A: Although practicing virtually, all telehospitalists have the same education and training as their in-person counterparts. We require at least two years of recent hospitalist experience.

A: Absolutely. Just as nocturnists get to know the daytime doctors and listen to their reports at sign out, telehospitalists take notes when they come on shift regarding patients needing to be seen, overnight labs to follow up on, and any patients that are deteriorating.

As the physicians get to know one another, they learn each other’s styles and preferences, just as they would in person, and know which daytime doctors want to put their own echo results in the next morning, and which ones don’t mind if the night shift does it for them.

A: After the staff is introduced to the program, the facility goes through at least three days of drills, practicing rounding, learning how to operate the carts, going through calls, and what to do. After the first few nights, support staff is still available, and they are very responsive to any technical or practical issues that arise.

A: Telehospitalists do their rounds with the aid of a rounding cart, simply a cart with a computer, camera, keyboard, and stethoscope attached. An assigned in-person nurse wheels the cart around to the patients that need to be seen.

The telehospitalist has controls to zoom in and out, as well as look around the room, allowing them to see patients, monitors, and family members. They can toggle back and forth between overhead and cart cameras, the stethoscope, and audio options. There is also a conferencing capability where doctors can invite family members who are not present to phone in to discuss patient progress and care.

A: Having the telehospitalists available at all times ensures the night nursing staff can always reach a physician and get a response in a timely manner. Calls to the telehospitalists are prioritized so that patients deteriorating will be taken care of before admissions or ER cases.

Secure messaging to the telehospitalist is available for when a call is not necessary, decreasing the time needed and ensuring a quick response. Because telehospitalists put all orders and documentation directly into the facility’s EMR, the need for verbal orders at night is alleviated.

A: Yes. Hospitals using the virtual hospitalist program are able to adjust coverage to match their needs, including nocturnist and daytime shifts, supplementary staff during shortages, specialty admissions, extended time off periods, physician supervision, and medical consultations.

Like many new ideas, the concept of telemedicine in hospitals may take some getting used to, but the benefits
to patient care, provider satisfaction, and cost-efficiency are numerous enough to make it worth the effort.

A: Telehospitalists make a positive impact on both quality of care metrics and satisfaction rates. By enhancing continuity of care virtual hospitalist programs see significant reductions in length of stay and transfer rates.

Additionally, organizations experience improved productivity and revenue, demonstrated by noticeable increases in both total volume and total billable RVUs. A decrease in verbal orders improves efficiency and an increase in physician documentation tells a patient story more accurately.