telehealth program will allow providers to conduct video appointments via the telehealth platform and then use those appointments to gather information about the patient’s social and environmental circumstances, such as the patient’s transportation options, proximity to grocery stores selling healthy food, and the safety of the local neighborhood.
The patients would also get an easy-to-understand overview of their health via a patient dashboard. If the patient for any reason was beginning to deteriorate, that would set off an alarm or notification, and the provider could initiate a video call with the patient to investigate further and get the patient back on track.
In short: a robust telehealth hospital-at-home program would facilitate preventive care that nips problems in the bud.
Telehealth home health care for chronic conditions would be efficient and effective
Another advantage of care-at-home models is that providers could check on more patients via video per day than they would be able to see if traveling to different nursing homes and assisted-living facilities.
In addition, a platform that incorporates social determinants of health data would enable providers to more effectively guide patients toward better health. Specifically, the social determinants data would reveal factors that were impeding patient compliance with the care plan.
For example, if the patient wasn’t following a recommendation to eat a plant-based diet, environmental data might reveal that the patient lived in a so-called food desert, where access to healthy food is limited. To address this problem, the care team could identify a program or service that delivers healthy food to the patient’s home.
Or, if the patient lacked transportation to a pharmacy, the care team could arrange for low-expense mail-order prescriptions.
In other words, the care model would enable a holistic approach to care that eliminates barriers to good health and even reverses chronic diseases.
Learn more about how we’re building the future of care for chronic diseases
If you’re interested in learning more about this new hospital-at-home model, please contact us.
As McLain explained, “The paradigm of care for chronic conditions has shifted to a telehealth model, and this new frontier is wide open for innovation.”
Ease of Use: What Does It Mean, Really?
Every telehealth vendor will claim their telehealth solution is easy to use — but how many have truly designed their platform for both patients and providers? And how many telehealth vendors have recognized the myriad constraints of different clinical environments, including during the pandemic, and chosen designs that address these challenges?
We recently created an eBook that provides a deep dive on ease of use in telehealth, including concrete examples of how a well-designed user experience in telehealth technology can address clinical challenges.
Below we share a few of the eBook’s critical concepts and insights:
The pandemic introduced three principal constraints in using telehealth technology
During the pandemic, hospitals and providers have faced three principal challenges in implementing and scaling up telehealth technologies:
Constraints facing clinicians
Constraints facing patients
Constraints inherent in clinical facilities themselves
To achieve true ease of use, telehealth solutions must address all of the above categories.
For example, an effective telehealth solution must address the challenge that clinicians have to continually monitor patients with COVID-19.
Similarly, a telehealth solution must consider that patients with COVID-19 often have very limited energy (or are completely incapacitated) and thus need a very simple telehealth interface that, when necessary, can function without the patient having to do anything.
In addition, given that patients with COVID-19 are often isolated from family and friends, it’s critical to patients’ morale that they have an easy means of communicating and connecting with loved ones.
Ease of use is also critical in responding to a facilities challenge that has arisen during the pandemic: specifically, many hospitals have had to repurpose existing spaces, such as gift shops and conference rooms, into patient rooms.
A telehealth technology that requires a time-consuming installation would not be ideal when trying to quickly set up these converted spaces.
What user-friendly telehealth looks like from the perspective of patients
Given the fatigue many patients experience, the interface on telehealth technology must be intuitive and clear.
For example:
In this example of an easy-to-use mobile telehealth interface, there is one large red button for help, and one large green button to reach family and friends.
With just that one button, the interface automatically routes the call to the correct pre-programmed party. There’s no need for the exhausted patient to remember phone numbers, punch in numbers, or go through several screens.
Another design choice that contributes to ease of use for telehealth technology is not requiring a patient’s family to download a specialized app to interact with the patient. Instead, the patient’s family can receive a video call from the patient simply by clicking a link in a text.
Practical examples of telehealth that is easy to use for providers
Just as user-friendly telehealth technology must anticipate a patient’s constraints, so must it address a provider’s needs.
For example, providers sometimes need to communicate with a patient who is too weak to pick up a video call request from a provider. That’s why a feature like auto-answer at the patient’s bedside is key.
Or consider a provider who needs to remotely monitor a patient at night when the lights in the patient’s room are dimmed or off. A telehealth solution that shows the provider only a darkened room wouldn’t be of much use. But a camera with night-vision will enable the provider to watch the patient, while enabling the patient to properly rest in the dark.
Overcoming facility challenges
With so many hospitals having to repurpose spaces as hospital rooms, imagine if a telehealth technology required drilling through drywall to mount specialized cameras and monitors. That would not be an easy-to-use system.
Instead, ease-of-use means that the telehealth technology is device agnostic. It can work on smartphones and tablets, or simple carts with small cameras and screens can be rolled into a room.
The telehealth technology should also be reliable but able to reduce its wi-fi use when feasible to preserve bandwidth for other critical network-connected devices.
Ease of use in telehealth saves time
When a telehealth solution takes into account all of these real-world issues and others, its ease of use facilitates quick care, and fast, efficient care in a hospital setting can often be the difference between life and death.
If you’re interested in reading more about how telehealth design choices facilitate ease of use and promote effective care, you can download our eBook What Ease of Use Really Means in Telehealth.
