2023: Telenursing, Integrated Telehealth Programs, AI In Spotlight

January 13, 2023

The significant extension of pandemic telehealth waivers in Congress’ year-end spending deal has given telehealth companies and health systems leeway to advance their telehealth programs and technology in the coming year. Among the likely advances by health systems in 2023 are expanding telenursing programs to save on costs, streamlining siloed telehealth programs and investing in less-invasive AI technologies.

Telenursing. Telehealth company Caregility reported to Inside TeleHealth it has witnessed a rise in hospitals employing virtual nurses to shore up nursing staff and save on costs. Telenurses can replace the need for contracted, agency-employed travel nurses -- whose hourly wage hit at least $200 in some regions in 2022, according to a former nurse at Caregility -- because of the workforce shortage faced by health care systems during the pandemic. Hospitals struggled with the cost of nurses in 2022, Caregility noted, and in light of the year-end spending bill expanding access to telehealth for another two years, an additional five hospital systems have reached out to Caregility to kickstart their telehealth nursing programs by January.

While telehealth nurses cannot completely replace in-person nurses, their ability to constantly monitor multiple patients at once, as well as provide consultative services for patients and their families, is a major asset to health systems. Having a nurse present via video in the hospital room also improves patient satisfaction and decreases the amount of disruptions the patient may have during the night when nursing staff are entering to check on the patient. Moreover, telenursing can bring in experienced nurses who may have developed physical limitations for hands-on nursing duties to provide their knowledge and skills via telehealth.

Telenursing is largely made possible through interstate licensing compacts, which Caregility urges should be further expanded beyond the public health emergency.

“Ideally, to simplify telehealth and bridge the gaps with the nursing shortage, all states should become compacted together for nursing licensure and/or a universal nursing license should be made available to eliminate barriers to support nurses at the bedside,” Caregility said.

The American Telemedicine Association said it agrees that telenursing programs will likely expand in 2023 and help lower workforce costs, as well as allow telehealth care professionals beyond nurses to augment the widespread shortage of health care professionals. But ATA noted that health and hospital systems likely will not be able to completely eliminate the need for travel nurses because hands-on care remains essential.

To facilitate the provision of virtual care, states can continue to adopt interstate compacts and licensure flexibility laws, ATA said.

Aggregating siloed telehealth programs. Saving costs is top of mind for the already-stretched budgets of health systems. Many health systems run telehealth programs that are siloed from one another because they were developed independently, Caregility said, sometimes with different technology platforms and product suppliers for each program. The separation of telehealth programs is costing hospital systems more money than if the programs were integrated, not to mention complicating workflows for health care professionals.

Bringing telehealth programs under one telehealth vendor, supplier, and workflow will likely be the goal of many health systems in 2023, as health care in general adjusts to virtual care as an enduring part of the way care is delivered and makes longer term adjustments. Minimizing the number of applications providers must navigate to deliver telehealth services to their patients in hospitals, outpatient settings and at home is top of mind.

ATA said that because health and hospital systems rushed to roll out telehealth programs for immediate use at the beginning of the pandemic, streamlining the programs is a priority for health and hospital systems. Though aggregating siloed programs will likely save costs for health systems, they should not shave back effective telehealth programs for the sake of savings, ATA said.

Radar and audio AI. Artificial intelligence solutions will likely have a growing role in hospital systems over 2023 and the coming years, Caregility predicts. Because many AI products that capture vital signs use a camera-based technology that requires the camera to be on at all times, and patients have cited privacy concerns, telehealth companies and hospitals are now investigating AI radar technology. One piece of radar technology captures 10 vital signs through wave signals and only requires use of a camera for 30 seconds to a minute at a time, rather than continuous capturing. Caregility is also investigating radar technology that will be able to detect when a patient is waking up and may need assistance by a virtual nurse or in-person staff member.

Additionally, the telehealth platform wants to leverage audio recordings of diagnoses and care plans for patients and their caregivers to keep and use for their own purposes and to integrate into electronic medical records.

Other stakeholders expect to see AI expand over the next calendar year to continue to improve efficiencies in hospitals.

“I expect to see a continuance in the use of AI technologies for workflow purposes. This includes increased use of AI in scheduling, triage determinations, recruitment tools and other staffing needs, and cybersecurity protocols and protections. I also expect to see an increase in the use of cloud-based digital platforms, which the industry has begun to use to foster a more collaborative environment between providers, patients, pharmaceutical and device companies, and even payers,” Natalie Oehlers, associate at Buchanan, Ingersoll & Rooney told Inside TeleHealth.

Caregility warns, however, that AI is not the panacea that hospital systems often desire, and that health care should not set unrealistic expectations for the technology, especially in the short term. Moreover, hospital systems should avoid implementing technology for technology’s sake and ensure the tech solutions are adding value to the patient and clinician experience. ATA commented that the health care industry will likely see movement and developments in AI this calendar year.

It also predicted that states and Congress may pass data use laws this year that would facilitate AI development and implementation, investment in AI, and care delivery models.

The Caregility platform spans inpatient and outpatient telemedicine settings, with clinical workflow integrations and secure, reliable two-way audio and video communication. From within major EMRs and telecommunication protocols such as SIP, family members, interpreters, and outside clinicians can be added to virtual visits or patient observation with a click. The company says its software is compatible with all major mobile and computing devices used in clinical, subacute care, and home environments, with 24/7, secure, HIPAA-compliant access. -- Emma Beavins (ebeavins@iwpnews.com)