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Six ways to ensure staff and patients have a better—and safer—virtual patient sitter experience

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Six ways to ensure staff and patients have a better—and safer—virtual patient sitter experience

Virtual patient observation, or virtual patient sitters, are innovative tools that many hospitals are utilizing to help them do more with less amidst an ongoing staff shortage.

Traditional patient sitters provide in-room 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 for many healthcare organizations. 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 “” 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 which 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 for virtual sitters

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.

Is your organization interested in adding a virtual observation platform? Find out more about your options by downloading our white paper, Considering Virtual Observation for Your Healthcare Organization.

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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:

Virtual observation isn’t just for fall prevention: 5 insights on the tech’s safety, savings opportunities

Becker’s Hospital Review

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.”

How technology can alleviate effects of the nursing shortage

HealthTech Magazine

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 to improve patient safety

McKnight’s Long-Term Care News

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.

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How AI is Set to Transform Virtual Patient Sitting

Just a few years ago, virtual sitting was being touted as one of the most important technology implementations a hospital could make to reduce costs and improve patient safety. Hospitals could install cameras into patient rooms, or make use of existing video-enabled carts, and then set up a remote monitoring center where patient sitters keep an eye on patients in multiple rooms (or even multiple facilities) all at once.

Yet such is the pace of change in information technology that even the traditional patient sitter model is now ready for a transformation. How? Enter “augmented intelligence,” commonly known as artificial intelligence, based on machine learning.

What you need to know about the existing virtual sitter model

The current virtual patient observation model is a proven, cost-effective strategy to replace in-person sitters, or hospital staff who sit in rooms with patients who are at risk of harming themselves, such as when attempting to get out of bed unattended.

As Caregility’s Donna Gudmestad wrote last year:

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.

Yet the existing model also has shortcomings.

To start, these systems tend to send a high number of false alerts to the remote patient sitters. According to a study published by the Journal of Healthcare Informatics Research in 2016, medical professionals in hospitals can encounter more than 700 alarms in a single day – making it difficult to differentiate a true emergency. ECRI listed false alarms among its top 10 health technology hazards in 2020. With so many false alerts, patient sitter fatigue becomes very real and dangerous as human monitors begin to tune out alarms.

Next, the current approach to virtual sitting usually only focuses on a rectangular area around the patient bed, unable to monitor or analyze what else is in the room.

With a new generation of machine learning-enabled video analysis software paired with video monitoring technology, we have the potential to solve these core problems.

What is Augmented Intelligence or “AI”?

It’s important to note that nothing can replace a knowledgeable, experienced caregiver, but how much more effective can they be if we augment the information they have at their fingertips?

This is precisely where AI comes in.

AI can be applied to the video recordings taken in most hospital patient rooms to better categorize alarms related to movement in those rooms. Augmented Video Analysis (AVA) systems can provide additional information and data to hospital decision makers, resulting in more accurate warnings and alerts, among other benefits.

AVA leverages real-time video and experiential knowledge to learn what is going on in the room, and alert clinical staff if help is needed. Over time, AVA learns how to better observe not just that one patient, but all patients, everywhere. It learns continually—and it doesn’t get tired.

What can AVA do that existing virtual sitting systems can’t?

As mentioned, the current systems have their shortcomings. But the AVA system uses unique algorithms (or sets of rules) for the computer to follow. The algorithms can determine the severity and/or scope of the action in the room.

The more video the system receives, the more detail it can detect, and the more accurate assessment it can provide. Has the patient fallen out of bed – or just leaned over to pick something up off the floor? Did a visitor reach to hold a patient’s hand– or did they pull out an IV?

Some distinguishing features of AVA systems include:

  • Identifying “regions of interest” that provide a holistic view of the patient room, rather than the traditional rectangular “static box”
  • Differentiating a caregiver, patient, or visitor – and applying different rules for each persona
  • Producing “bounding boxes” around each object in the room and indicating when they interact (for example, when a visitor touches a patient or a patient touches an IV pump)

Protecting patient privacy

With all this capability to observe and analyze what is going on in a room, AVA can still be configured to protect the patients’ privacy.

First, AVA de-identifies patients by blurring their faces. Second, the cameras only capture video—the software does not listen in on conversations. And third, all data is captured and stored in a secure, HIPAA compliant system.

Built to leverage existing infrastructure and grow over time

The new generation of advanced video analysis can make use of video technology that the hospital or health system is already invested in, whether that is carts, wall-mounted video cameras, or another system.

Plus, AI can be trained on and applied to new problems identified over time, or new risks. Whatever challenge your current virtual sitting solution is facing, there is a good chance that AVA can help.

Interested in learning more about AVA? Download our whitepaper, “How Augmented Video Analysis Is Improving Patient Care— and More — and More” now to learn how:

  • AI and machine learning work hand-in-hand with video systems
  • AVA systems function in a hospital room
  • Patient privacy can be protected using AVA systems
  • AVA systems can benefit patient care and your bottom line.
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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.

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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.

According to the Centers for Disease Control and Prevention, 90% of healthcare spending is on patients with chronic and mental health conditions. Moreover, chronic diseases such as cardiovascular disease, diabetes, and chronic obstructive pulmonary disease are responsible for more than seven out of 10 deaths in the United States and are the leading cause of disability.

Despite widespread awareness of this problem, the healthcare system has struggled to find an effective approach to chronic conditions in part because healthcare accounts for only 10 to 20% of populations’ health outcomes.

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.”

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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:

  1. Constraints facing clinicians
  2. Constraints facing patients
  3. 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.

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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.

Virtual Patient Observation: Common Applications

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:

  1. What is our current daily/monthly/annual spend on physical sitters?
  2. What are our current fall rates per patient day?
  3. Are there other use cases that we might be able to leverage with the technology?
  4. Are there issues with inappropriate transfers from outside locations?
  5. What is our ICU bounce-back rate?
  6. 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.

Download our white paper Considering Virtual Observation for Your Healthcare Organization, for more detail on key factors to consider when identifying the right virtual observation solution for your healthcare organization.

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Virtual Observation: 8 Things to Look for in a Solution

If you’re considering implementing virtual patient observation technology within your organization, you’ll want to make sure that the solutions you’re considering have the capabilities you’re looking for. Make sure to ask potential vendors about these features:

  1. Does the system have one-way or two-way audio and/or video capability? In some situations, you may want to talk to a patient without using two-way video. Or 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).
  2. Does the camera have pan, tilt, and zoom capability?
  3. Is there an alerting/notification system to bring someone to the bedside quickly, if needed?
  4. Does the camera have night vision capabilities so that you can clearly observe patients when the room is dark?
  5. Does the system offer language translation? Which languages? This doesn’t work for two-way communication but can be helpful for simple instructions like telling the patient to stay in bed while a nurse is alerted.
  6. What types of reporting and analytics does it provide to help you demonstrate ROI back to your organization?
  7. Can the software be delivered with a cart or a wall system? Can the hardware be installed from the ceiling or the wall, or wherever you need it to be, based on your room configuration? If you already have certain technology, such as 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?
  8. Is the technology scalable? What additional costs might there be if you want to scale the solution across multiple facilities? What are the applicable licensing fees?
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Learn about virtual patient observation

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 Patient Observation Protects 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.

To find out more about how virtual sitting resources work, which patients are candidates, and what to look for in a solution, download our white paper, Considering Virtual Observation for Your Healthcare Organization.

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