How smart rooms are supporting virtual nursing operations

Using smart room tech to enhance virtual nursing workflows

Virtual nursing offers numerous benefits for health systems. Not only do these models offer a potential solution to the ongoing nurse shortage and staffing crisis, but they also support positive clinical outcomes. One recent study, for example, revealed that virtual nursing models were associated with lower 30-day emergency department readmission rates.

Smart hospital rooms can help enhance the virtual nursing model and the benefits it provides. At Illinois-based OSF HealthCare, AI-enabled smart rooms have enabled a more efficient and seamless remote care workflow for virtual nurses, explained Brandi Clark, vice president of digital care at the health system's digital health arm, OSF OnCall.

The health system worked with hellocare.ai to create its smart rooms, which include tablets, televisions with teleconferencing capabilities and digital whiteboards integrated with the EHR. At OSF Healthcare, virtual nurses' primary task is to conduct admissions and discharges using a tablet brought to patients' bedsides. But now, through smart rooms, virtual nurses can connect with patients via the in-room television whenever needed.

"So, from a workflow standpoint, they become no longer dependent on the bedside nurse's workflow," Clark said. "The [bedside nurses] are busy, and taking a tablet into the patient's room isn't as important as passing a medication or managing a need that a patient has. So, as [virtual nurses are]  able to drive their workflow, they're able to be much more efficient."

For virtual nurses at Sanford Health, smart room technology has been critical in supporting fall prevention efforts, Erica DeBoer, the health system's chief nursing officer, shared. The health system worked with Artisight to install its smart rooms, which feature AI-powered computer vision and motion sensors that alert virtual nursing staff to fall risk in patient rooms.

"The AI  actually gives a visual cue to that individual that's watching several patients," DeBoer said. "[The AI] took 90 days to learn our rooms, so it can now more effectively manage low-risk, high-risk activities that are happening."

"We don't want to just put AI in to put AI in, but computer vision technology can help us gain so much more information, as well as increase efficiencies and safety," she added.

The health system has not yet added two-way audio-video technology to its smart rooms, but the rooms are outfitted with video capabilities, enabling virtual nurses to see into the room, as needed, and alert bedside nurses to any patient needs.

OSF Healthcare is also using AI capabilities built into its smart rooms to manage fall risk and prevent pressure injuries.

Computer vision and sensor technology detect when the patient is moving or making movements as though they're going to get up from their chair or bed and alert the care team so they can ensure the patient is not at risk of falling, Clark shared. Sensor technology, combined with AI, also gauges whether patients are turning and moving on their own while in bed, allowing virtual nursing staff to better assess which patients need help to avoid pressure injuries and to notify bedside teams.

In addition to more efficient workflows and enhanced patient oversight, integrating virtual nursing with smart rooms has also bolstered nurse safety.

"We do have a large amount of workplace violence that happens within our walls," DeBoer said. "And so, what we found is that by having a virtual nurse, it actually can help to reduce some of the concerns and actually increase the safety for our employees as well."

Addressing smart room implementation challenges

For both Sanford Health and OSF Healthcare, implementing the smart rooms required redesigning and upgrading aging infrastructure.

For instance, Sanford Health's Sioux Falls market, which is anchored by Sanford USD Medical Center, has older rooms and implementing smart room technology has involved logistical reorganization, DeBoer shared.

Similarly, smart room implementation at OSF Healthcare involved integrating the technology into 100-year-old rooms and managing variation in the room configurations.

"Some of the rooms are private, some of the rooms are semi-private," Clark said. "So, we had to install two sets of equipment in one room to serve two patients."

While some rooms were already primed for the technology implementation, the health system had to reconfigure other rooms and adjust existing infrastructure to create more space for the smart room technology, she added.

Another challenge that health system leaders had to address was staff resistance to the technology changes.

DeBoer said that Sanford leaders involved nursing staff in designing the rooms to gain and maintain buy-in. Virtual and bedside nurses were encouraged to share what they wanted the workflows to look like and the tools that would ease administrative burdens.

Contrary to leaders' expectations, newer nurses appeared more resistant to technology-based workflows than nurses with three years or more of experience. The latter "were very excited about the tools and quite engaged," DeBoer said.

At OSF Healthcare, leaders listened to nurses' concerns and provided the support staff asked for, Clark shared. The health system is also only converting 10 rooms at a time into smart rooms, giving staff time to get used to new workflows and share bottlenecks that need to be addressed.

Growth plans for smart rooms

Both health systems are in the process of expanding smart room technology across their facilities. At OSF Healthcare, Clark expects all 400 beds at OSF Saint Francis Medical Center to be outfitted with smart room technology by next year. The health system will then make plans to expand the technology to other facilities.

Sanford Medical Center Fargo in North Dakota has over 100 smart rooms. By March 2027, the health system plans to install another 29 rooms in Sanford Bemidji Medical Center in Minnesota, DeBoer shared.

"What's exciting to see and to dream about though is what could it look like in our rural healthcare situation?" she said. "So, when you think about the number of rural healthcare organizations that we have in our footprint, what could it look like if we expanded it there?"

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers healthcare IT and innovation, including artificial intelligence, digital healthcare, EHRs and interoperability.