Jan 12 2021

Hospitals’ In-Room Cameras Enable Seamless Visits and Better Safety

Expanded inpatient telehealth solutions support safety protocols and a more personal connection.

As COVID-19 swept across the country last spring, teams at Banner Health quickly acquired more tablets so doctors could conduct virtual rounding and other critical communications from a distance.

The solution, though effective, wasn’t good enough for James Roxburgh, the organization’s CEO of telehealth.

The approach still required a nurse to enter a patient’s room with the tablet to facilitate each telehealth session. “The doctor could remain safely outside, but the nurse was still at risk, which seemed unnecessary,” Roxburgh says.

Convinced that Banner Health could do better, he reached out to his previous employer, VeeMed, a California-based telemedicine solutions company, as well as Intel to convert existing televisions in nearly 1,200 patient rooms into “virtual care endpoints” across the Phoenix-based system, which operates 28 hospitals in six states.

The solution: a telehealth kit with an Intel NUC Mini PC, a pan-tilt-zoom camera and a Jabra Speak 510 speakerphone. The kit connects to the patient’s room television with an HDMI cable, and the NUC runs VeeMed software.

Now, when physicians want to meet with a COVID patient virtually, they can launch the visit via their own tablets or smartphones and connect directly to the in-room television monitor. Or, if an onsite nurse determines a virtual consult is needed, he or she may notify a doctor through the telehealth portal and use a remote control from outside a patient’s room to cue up the TV.

Not only is the technology efficient, but it’s also highly precise.

“The camera lets you zoom in on anything you want,” Roxburgh says. “You can focus on a pupil, look at waveforms on the monitor, check the drip rate on a pump — and as you do, you can be talking with the patient, all without ever having to go in.”

The setup has reduced staff exposure to COVID-19, preserved personal protective equipment and saved time and expenses associated with carting cleaning equipment from room to room.

“Interestingly, the patients like it too,” Roxburgh says, noting that many have said they find the virtual visits to be more productive. “What the patient sees is a doctor without distractions. Because it’s just their face up there, the focus is on them and nothing else.”

Providers Must Adapt to Deliver for Their Patients

Before the pandemic, most providers saw little reason to use virtual technologies for inpatient visits. And while Roxburgh says he knew Banner Health’s telehealth solution “would be a winner” for obvious COVID-related reasons, he’s now visualizing its role in other functions.

“We can bring in outside specialists for visits or do guest visits with family members at home,” Roxburgh says. “My vision is that every hospital room should have this capability, and I think we’ll find it’s valuable even after the pandemic.”

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Others in the medical arena agree. “These systems are going to be beneficial to both nursing and support staff in responding to a patient’s needs,” says James Welch, president and chief strategy officer with ARC Biomedical Consultants in Bend, Ore. In-room telehealth advancements won’t eliminate the need for face-to-face care, he adds, “but they may increasingly supplement routine calls and more frequent check-ins.”

David Hinkle, executive director of business operations with Mercy Virtual, has long been a champion for in-house telehealth. The Chesterfield, Mo.-based organization has offered its own virtual care services for more than a decade.

It was the first health system in the country to open a dedicated virtual care center designed for intensive care doctors and other specialists to monitor patients across an extensive network of Mercy hospitals and clinics.

“Early in COVID, we quickly recognized how lucky we were to already have this infrastructure in place,” Hinkle says.

That infrastructure largely involves HIPAA-compliant telehealth systems, including Vidyo and other solutions. Hospital rooms feature wall-mounted units with adjustable monitors, pan-tilt-zoom cameras, and built-in speakers and microphones. The cameras have infrared capability so clinicians can check on patients at night.

James Roxburgh, Banner Health
The camera lets you zoom in on anything you want. You can focus on a pupil, look at waveforms on the monitor, check the drip rate on a pump — and as you do, you can be talking with the patient, all without ever having to go in.”

James Roxburgh CEO of Telehealth, Banner Health

Nearly all remote monitoring was once funneled through Mercy’s telehealth hub, but that’s no longer the case. “Now, we have this technology at all of our nurse stations, and we’ve also made it so physicians can use it from home” to connect with hospitalized patients, Hinkle says.

Collectively, the changes are critical.

“There’s a lot less of what we were doing initially, with the provider going in and out of the room, putting on PPE, taking it off and throwing it away,” Hinkle says. “The way we’re doing it now is much more efficient, and our clinicians are much less likely to get sick.”

Preparing for the Future of Healthcare

As Mercy took its established telehealth program and adapted it to fit the contours of the pandemic, many other organizations — including the San Francisco Bay Area’s MarinHealth — didn’t have the luxury of starting with a tested infrastructure.

Although MarinHealth Medical Center was constructing a new building with plans to feature inpatient telehealth technology, the pandemic hit before construction was complete.

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“We realized we couldn’t wait for the move-in date,” says Michael Aubry, the organization’s director of technical services, “so we decided to install the system in the facility we had.”

By late March, more than 90 existing patient rooms, including 10 in the ICU, had been equipped with cameras with integrated speakers and microphones. The MarinHealth IT team expedited the process by assembling and prepping the units ahead of time; installations took place during patient transitions.

“That way, as soon as we knew a room was being emptied, we could run in, hang it on the television, then take off and get to work on the next one,” Aubry says.

Close to 135 rooms in the medical center have been outfitted with technology to deliver in-house virtual care — a service Aubry predicts will have enduring value for a wide range of care scenarios.

“In the short term, it’s given us flexibility at a time of crisis and helped us keep a difficult situation under control,” he says. “But long term, this is something we’ve wanted to do. It’s another way for us to enhance patient care.”

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