The healthcare landscape in the U.S. is undergoing a significant transformation, driven by challenges such as nursing shortages, increasing patient complexity, and cost constraints. As a result, nurses are feeling stretched thin, with many considering leaving the bedside — highlighting the urgent need for innovative solutions. Virtual care platforms are emerging as a powerful strategy to address these challenges, optimize care delivery, and enhance both patient outcomes and staff satisfaction.
Hospitals are actively seeking ways to alleviate the burden on bedside staff and improve overall efficiency. 74% of hospital leaders believe virtual workflows will become integral to care delivery models in acute inpatient care, but only 10% of leaders have reached a phase where virtual care is a standard part of care delivery. This indicates a knowledge gap in how to start and scale virtual care programs.
Based on AvaSure’s experience helping over 1,100 hospitals across the U.S. with their virtual sitting and virtual nursing programs, we’ve put together a 7-step roadmap to help you successfully launch your own virtual care program.
1. Identify your facility’s unique pain points
It’s important to identify your biggest challenges within your organization. What’s unique about your facility and where should you focus your efforts?
To help identify your top pain points, gather a group of cross-functional stakeholders, including bedside staff. Ask them to provide feedback on what they are struggling with on a day-to-day basis.
Expect to hear things like:
- Recruitment and retention of all levels of staff – from nursing assistants to nurses to highly specialized physicians.
- Patient capacity challenges & bottlenecks
- Loss of joy and fulfillment leading to burnout for all types of caregivers
- Patients’ desire for an integrated experience, bringing consumer expectations to healthcare
- Rise in patient complexity
- Quality metric declines across key areas
Once you’ve cataloged your challenges, you can get to prioritizing.
2. Prioritize the challenges with the greatest impact
Once you understand the challenges across your facility, identify which is creating the biggest drain on the system. There are a number of use cases for virtual nursing platforms — each with its own potential impact.
Some of the most prevalent use cases & outcomes they’ve been proven to impact include:
| Use Case | Potential Outcomes |
| Virtual Specialty Consults | • Shorten response time for specialty consults • Decrease time to diagnosis and treatment • Improve ED-to-admission time • Retain higher-acuity patients in-network • Reduce unnecessary transfers • Decrease locum costs • Cut down windshield time for specialists |
| TeleStroke | • Decrease unnecessary transfers • Decrease stroke treatment response time • Reduce unnecessary transfers • Shorten stroke patients’ length of stay |
| Virtual ICU | • Improve evidence-based care compliance • Ensure 24/7 intensivist coverage • Prevent CLABSI, self-extubations • Reduce sepsis mortality • Lower malpractice expenses |
| Patient Observation/Virtual Sitting | • Reduce rate of falls and falls with injury • Reduce reliance on 1:1 sitters • Reduce labor costs • Prevent self-harm during behavioral health monitoring • Improve patient and staff satisfaction ratings • Reduce elopements • Reduce incidents of harm to caregivers |
| Virtual Nursing | • Decrease bedside RN documentation time • Improve RN retention • Improve timeliness of admission and discharge from time of order • Reduce number of patients, and time spent, holding in the ED • Improved throughput and reduced overall LOS • Improved patient experience scores on HCAHPS including: Responsiveness, Nurse courtesy, Discharge information clarity |
| Nurse Mentorship | • Improve RN retention rates, especially new grad retention rates • Improve staff satisfaction • Improve speed to clinical readiness of new nurses • Improve preceptor-to-orientee ratio • Improve eNPS score • Reduce travel/agency spend • Improve response time for questions/escalations |
| Patient Education | • Improved patient experience scores on HCAHPS including: Responsiveness, Nurse courtesy, Discharge information clarity |
| High-Acuity Patient Monitoring | • Decrease 30-day readmission rates • Reduce adverse events and hospital acquired conditions such as: CLABSI, CAUTI, HAPI, falls, adverse drug events • Improve sepsis bundle compliance • Decrease code blues • Prevent unnecessary ICU transfers |
| Pediatric Patient Monitoring | • Reduce cost of monitoring eating disorder patients • Improve staff safety, preventing violence against caregivers • Reduce incidents of self-harm during behavioral health monitoring • Prevent non-accidental trauma |
| Hospital Operations | • Reduce RN turnover rates • Improve labor cost per unit of service • Improve room turnover times • Improved patient experience |
After identifying your facility’s unique pain points and prioritizing the most impactful ones to address, the ideal starting use case will become clearer. We recommend starting with one or two use cases: one use case that has a tangible financial ROI and one that has a positive impact on staff. This helps get staff on board and allows you to build a strong business case for leadership with clear, manageable goals. Once you’ve established a solid foundation, you can add more overtime.
3. Build your business case
Building a strong business case is essential for ensuring a virtual nursing program’s long-term success. At this stage, collaboration between clinical, financial and IT leadership is crucial to demonstrate how the IT infrastructure can support clinical needs—both now and into the future.
Once you’ve identified the virtual nursing platform use case with the most potential impact for your facility, begin to identify goals and benchmarks for your program.