Virtual Observation: 6 Ways to Evaluate Solutions
Virtual observation systems are rapidly gaining traction in a variety of healthcare settings, serving as a first line of defense for at-risk patients by alerting clinical staff so they can quickly intervene. This technology also drives workflow efficiency by freeing up clinical staff — who might otherwise be assigned to sit and monitor patients in-person — to perform other tasks.
Patient bedside systems can be portable wireless units or permanent installations that consist of a video camera and two-way audio that transmits to a central monitoring station. Cameras can tilt, pan, zoom, and utilize night vision technology when lighting is dim. Each monitoring station is typically staffed by a trained virtual sitter, often a nurse tech, who watches up to 10 to 12 patients at a time. The observer can centrally observe a group of patients either within a single facility or across multiple facilities.
Common applications for virtual observation include:
Rapid response
Fall prevention in hospitals
High-risk patient monitoring (harm to self, harm to/from others)
NICU observation
Telestroke management
Patient transfers
Not all patients are viable candidates for virtual observation. Typically, a patient’s nurse and clinical staff will determine if a patient meets the criteria for virtual observation by considering a variety of factors and asking questions such as: Is the patient re-directable? Does the patient have low impulsivity? Is the patient able to hear and comprehend verbal direction?
If the answer to any of the above questions is “no,” the patient may instead benefit from having a physical sitter in the room.
How to Tell if Your Organization Can Benefit from Virtual Patient Observation
The decision to use virtual observation technology must be made by carefully evaluating the needs of your patients, staff, and organization. How do you see the technology being implemented within your organization or facility? Do you have existing technology that might be integrated with new virtual observation software?
Here are some additional questions to consider if you are evaluating a virtual patient observation solution for your organization or facility:
What is our current daily/monthly/annual spend on physical sitters?
What are our current fall rates per patient day?
Are there other use cases that we might be able to leverage with the technology?
Are there issues with inappropriate transfers from outside locations?
What is our ICU bounce-back rate?
What is our post-acute hospital readmission rate?
From night-vision features to language translation services, there are key capabilities to be mindful of as you lay out your virtual care and observation strategy.
Virtual Sitters: How Hospitals are Protecting Patients While Keeping Costs Down
Today, hospitals and healthcare systems need to innovate in order to do more with less by providing exceptional patient care without overstretching their resources. One way that hospitals have improved patient care and reduced costs is through virtual patient observation, or virtual sitters.
But what is a patient sitter in the first place?
Patient sitters traditionally provided in-room support to patients at risk of falling, injury, self-harm, or other behavioral issues. But, providing a physical sitter in each room can amount to a hefty unbudgeted expense for healthcare organizations.
Thanks largely to recent advancements in telehealth, virtual patient observation has emerged as a cost-effective alternative to the use of live patient sitters. These camera-based e-sitters help hospitals overcome financial hurdles while improving patient safety. The real-time remote monitoring solutions enable clinical staff to simultaneously support higher numbers of at-risk patients via two-way video and audio feeds.
Virtual sitting can reduce hospital costs and improve patient safety. Here’s how.
Financial Benefits of Virtual Patient Observation
The use non-clinical staff to provide bedside patient monitoring — also known as “specialling” — is a common practice in hospitals. Patient sitters provide in-room support to patients at risk of injury while freeing up nurses to focus on clinical duties.
The drawback is that these services are not reimbursed. Even though non-clinical staff typically receive lower wages than clinical staff, the cost can add up quickly. One 900-bed hospital, for example, saw an annual unbudgeted expense of $3 million for patient sitters.
Virtual patient observation can be used in a variety of settings but is key to helping hospitals avoid costs from fall injuries. Every year hundreds of thousands of patients fall in hospitals, with one-third resulting in serious injury. The Joint Commission estimates that, on average, a fall with injury costs $14,000, but depending on the severity of the injury, unreimbursed costs for treating a single hospital-related fall injury can be up to $30,000.
How Virtual Sitters Protect Patients
Virtual observation technology can be used for physical observation of high-risk patients. This could include patients on telemetry, those who require frequent suctioning, or patients who frequently bounce back to the ICU. It can also be used to remotely monitor blood pressure or other equipment in the room.
But there are many other applications of virtual patient monitoring that can also add value to patient safety protocols, including:
Lower fall risk: If a patient who is a fall risk attempts to leave his or her bed, the virtual observer can address the patient over a speaker, advising him or her to stay in bed, and then can alert clinical staff to assist the patient.
Lower suicide risk: If the patient poses a risk to him- or herself, the virtual observer can act as a second set of eyes (often in addition to a physical sitter in the room) to keep that patient safe.
Reduced risky or dangerous behavior: Virtual patient observation can be a deterrent for negative or dangerous interactions with others. This can include dissuading visitors from brining a patient something that might put them at risk (e.g., outside medications or illicit drugs), or functioning as a second set of eyes if a patient has the potential to become aggressive or violent.
Continuous monitoring while waiting for care: As patients wait to be transferred — to a higher or lower level of care, from the ED to a critical care bed, or to an outside organization —virtual sitting can help provide continuous monitoring.
Faster care when physicians are not physically available: Virtual sitting can also be helpful when providers aren’t physically available. In this situation, a rapid response team with mobile carts can utilize camera capability for visual assessment.
NICU observation: Virtual sitting can also be beneficial for the littlest patients. A remote clinician can provide continuous monitoring of newborns and infants in the NICU through one central location.
Virtual patient monitoring has the capability to improve patient safety while enabling hospitals to more efficiently allocate resources —all without sacrificing the essential human-to-human element of patient care.
