By Beverly Welch, MSN, RN, NEA-BC, Market SVP Patient Care Service and Chief Nurse Executive at St. Joseph Health

 

Only a few years ago, virtual medicine was in its infancy. Virtual visits were a novelty, viewed with skepticism by those within and without the medical community. That all changed with the COVID-19 pandemic. Almost overnight, virtual medicine transitioned from an oddity to a necessity, which led the American Medical Association to update its telehealth best practices.

The use of virtual doctor’s appointments during the pandemic set the stage for rapid growth as we responded to the needs of our patient population. This benefit was most keenly felt among our rural communities in which health care disparities are most pronounced. Forced to identify a solution to provide patient care and prevent infection spread, the world moved toward virtual care.

In the years since, many fears regarding long-distance, technology-centric patient care have proved unfounded. The popularity of this advanced technology has changed the face of health care forever, making care delivery more consumer-driven across all health care markets.

Making full use of this shift will position health organizations to stay ahead of the curve and serve their patients well into the future.

The Expanding Role of Virtual Care 

At St. Joseph Health, we experimented with virtual visits long before the pandemic, providing distance care for those with neurological and other issues. However, our virtual offerings have expanded dramatically in the last five years.

Whereas only a handful of doctors adopted virtual medicine in its earliest iteration, nearly all offer it in some capacity today. Some use it primarily for consultations or follow-up appointments that don’t require physical proximity. Others, trained in its efficacy during the pandemic, make use of virtual visits for nearly all aspects of the course of care, including the following:

• Diagnosis

• Medication prescription

• Other treatment recommendations

A Digital Problem in the Path

The main obstacle in the way of virtual health care is access. Because rural areas are more likely to have unstable internet speeds, communicating with rural Texas residents via the internet can be difficult. 

Unfortunately, access to high-speed internet in patient homes is largely out of the hands of health leaders. We can, however, contact government officials and encourage them to continue moving forward with efforts to improve internet access in rural areas. 

Despite difficulty in rural areas, virtual medicine is flourishing here and across the country. Where internet service is insufficient, improved phone service sometimes allows for virtual visits. 

Whether via a mobile network or a home network, telemedicine is thriving. The CDC reports that from 2019 to 2021, physician adoption of telemedicine grew from 15.4 percent to 86.5 percent. SJH’s growth reflects the national average. In fact, as we’ve grown our use of virtual medicine, we have also brought it in-house.

Virtual Care in the Hospital

Though virtual medicine helps connect patients with clinicians and other medical experts anywhere around the globe, we’ve found virtual medicine a powerful tool within the walls of our inpatient units. To date, we’ve established two programs that take advantage of virtual care. 

These are:

Virtual Nurses

Through our virtual nursing program, remote nurses respond when patients push the nurse call button. This is possible because, excluding medication administration and assistance using the restroom, most patient needs don’t require a nurse to be present at all times. Our virtual nurses are part of the care team and answer questions the patient and loved ones have regarding care plans, recovery and more. Virtual nurses can also call family members with regular updates on their loved one’s progress, if requested. Should a patient require a nurse’s assistance, the virtual nurse notifies the on-site nursing team. Otherwise, the virtual nurse handles all care, while on-site nurses tend to other patients. We initially launched virtual nurses on March 26, 2024, inside a 35-bed unit. The program has been so successful we plan to expand the program to all inpatient beds by the end of summer 2024. 

Virtual Sitters

Fall risk is a very real issue when caring for patients with Parkinson’s disease, dementia and traumatic brain injuries. Virtual sitters mitigate this risk by providing nonstop monitoring of patients at risk for falling. With six mobile consoles, virtual nurses monitor patients with fall risk at SJH around the clock. When these patients attempt to stand up or leave their bed, the virtual nurse encourages them to remain in bed. Additionally, virtual nurses reorient confused patients and notify on-site nurses when patients require immediate attention. Like our other virtual efforts, virtual sitters have successfully prevented falls and freed up on-site nurses to manage other tasks.

Any time the virtual nurse or sitter interacts with the patient, the remote caregiver updates the patient’s medical chart. This keeps all members of the care team notified of the patient’s status.

Exercising Patience When Adopting Virtual Visits

Whether encouraging clinicians to open the door to virtual patient visits or adopt virtual nursing or virtual sitting, the most important tool to have at your disposal is patience. Medical professionals, patients and family members respond differently based on their exposure to this novel capability in the medical space. By maintaining equanimity and educating yourself on the strengths and limitations of virtual medicine, you will position yourself and your facility to avoid negative experiences. 

Of course, you will have a group of early adopters—medical professionals eager to put technology to greater use. However, there may be health care professionals or patients unwilling to walk away from traditional, hands-on care. Be patient with these individuals. Remember and remind them that virtually integrated care improves the patient experience. Virtual nurses, for example, improve patient satisfaction, employee engagement, quality outcomes and patient safety. 

In time, those who are cautious about the technological transition should see the benefits of virtual care and become more tolerant and accepting of this efficient and effective care model.