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