Two types of virtual nursing will become common practice in the next five years. Here’s why.
By: Patrick Allen, BSN, MBA
Virtual nursing gets a lot of attention for its ability to relieve clinician workload. That’s a compelling advantage.
However, the value of virtual nursing goes much deeper than freeing up precious time. When implemented properly, virtual nursing solves three chronic healthcare problems: lack of capacity, lack of RNs, and capital constraints.
Virtual nursing is a type of telemedicine that supports both the team at the bedside, their patients, and families. Healthcare organizations began implementing virtual nursing programs before the pandemic, the public health crisis brought its value to light.
The Two Types of Virtual Nursing
Virtual nursing programs fall into two categories: inside the hospital and outside the hospital. Ideally, both programs would work together to create efficient, patient-centric care.
In an in-house virtual nursing scenario, one or more expert nurses perform core roles for specific care delivery teams. Virtual nurses assume responsibilities such as patient education, staff mentoring, patient safety surveillance, physician rounding, admissions, and discharge. Which units receive virtual nursing support depends on the skillsets of the available nurses, and the hospital’s clinical and business goals.
Virtual nurses typically work from a central command center. They communicate with patients via two-way video. Patient rooms include either a wall-mounted monitor or a tablet. Depending on the system, patients can use a call button or a mobile device to start a dialog. In other situations, a virtual nurse and bedside nurse work together to provide care.
Remote virtual nursing enables hospitals to provide top-of-license nursing care to patients outside the hospital. Patients receive real-time support, guidance, and education, while the hospital has more available beds for patients who need them.
Remote virtual nursing also helps improve efficiency and patient experience by converting in-person appointments to a telehealth model. Patients can attend post-operative appointments such as medication management and symptom monitoring remotely.
A hospital-at-home model—a model increasingly embraced by the Centers for Medicare & Medicaid Services (CMS)—enables hospitals to expand their physical capacity without expanding their physical space. To ease the complexity of implementation and smooth the process of change, we recommend hospitals start with an in-house program and expand to remote nursing care.
Lack of hospital capacity
Balancing supply and demand is one of the more challenging tasks hospitals face. Demand can be unpredictable. Overstaffing drives up costs but understaffing negatively impacts patient care. An outpatient virtual nursing program—a type of remote monitoring—allows patients to return home sooner, freeing up hospital space for new patients.
Lack of experienced clinicians
While the serious staffing shortages experienced during the pandemic have eased, the demand for RNs remains high. According to a Health Workforce Analysis published by the Health Resources and Services Administration (HRSA), federal authorities project a shortage of 78,610 full-time RNs in 2025 and a shortage of 63,720 full-time RNs in 2030.
Virtual RNs can contribute their expertise in a way that benefits more patients. With an RN observing, less-experienced clinicians and staff master top-of-license tasks faster. Depending on the task and state law, these staff could also complete tasks they couldn’t do independently. Our clients’ internal surveys indicate that new nurses are very happy with this arrangement and view it as an additional set of eyes and ears vs. a “watchdog.”
Capital constraints
As budgets tighten and hospitals operate with razor-thin margins, healthcare executives must devise new ways to lower costs while maintaining or improving quality. Because labor costs now account for about 60% of an average hospital’s expenses, it’s an area worth reinvention.
Virtual nursing programs enable healthcare organizations to retain RNs who need a less physically strenuous work environment. Depending on the model, virtual nurses can also assume tasks such as medication reconciliation, data entry, discharge paperwork, and patient education.
For these reasons and others, virtual nursing has evolved from novelty to standard practice. If you’re one of the many healthcare organizations that want to start or expand your program, here’s where to start.
People, Process, Technology, Experience
When we think about re-inventing a healthcare organization’s operating model to include virtual nursing, we use a people-process-technology-experience framework.
People and Experience: includes an in-depth assessment of the current staff roster. Here, we determine whether you have the right quantity and quality of staff to run a virtual nursing program, but also the right mix of experience. If not, what gaps do you need to fill? We also look at technical capabilities. What training do we need to provide your staff so they can use the new system with confidence?
Process: includes an assessment of the workflows and how to incorporate virtual nursing into the current operating model. Will a virtual nurse handle discharge? How will patients contact virtual nurses? When and how will bedside nurses contact virtual nurses? If a virtual nurse is going to verify insulin administration, how will that happen?
Technology: includes an assessment of existing technology as well as identifying and evaluating the technology needed for implementation. Do you want to start with a bring-your-own-device model or do you want to go big with smart TVs and interactive patient consoles (any of these are viable technologies)? Does your virtual nursing platform scale to support devices across your organization?
Strong data and network connectivity are required to support a standard virtual nursing system. Upgrading to a 5G network is a “smart” solution to shore up connectivity.
Healthcare organizations will also want to reassess their network and security protocols. Virtual nursing systems must operate 24/7 without disruption caused by device timeouts or logouts.
As healthcare technology experts, Pixel Health consultants are here to help you determine whether virtual nursing is right for your organization and develop a program that suits your clinical and operational goals.
Past clients that have implemented virtual nursing platforms have relayed 100% positive feedback from clinicians and patients alike. Given the benefits to patients, clinicians, and the system at large, we expect virtual nursing to become common practice in the years to come.
In our next article, we’ll discuss implementation. In the meantime, contact the Pixel Health team to find out how we can help you design a virtual nursing program that fits your technology and business goals.
