It can be challenging to know when or if to admit a patient, which is why observation care is so important, not only for optimal outcomes but also for optimal reimbursement. According to the CMS, “Observation care is a well-defined set of specific, clinically appropriate services, which include ongoing short-term treatment, assessment, and reassessment before a decision can be made regarding whether patients will require further treatment as hospital inpatients or if they are able to be discharged from the hospital.”[1]
Observation care is most often used for patients who have presented to an emergency department (ED) and require a “significant period of treatment or monitoring” before determining whether to admit or discharge the patient.[2] Managing observation care can be challenging for EDs, especially those that have been hit hard by staffing shortages. It is one of the most expensive and resource-constrained settings in healthcare. Many hospitals and health systems have had to shutter their emergency services altogether.[3] The 88-hospital Trinity Health has been forced to close 13% of its emergency departments due to staffing shortages.[4]
Another challenge for short-staffed EDs is that their utilization is often for care that could be provided elsewhere. Nearly 30% of ED visits are for nonemergent care, costing approximately $4.4 billion annually.[5] Spending time on non-urgent patients leaves less time for critical patients. This can result in backlogs, a shortage of ED beds, a stressful work environment, and poor patient experience.
Many forward-thinking hospitals are turning to virtual sitters as a way to mitigate these challenges and to better manage observation care without having to add staff.
More effective observation care
A virtual sitter solution allows hospitals to leverage remote clinicians to provide quality observation care for patients needing round-the-clock monitoring. The best solutions enable clinicians to simultaneously monitor up to 16 observation care patients from a single screen. This means hospitals can set up a virtual “command center” where dedicated clinicians can oversee all observation care patients regardless of where they are located within the hospital.
Virtual sitter solutions often include equipment such as digital stethoscopes, Horus scopes, and other medical devices that allow remote clinicians to examine patients and monitor vitals in real-time. If an issue is identified, the virtual sitter can quickly notify the patient’s bedside clinician or floor nurse.
Falls Prevention
Patients who are undergoing observation care may be at increased risk of falling. According to the AHRQ, up to one million people in the U.S. fall in the hospital each year.[6] Yet, research shows that nearly a third of those falls could be prevented. A virtual sitter can help prevent falls in observation care patients by identifying situations where a fall is likely. The virtual sitter can immediately notify an onsite nurse that the patient needs assistance while also letting the patient know that help is on the way.
Post-discharge care
Virtual sitters can be beneficial as part of a post-discharge monitoring solution for observation care patients who have been sent home. Nearly one in five patients experience an adverse event within three weeks of being discharged from a hospital or ED, most of which are preventable.[7] These events can lead to readmissions, trips to the emergency department, or worse. Virtual sitters can continuously monitor and evaluate these patients during this critical time to ensure they remain stable and well on their way to healing.
Choosing a virtual sitter solution
There are many virtual sitter solutions on the market, so hospitals must identify the features that best fit their unique requirements. The following seven capabilities are a great place to start.
- A unified user experience. A virtual sitter solution must provide a unified user experience across all mobile, desktop, and clinically focused endpoints. The best solutions are designed to support an observation care setting. This ensures consistency and ease of use, which can help drive clinical adoption across the care continuum.
- Exceptional video quality and error resilience. Quality observation requires that clinicians see true-to-life color, motion, and skin tone. The best virtual sitter solutions provide high-quality audio and visual options, including 4K and 5K displays.
- Easy for patients and clinicians to use. Choose a solution that uses simple, onscreen buttons that make it easy for patients and clinicians to connect. A one-click solution is the best choice. Onscreen email and text options allow clinicians to invite the patient’s family, providers, specialists, and other care team members to the call. Ease of use is critical for clinician adoption and optimal collaboration.
- Customizable deployment. The virtual sitter solution you choose should be simple to deploy on any application, including Windows, macOS, and Android, and on various screens, including desktops, browsers, medical carts, and mobile devices. Choose a solution that will meet your unique deployment needs. This might include on-premises for high-level control over traffic, CDRs, and network access; private cloud through Google Cloud Platform or Amazon Web Services; or a multi-tenant cloud for scalability, silent upgrades, and proactive monitoring.
- Integrations with top EHRs. The best virtual sitter solutions are those that fit seamlessly into existing workflows. Therefore, it is essential to pick a solution that integrates with your EMR, HIS, or PMS systems. Choosing a solution with long-standing integrations with systems like Epic will help reduce operational interruptions and facilitate a more efficient implementation.
- Call recording. Depending on your organization’s needs, having the option to record virtual sitter calls can be important, especially for consult reviews and patient education. To address privacy concerns, you may want to bypass solutions that offer to keep recordings in their systems. Instead, opt for a solution that allows hospitals to manage recordings within their own systems.
- Supports HIPAA compliance. Be sure to choose a virtual sitter solution that meets all HIPAA-compliant Business Associate Agreement requirements.
A better care observation care experience
Observation care is essential for providing optimal care while avoiding unnecessary and costly admissions. Better managing observation care can help reduce denied claims and payment retractions. One of the best opportunities for improving observation care, even amid severe staffing shortages, is through the use of virtual sitters. VidyoHealth can help.
VidyoHealth’s VirtualSitter solution was designed for hospitals that need a turnkey solution to connect clinicians with patients and their families within an in-patient or outpatient setting. With VirtualSitter, clinicians can easily observe multiple patients simultaneously on the same monitor from any location. Conferencing with a patient is also easy, with onscreen buttons for audio-only or audio-visual calls. Clinicians can invite family members, providers, or specialists to join the conference via an onscreen email or text invitation option. There’s even a “doorbell” alert to let patients know a conference is about to begin and a privacy option patients can choose when having confidential conversations with family or friends.
Learn more about the VidyoHealth VirtualSitter solution at www.vidyohealth.com.
[1] https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r42bp.pdf
[2] https://www.cms.gov/regulations-and-guidance/guidance/transmittals/downloads/r42bp.pdf
[3] https://www.reliasmedia.com/articles/149037-dangerously-understaffed-eds-can-legally-expose-hospital
[4] https://www.fiercehealthcare.com/providers/unsustainable-losses-are-forcing-hospitals-make-heart-wrenching-cuts-and-closures-leaders
[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3412873/
[6] https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/index.html
[7] https://psnet.ahrq.gov/primer/readmissions-and-adverse-events-after-discharge
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