Enhancing Patient Care: The Shift to Virtual Hospitalist Services

Editor’s Note: This story is Part 2 of a 2-part series on virtual health. Part 1 covers the benefits of virtual health.

With UCHealth’s Virtual Health Center, smaller hospitals now have overnight access to a team of hospitalists, or physicians who oversee the care of patients who are hospitalized.

Dr. Gary Breen, a hospitalist at UCHealth Yampa Valley Medical Center, highlighted the challenges faced by rural hospitals, stating, ‘It’s virtually impossible for any rural or smaller hospital to provide in-house, 24-7 hospitalist coverage.’ He added, ‘We have that level of care now, and it has provided a level of continuity for patients that we didn’t previously have at night.’

Accessing remote specialists isn’t a new concept; for over a decade, UCHealth’s telestroke program has connected overnight patients to neurologists specializing in stroke care. The virtual hospitalist program has built upon this foundation.

‘It was a pretty seamless rollout for us to essentially be doing this with hospital medicine instead of neurology,’ Breen noted.

The virtual hospitalists act when new patients arrive at the hospital at night, or when hospitalized patients experience emerging clinical concerns during the night.

In such cases, the on-duty emergency department physician consults the virtual hospitalist to create a treatment plan.

‘Once the patient reaches the medical floor, a nurse gets the telemonitor in place and calls the hospitalist, who has a virtual interaction with the patient,’ Breen explained. ‘The virtual hospitalist talks to the patient about what they think is going on, outlines a treatment plan, and answers questions.’

This initial consultation with a virtual hospitalist typically occurs within an hour of the patient’s hospital admission.

The team operates from 7 p.m. to 7 a.m., equipped with all necessary information comparable to a local doctor, including vital signs, lab and radiology test results, EKGs, and more.

‘It’s a relatively small group of physicians that provide this service, so there’s consistency. At least on a virtual basis, we get to know them really well,’ said Breen. ‘Often they’re on three to four nights in a row, so they get to know the patients.’

If a patient’s condition declines or complex care is required, the virtual hospitalist contacts the local hospitalist for in-person attention.

‘We’re still on call 24/7,’ Breen remarked. ‘This has just relieved some of the calls we get at night.’

This virtual support fosters better continuity of care. For instance, as Breen concludes his shift, he can request the virtual hospitalist to monitor a patient’s lab results every four hours. When he returns in the morning, the virtual hospitalist updates him about any significant changes and new patient admissions overnight.

‘I understand exactly who came in, how busy it’s going to be, and really have a sense of what is ahead first thing,’ Breen stated.

Patients have expressed gratitude for the timely assessments and continuous availability of the hospitalist services.

‘In the past, questions may have lingered through the night and they may not have talked with a physician right away,’ Breen reflected. ‘That’s all happening in real time, and patients appreciate the technology and the promptness of care they’re getting.’

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.