How virtual health tools are making hospital rooms 'smart'

What the 'smart rooms' will feature

Several virtual health tools will take Virtua Health's inpatient rooms from standard to smart, including cameras installed in every patient room. According to Capriotti, the health system has committed to installing 1,200 cameras systemwide, of which about 550 have been installed thus far.

The traditional pan-tilt-zoom cameras sit on top of the TVs in patient rooms. Capriotti explained that there is a doorbell functionality, which triggers the TV to display the Care.ai platform. A blank circle appears on the TV, through which clinicians virtually "knock" and ask to enter the room. Once the patient agrees, the audio-video feed initiates, allowing the clinicians and patients to see and speak with each other through the TV.

Additionally, the platform allows family members and other loved ones to join in on these calls.

"Our virtual clinician can text them a link [and] they can link right into that exchange," Capriotti said. "We use that all the time as we're doing discharge planning, medication reconciliation if patients don't know their meds. We've pulled in patients' family members from all over the country. We can pull in another clinician, and also interestingly enough -- we didn't anticipate this -- [it] was [of] huge value in our translation services."

And it's not just the cameras. Virtua Health will also implement Care.ai's ambient sensors, which are little boxes that sit below the cameras, Capriotti described. These sensors map the room with Light Detection and Ranging (LiDAR) and thermal imaging, allowing hospital staff to monitor the movements in the room.

The health system is currently planning to use the sensors to reduce patient falls, one of the most common types of medical errors. In this use case, the sensors map the bed or a patient's chair and create a safe zone. Based on the patient's movement, the sensors can predict whether they're going to exit that area and have a potential fall.

These are care models that traditional clinical teams are not totally used to. So there's a tremendous amount of communication and tremendous amount of change management we do to make sure that our teams understand that we're building out supportive care -- that this is not in any way meant to replace them or to do away with their jobs.

"You think about how transformative that is in a traditional setting -- we do telesitting via video feed, we roll in cameras, and we watch our patients, and we are dependent on those telesitters to see any movement happening and to intervene to try to get the patient either help," Capriotti said. "This will be an earlier predictor of whether that patient is potentially at risk of a fall, and we'll be able to do an earlier intervention."

Another potential use case for the ambient sensors is reducing pressure ulcers. Capriotti explained that the tool's ability to map patient beds and track movement allows it to determine how often a bedridden patient has moved and their potential risk for developing a pressure ulcer. The platform can then alert the clinical team when the patient must be rotated or moved to avoid that.

Finally, the ambient sensors will enable ambient listening to support bedside clinical teams. According to Capriotti, the health system has established a safe word, which, when said inside a patient's room, triggers an alarm for help.

"So, if I'm helping a patient and things are not going well, I can trigger that without having to hit an alarm, without having to necessarily even alert the patient [and] without stressing them out," he explained.

As the technology rollout continues, Virtua Health and Care.ai will identify and pilot more use cases for the platform. For instance, Capriotti said the health system plans to use the platform's ambient listening capabilities to ease clinical documentation burdens.

Implementation hurdles and strategies for success

Deploying technology across five hospitals requires a strategic approach, and Virtua Health has determined that a hospital-by-hospital phased approach works best.

Virtua Willingboro Hospital completed its Care.ai implementation in April. Virtua Voorhees Hospital and Virtua Our Lady of Lourdes Hospital in Camden are in the midst of implementation, after which Virtua Marlton Hospital and Virtua Mount Holly Hospital will begin implementation. The health system is piloting multiple use cases with the technology, including virtual nursing, telesitting, teleICU, virtual hospitalist services and virtual care discharge processes.

However, implementing the new technology also required upgrades to the health system's technological hardware.

"You run into all sorts of challenges that you don't anticipate," Capriotti said. "We had to replace all of our TVs. We had older technology that was not able to integrate with what we were doing. So, we are not just installing cameras and wiring, but we are installing all new TVs across the organization as well."

This means that the implementation process is running slower than expected. Capriotti said that he had expected to have all the cameras installed by this month. However, since the TVs also need to be replaced, the installation teams can only work in rooms not occupied by patients. The installation is expected to be completed by the third quarter of 2025.

Virtua Health has established an enterprise care logistics center to serve as the hub for all virtual health programs. A clinical support team of physicians and nurses staffs the hub.

But bridging the gap between virtual and bedside care teams is critical when introducing virtual health programs on a large scale.

"These are care models that traditional clinical teams are not totally used to," Capriotti said. "So there's a tremendous amount of communication [and] tremendous amount of change management we do to make sure that our teams understand that we're building out supportive care -- that this is not in any way meant to replace them or to do away with their jobs."

For instance, the health system has implemented virtual nursing care models supported by the Care.ai platform. In doing so, leaders were mindful of nursing concerns, conducting regular weekly and monthly meetings to discuss how the program was developing, what was working, and what was not working, and to problem-solve.

Another way health system leaders tackled change management was by rotating hospitalists through the virtual service so they could alternate shifts between virtual and on-site settings.

"It's a value add for them in that they can work from home if they do it and gets them out of the bricks-and-mortar facilities for a shift and really gets them to, with the platform, understand what the benefits are so when they're on the floor, they understand the value add of these virtual services," he said.

As the health system continues to deploy virtual health technology across its hospitals, leaders plan to monitor patient satisfaction and operational metrics, such as patient throughput.

Capriotti believes that these virtual health tools will significantly boost efficiency and patient experience by allowing clinical teams to spend uninterrupted time with patients.

"When you're in a virtual environment, you're not tied to the distractions that our med-surg nurses face every day," he said. "They're crazy busy. Our hospitals are crazy busy. So, to spend that half hour, to spend that hour with a patient to do true discharge education, to do med [reconciliation], it's been transformative."

The virtual care team has also been able to take on administrative tasks, such as admissions and discharge, giving on-site care teams more time to complete hands-on tasks.

Further, creating a new type of role within the organization -- one that is not physically taxing -- has provided healthcare workers with a new avenue to continue their work as they age. Capriotti noted that amid ongoing workforce shortages and resignations, virtual care offers a way to keep older and burned-out healthcare workers in the workforce. Not only that, but older and more experienced staff can also provide newly graduated healthcare workers with support via virtual health capabilities.

In the age of digital transformation, health systems must consider the tools that will help them achieve organizational goals. It is becoming increasingly apparent that virtual health tools offer clinical teams new approaches to enhancing patient care without adding to existing burdens.

"It's kind of like a win-win for almost everybody," Capriotti said. "It really is. It's hard to argue against."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.