Business Case Highlight: One health system was struggling with high rates of ED boarding in their community. A recent study published in Academics Emergency Medicine demonstrated that it costs $863 more per day to care for a patient in the ED than on a med/surg unit. Based on this alone, this facility was able to establish that decreasing their ED boarding by less than 5%, or 1.2-1.4 borders per day, would offset the costs of installing technology and staffing a virtual nursing program to expediate discharges.1
Best practice from AvaSure’s clinical team: Be sure to include feedback from frontline staff and managers throughout the process—their buy-in is essential for long-term success. It’s important that care teams understand this program is designed to support them, not add extra work or replace jobs.
4. Select a vendor partner
The final step in building your business case is selecting a virtual care partner who can help you achieve your long-term goals. Select a partner with both clinical and technical expertise—one who can not only meet your current needs but also help grow your program over time.
When evaluating vendors, be sure to consider:
- Platform ease of use & open architecture
Select a vendor with a virtual nursing platform that supports multiple clinical use cases and is easy for nurses to use.
No single vendor will be an expert in every use case, so it’s important to select a partner with an open ecosystem. This flexibility allows you to utilize specialty solutions—such as ambient documentation—when their expertise prevails.
- Support
Implementing a new care model involves significant clinical change and workflow management, so it’s essential to choose a vendor with the expertise to actively partner with your clinical teams throughout the process. IT teams also have a lot on their plates and shouldn’t be overburdened with implementing a new platform. Consider a vendor who provides robust technical and project management with 24/7 support—not just at the time of deployment, but throughout the partnership.
- Demonstrated outcomes
In any emerging area, many new solutions will become available with little real-world experience. In the clinical space, it’s more important than ever to select a partner with demonstrated experience in delivering outcomes for patients.
- Current technology
Vendor consolidation is key for maximizing the impact of current spend and reducing technology duplicity. Before bringing on a new vendor, evaluate whether current solutions—such as your TeleSitter® solution—also offer a virtual nursing platform before investing in additional technology.
5. Roll out your first use case
Now that you’ve identified the challenges, started formulating a business case with IT and secured leadership support, it’s time to start building your program. You can start with a single unit or department if preferred.
Starting small is a smart approach, as it allows you to demonstrate early success. Consider launching during peak hours, such as 9 a.m. to 9 p.m., to ease staff into the program and ensure the virtual team is properly staffed. However, stay flexible—real-time feedback might show that this isn’t the most impactful area to address first. Be ready to adapt quickly. Achieving quick wins is crucial for securing buy-in from frontline staff and maintaining leadership support, so an agile approach will be key.
When deciding what unit to start on, think about the following:
- Highest churn unit for admission & discharges – may be a high need for offload of documentation
- Unit with highest amount of novice nursing staff – may benefit from virtual nursing & mentorship
- Unit with highest percentage of travel nurses – help to reduce agency spend and fuel a program ROI
- Virtual nursing for specialists that are low staffed – support nutritionists, diabetic management, wound care, social workers/case managers & more
- Units with residents using a virtual nurse – Assist with morning rounds and facilitate documentation to communicate with family
- High complexity patient unit – allows virtual nurse to do purposeful rounding and be a second set of eyes on patients
- Units with deterioration or sepsis protocols and/or wearable monitoring – helps reduce false alarms and identify early signs of adverse events
Make sure to establish a feedback loop to hear directly from frontline staff about how the program is progressing and create a system to share successes both across the facility and with leadership. This positive word of mouth will be key to gaining broader support for the program.
6. Share results with stakeholders and spread the word
After a few weeks or months, ensure you hold a forum with leadership and the cross functional teams involved to update them on your progress. Show how the pilot has driven change against your key goals or metrics. AvaSure’s clinical team will help you pull your data and showcase your progress.
Tip from AvaSure’s Customer Success Team: It’s important to have a baseline before starting so you can demonstrate progress. Be sure to log all relevant metrics, including financials, before implementation. It’s also great to include great catches and stories from the front line leaders. Metric progress is great, but it’s the stories that will win the hearts of your teams.
7. Scale up your program – you’re really doing it!
Now that you’ve demonstrated success (and it was easy!), consider expanding to additional units or use cases. However, be reasonable about what your team can handle at once. Take a slow and deliberate approach, ensuring that your teams have a venue to speak up if it gets overwhelming.
Advice from the AvaSure team: If you’re going to fail, be ready to fail fast. Not every use case will be suitable for every facility. Sometimes, you may identify a need, but virtual care may not be the best solution. Ensure leadership is open to abandoning an idea if it’s adding more burden to teams instead of alleviating it. Your team will appreciate that you prioritize their work experience over forcing something that isn’t a good fit.
Worried about staffing your program as it grows? Learn about hosted options if you are lacking adequate talent to pull from your area.
A successful virtual care deployment can help address labor challenges by optimizing staff productivity, while also driving staff satisfaction and retention. Care teams will feel more supported, spend more time at the bedside, and leave each day feeling accomplished. AvaSure is here to support you through every step of scoping, implementing, and scaling a virtual care and virtual nursing program. With 15% of our staff being RNs, we understand the unique challenges facing care systems today. Our robust clinical team is ready to help with business case development through implementation, metric tracking, and expansion.
1 Canellas, M.M., et al (2024) Measurement of cost of boarding in the emergency department using time-driven activity-based costing. Annals of Emergency Medicine. 84(4);376-385
