Hybrid Care: Making the Case for Telehealth in Every Patient Room
During the pandemic, many health systems adopted telehealth to meet one specific objective: to ensure access to care for patients isolated at home. Telehealth and virtual care delivered on that and more. Homebound patients maintained ties to their providers, and hospital-based care teams used telehealth resources to reduce COVID-19 exposure and keep families connected during visitation restrictions.
As isolation issues abate, new challenges are driving health systems to explore ways telehealth can further support care delivery within inpatient settings. Clinical workforce shortages, patient safety concerns, and increased competition are all taking a toll on hospitals.
Here we look at how the integration of virtual tools into bedside care can help health systems adapt and overcome, making a strong case for hybrid care and the push towards telehealth in every patient room.
The Immediate Need: Staffing Relief
The 2022 NSI National Health Care Retention and RN Staffing Report reveals that in 2021 hospital turnover increased 6.4 percent, resulting in a national average of 25.9 percent. McKinsey and Company research cites a 25 percent increase in labor costs per adjusted hospital discharge between 2019 and 2022, much of which was driven by the high cost of travel nurses and staff recruitment and relocation.
The potential for telehealth to help bridge staffing gaps and reduce labor costs is four-fold:
- Virtual workflows like tele-rounding, tele-nursing, and tele-sitting free up valuable time for bedside clinicians, helping to reduce burnout.
- Telehealth-enabled remote work opportunities can extend the careers of seasoned clinicians considering leaving or retiring.
- Virtual mentoring programs between new hires at the bedside and experienced remote clinicians improve staff onboarding, training, and experience.
- Telehealth platforms allow health systems to easily bring third-party clinical service support into hospital workflows as needed, regardless of where the clinician is located.
Virtual nursing is one area of opportunity that is gaining traction. Research and consulting firm ITIC reports a 34 percent increase in the number of virtual nursing programs around the U.S. in the past year.
The Primary Objective: Patient Safety
Research has repeatedly demonstrated that poor staffing ratios lead to poorer patient care and outcomes, including increased morbidity, medication errors, and risk of infection.
Additional factors are leading to worsening patient acuity levels. American Hospital Association recently issued areport that found that deferred patient care during the pandemic led to a 9.9 percent increase in the average length of stay from 2019 to 2021.
As hospitals treat sicker patients, often with fewer clinical resources, deploying telehealth endpoints in patient rooms across the hospital enterprise helps amplify patient coverage and safety and improve the speed of clinical intervention. Virtual observation programs, for example, are increasingly moving beyond critical care units to help care teams keep eyes on at-risk patients for things like fall prevention. The ability for care teams to move from a one-to-one in-person model to a one-to-many virtual caregiver-to-patient model maximizes staff resources while reducing the cost of care.
A single telehealth platform may serve many use cases in the patient care journey, from virtual rounding in the morning, to virtual behavioral health appointments in the afternoon, to virtual patient observation at night. When integrated with clinical decision support tools, virtual nursing can support patient stratification to detect and intervene when patients are in decline and potentially discharge those doing well early. Bringing virtual resources to the bedside also enhances clinical collaboration as well as family engagement, which reduces anxiety and speeds the recovery process.
The Future State: Strategic Differentiation
Another motivator driving health systems to adopt an enterprise approach to telehealth is the pursuit of competitive differentiation. Hospital Room of the Future initiatives are cropping up across the nation as healthcare organizations seek to attract tech-savvy consumers and partners. These digitally enabled rooms enhance the care experience for patients and care providers alike. Patients benefit from virtual access to their clinical team and interpreters, which can improve HCAHPS scores. Clinicians benefit from access to innovative connected health integrations that streamline workflows and improve efficiency.
Many additional healthcare initiatives that are on the horizon are only feasible when telehealth is involved. Hospital at Home, Chronic Care Management, Aging in Place, and even advancements in preventive care coordination all require or benefit significantly from the ability to virtually engage with patients between in-person encounters, representing additional use cases where telehealth can enhance patient care.
The Challenge and a Path Forward
Inflation, increased labor expenses, and a rise in patient acuity are all putting strain on hospital financials. According to recent research from Kaufman Hall, the hospital median operating margin was down by 29.9 percent year over year as of June 2022.
So how can health systems enable enterprise-wide telehealth in the midst of record-setting low margins? Many recognize the value and long-term ROI that augmenting inpatient care with virtual workflows can bring but struggle to invest the upfront capital typically associated with enterprise-wide implementations. Without a way for health systems to wade into enterprise telehealth, financially speaking, few will be swimming.
The good news is that new pricing and acquisition models are emerging to help providers step into hybrid care and enterprise telehealth. Subscription-based models that offer pay-as-you-go pricing reduce up-front capital investment requirements. New cost-effective endpoint options for lower-acuity patient engagement that does not warrant the same intensive clinical communications needed in higher-acuity environments like the tele-ICU are also entering the market.
Enterprise telehealth platforms that master the basics – security, centralized program and fleet management, integration adaptability, and scalability – offer a solid foundation to build on that will also help health systems mitigate solution sprawl and resource redundancy in the years to come.