Virtual Rounding:  Telehealth for Emergency Departments

Telehealth has indeed come of age with the COVID-19 pandemic, propelling the evolution of new agile innovations to solve emerging problems. Virtual rounding is one such example. It’s not the first thing that comes to mind when telehealth is mentioned in the traditional sense, but it is the form of telehealth that I rely on daily to efficiently provide high quality care in an emergency department that rarely has relief from overcrowding.

Overcrowding in the ED has become a pervasive problem across the country as hospitals continue to struggle with resources and clinical staff burnout resulting from COVID-19 surges.  Virtual rounding is a solution that has allowed our hospital to mitigate these challenges by allowing clinicians to virtually assess patients while they wait in the ED – and here’s the kicker – we do it without disrupting the clinician’s workflow or requiring the in-person staff to take on additional work.

Seamless integration may be the buzzword du jour, but it’s the fait accompli of virtual rounding. Providers can continue working clinically during a time of decreased hours and contribute to patient care, outcomes, and safety while adding to overall productivity. Here’s an example from our ED of how virtual rounding is streamlining workflow, improving outcomes, while combatting wait time frustration and improving the overall patient experience.  

While a medic rounds to repeat vitals, a virtual session is launched with a clinician (in this case an advanced practice provider or senior level resident). This allows for adding labs to existing specimens that were pulled for protocol orders or adding advanced radiology studies to be completed, which means faster disposition times. This also leads to patients feeling like someone is actively watching out for them, allows them to ask questions regarding results and empowers communication with a discussion of the importance of a treatment plan or admission and an in-person evaluation.

And here are the results that I have experienced with ThinkAndor Virtual Rounding:

• A 49% decrease in rates of patients “leaving without being seen.”
  • Of those patients seen by the virtual provider, this reduction jumps to 92% (includes elopements and those leaving against medical advice).
• 20% of patients are being identified for immediate discharge and 3 patients per 8 hour shift are being identified as needing expedited care.
  • We have caught early sepsis, called a stroke alert, and identified a GI bleed ultimately requiring blood transfusion – all by virtual assessment.

More than the improvement to patient flow and data on throughput; for clinicians, improving patient care is the real ROI. This is what I have experienced with virtual rounding and why I will continue to rely on it to add value as we push through these unprecedented times in emergency departments and across many other areas of care.