Patient-Centered Care

The Evolution of Telesitting in Healthcare

Telesitting allows one clinician to monitor several patients remotely. Prior to the pandemic, the technology was used to cut costs; today, it’s become a necessity amid staff shortages.

Elliott Wilson

After a 20-year career focused on the advancement of virtual care and digital health transformation in the healthcare provider industry, Elliott Wilson joined CDW Healthcare in 2021 as a member of its healthcare strategy team. His focus remains on innovating care models through the practical application of advanced technologies and remote modalities aligned to customers’ strategies. He is a former HIMSS Chapter President, a Co-Chair of the American Telemedicine Digital Transformation Special Interest Group, and received his MBA from Villanova University.

Telesitting technology can play a crucial role in mitigating the impact of staff shortages and burnout among nurses and other clinical staff. As telesitting evolves with the integration of new technologies and artificial intelligence (AI), it can do more to improve clinical efficiencies and patient experiences.

Patients who are fall or safety risks need someone watching them to ensure their well-being. In the past, this required that someone be in the room with each patient. As the number of patients needing safety sits rose, it became increasingly more expensive and difficult to fill sitter roles. This meant patient care technicians (PCTs), who support nurses on the floor, were being pulled into patient rooms to sit while nurses were left to handle tasks such as bringing ice chips to patients rather than working at the top of their licenses. The result was often clinician burnout, which can have a negative effect on patient experience.

Telesitting technology allows sitters to monitor several patients at once, freeing up patient care technicians and nurses. The most common telesitting technology includes two-way audio and one-way visual. Sitters can monitor remotely or from a central location within a health system.

Click the banner for access to exclusive HealthTech content and a customized experience.

The Benefits of Telesitting for Clinicians and Patients

Prior to the pandemic, many healthcare organizations pursued telesitting as an operational efficiency and cost-cutting measure. A PCT can simultaneously monitor around 12 patients remotely. They can talk to patients if needed, deploy automated responses in different languages and ring an alarm if a patient needs immediate help. An organization no longer needs to hire a sitter for each patient room.

As the pandemic took hold, resources for healthcare organizations became scarce, including staff. Existing staff also had to be protected from exposure. Health IT teams began deploying telesitting not only to cut costs but out of necessity. Post-implementation, and with nursing support teams back on the floor, nurses again can focus on key clinical activities and caregiving. They can perform med-reconciliation instead of tech support for pillow speaker issues. Having nurses operate at the top of their licenses means more quality patient care in addition to clinician well-being.

Implementing telesitting programs benefits patient outcomes. In addition to saving money, organizations that use this technology also can track quality metrics, like the number of falls and falls with injury within a facility. However, healthcare providers should listen for anecdotes about successes. I remember a telesitting implementation some time ago during which one of our remote sitters, having watched a patient for a long while, noticed that he had stopped behaving as he normally did. The patient was decompensating and was moments from crashing. That observation potentially saved the patient, which is an immeasurable win.

Considerations for Implementing Telesitting Technology

Telesitting technology isn’t — and shouldn’t be — just about throwing technology at a problem. Organizations will need to write job descriptions for sitters; weigh the benefits of nursing or physician-led protocols for remotely monitoring patients; and develop procedures for intervention, program discharge and equipment recycling. Implementation teams should include representation from legal and privacy teams to ensure policies and consents for facilities cover the use of 24/7 audio and video monitoring. Perhaps most important, healthcare organizations must clearly identify protocols for noncompliance — for example, how many patient redirects will be allowed before someone needs to transition to a one-to-one safety sit.

From an IT perspective, before implementing the technology, health IT teams must ensure their organizations’ networks can handle the bandwidth for streaming video of that magnitude. Some organizations may not be able to implement telesitting until a network upgrade is complete, or they may have to deploy on a smaller scale at first. A network assessment by technology partners such as CDW can help healthcare organizations determine whether their networks can handle the addition of telesitting programs. Telesitting platforms also should have the ability to integrate directly with an organization’s electronic health record.

DISCOVER: How partner-delivered IT services help mitigate the effects of staff shortages.

What’s Next for Telesitting Technology and Clinical Efficiency?

Telesitting, which seemed revolutionary prior the pandemic, will continue to evolve over the coming years. Organizations have already started overlaying AI algorithms onto video feeds to detect patient movement and probability of getting up. LIDAR technology, used to great effect in autonomous vehicles, can autonomously scan rooms for patient obstacles.

This technology can be implemented under Patient Room ‘Next’ strategies to advance patient care. Part of that overall strategy is getting away from having several point solutions and moving toward platforms with applications in other use cases across the system, thereby maximizing the investment. Examples of this include Artisight’s clinical automation capabilities and Caregility’s virtual nursing platform.

Telesitting has proved to be an excellent foray into using remote technology to ease the clinician burden. The evolution toward autonomous monitoring holds great promise for the future of care.

This article is part of HealthTech’s MonITor blog series. Please join the discussion on Twitter by using #WellnessIT.