Digital Minute: Virtual Nursing

Premier Pulse     August 2023

1467409706P-W-EMS62057-Via_MandyBy Walter Reiling, MD, system chief medical information officer, Premier Health; and Mandy Via, senior product manager of digital health, Premier Health

In late May, Premier Health launched an exciting new pilot for Virtual Nursing.  As health care leaders across the nation work to redesign care delivery models, we began our journey by leveraging current telehealth technology and an agile and innovative team. Virtual nursing is now deployed across our system at three hospitals and five nursing units.  

In application, a virtual nurse will join the patient through a secure videoconferencing platform on a telehealth tablet cart to complete portions of the admission and discharge process.  This frees up the bedside nurse’s time to care for other patients, with the virtual nurse providing focused admission and discharge communications.  Patients have shared that they like having the virtual nurse encounter as it speeds up their hospital stay without interruptions. Bedside nurses also share that they know their patients are getting virtually connected with another Premier nurse, allowing the bedside nurse additional time to see other patients. The excitement of virtual nursing is spreading as we consider the possibilities that will support our staff and patients.

Digital Stethoscopes

As technology continues to evolve and expand, Premier Health recently implemented digital stethoscopes across our emergency departments and to TeleSNF sites.  Layering this technology onto current telehealth platforms and programs, we are augmenting care delivery to provide a more robust telehealth experience. The digital stethoscope has 40x amplification and noise cancellation, ideal for enhanced sounds. The bedside clinician can also send a livestream link to the remote provider to share real-time auscultation of sounds. The livestreaming allows the provider to direct the bedside clinician to auscultation points if needed while gaining enhanced assessment for the patient.

Post-PHE Update

The Public Health Emergency (PHE) stemming from the COVID-19 pandemic ended on May 11, 2023, and brought the return of requirements to which providers must adhere.  One key component is that only HIPAA-compliant platforms are to be utilized for telehealth.  Premier offers Vidyo and MyChart platforms to meet this requirement. Our PPN providers can continue using these platforms for patient visits as they have been for the last couple of years. Facetime, Google Duo, Facebook, TikTok, Snapchat, Thread, Twitter, Instagram, and other platforms are NOT permitted.

The telehealth landscape continues to shift as we watch payer behaviors and monitor CMS. Even though the PHE ended, certain flexibilities were extended through December 31, 2024.

Temporary Medicare changes through December 31, 2024 are as follows:

  • FQHCs and RHCs can serve as distant site providers for non-behavioral/mental telehealth services
  • Medicare patients can receive telehealth services in their home
  • There are no geographic restrictions for originating site for non-behavioral/mental telehealth services
  • Some non-behavioral/mental telehealth services can be delivered using audio-only communication platforms
  • An in-person visit within six months of an initial behavioral/mental telehealth service and annually thereafter is not required
  • Telehealth services can be provided by all eligible Medicare providers

Back to the August 2023 issue of Premier Pulse

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