There is no questioning the exponential progression of technology in our everyday lives, even over the last few years. Just look within our own homes: Wi-Fi-enabled thermostats and coffee makers, wireless smart TVs, Bluetooth smart speakers, and we can even start, lock, and unlock our cars from our smartphone. Connected technology is integrated into every facet of our daily lives, replacing burden with convenience. Unfortunately, while the Internet of Things (IoT) has advanced connection and convenience within the home, the technology revolution to enable inpatient healthcare is not as far along.
As a practicing intensivist of more than two decades, I would argue the inpatient hospital room is one of the most deserving settings for advanced technology in the United States, but adoption is slow.
The global pandemic has in many ways exacerbated this problem, particularly for nurses. Consider all the administrative functions handled by nurses daily: admission data collection, discharge planning, patient education, chart audits, mentoring of less experienced nurses, care plan updates, and the list goes on. And all of this is in addition to actual, bedside patient care, including having difficult conversations and providing lifesaving work during patients’ most vulnerable moments of critical illness.
These circumstances have led to an exhausted workforce with over 18% of the workforce leaving the bedside during the pandemic. An April 2022 nursing workforce analysis in Health Affairs found that total supply of RNs decreased by more than 100,000 from 2020 to 2021 – the largest drop ever observed over the past four decades. It is now projected that we will be short 2.1M nurses to provide care in the United States by 2025.
We often think of virtual care as helpful on the consumer level or ambulatory level – how we can conveniently receive care from the comfort of our own home and on our terms. That same technology can just as easily be applied within the inpatient setting, augmenting and supporting high-quality care delivery while improving the care experience for nurses, all care team members, and patients. We’re seeing this successfully play out in our virtual nursing units across the country.
While hands-on care will always be needed, especially for critical care, many duties can be fulfilled virtually. In many successful virtual nursing programs, administrative tasks like discharge paperwork, medication reconciliation, etc., have been shifted from bedside to virtual nurses. Virtual nursing systems enable nurses to remotely monitor patients and communicate with them, their families, and other visitors and care team members in real time, including responding to patient nurse calls. It allows nurses to assess patients’ conditions and give them advice and guidance on how to manage their health, monitor their progress and make any necessary adjustments to their care plans. It can also help to reduce the amount of time patients spend in hospitals and other healthcare facilities, reduce the workload of the bedside nurse, all which can help to reduce healthcare costs and improve overall staff and patient satisfaction.
We are seeing firsthand the impact of connected technology within the inpatient hospital room. Several health systems with these novel and unique virtual nursing programs have reported high job satisfaction for their virtual nurses. Nurses say the virtual role enables them to spend more time with patients overall. These same organizations have also reduced length of stay, improved quality metrics like HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) and boosted recruitment with the availability of flexible work schedules, locations and career options for nurses and staff.
Patient engagement and satisfaction is also improving because of these models. We are seeing and hearing from clients that patients have come to appreciate the idea that they are always being looked after, there is always a nurse readily available for any questions or concerns, and many develop close relationships with their virtual nurses.
This new care model has and will continue to evolve significantly. We have seen it be adopted by other specialties to support intensivists and hospitalists rounding, provide more timely virtual specialist consults, and extend the capacity and reach of social workers, pharmacists, physical therapists, and even chaplains. One could imagine the possibilities for this model to incorporate natural language processing (NLP) and artificial intelligence (AI) that could dramatically help physicians, nurses, and allied healthcare providers with all aspects of bedside and patient care.
The transformation of how care is delivered in hospitals is required and virtual nursing is an evolution in patient care. Healthcare will not be able to sustain without a fundamental shift in thinking about how hospitals and health systems can provide technology-enabled quality care.
It is imperative that healthcare leaders start to invest and adopt in technology that improves bedside patient care and simultaneously unburdens caregivers.
Dr. Shayan Vyas
Dr. Shayan Vyas is SVP and Hospital & Health System Medical Officer for Teladoc Health. As a practicing intensivist of more than two decades, Dr. Vyas believes that the inpatient hospital room is one of the most deserving settings for advanced technology in the United States, but adoption is slow. Unfortunately, this lack of inertia is hitting nurses the hardest, evidenced by the current nursing shortage and workforce crisis. Dr. Vyas shares how technology, specifically virtual care, can be applied within the inpatient setting, augmenting and supporting high-quality care delivery while improving the care experience for nurses, all care team members, and patients.