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?
Learn more about key considerations that can help ensure long-term ROI on your virtual patient observation initiatives by downloading our white paper Best Practices for Tele-Sitting and Virtual Patient Observation.
Lee Health Virtual Patient Observation Program Earns Innovation Award
HIMSS South Florida chapter members gathered recently for the 11th annual Integrate Conference, where Caregility partner Lee Health was announced as the recipient of the 2022 Digital Transformation Innovation Award.
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.
Lessons Learned: Virtual Patient Observation Essentials
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.
With a successful implementation and proper training, you will begin seeing benefits of virtual observation, including:
- 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.