What’s In a Virtual Hospital?
In a Virtual Hospital doctors and nurses sit at carrels in front of monitors that include camera-eye views of the patients and their rooms, graphs of their blood chemicals and images of their lungs and limbs, and lists of problems that computer programs tell them to look out for. The nurses wear scrubs, but the scrubs are very, very clean. The patients are elsewhere.
It’s a strange mix of hospital and office: Instead of bright fluorescent lighting, beeping alarms and the smell of chlorine, you’ll see soft rugs, muted conversation and a fountain that spills out one drop a minute. The mess and the noise are on screens, visible in the hospital rooms the staffers peer into by video—in intensive care units far away, where patients are struggling for their lives, or in the bedrooms of homebound patients, whose often-tenuous existence they track with wireless devices.
Nurses and doctors at a Virtual Hospital use web cameras and track vital signs remotely to assist healthcare professionals in hospital rooms far away and also homebound patients with chronic illnesses.
It is built on many of the new ideas gaining traction in U.S. health care, such as using virtual communication to keep chronically ill patients at home as much as possible, and avoiding expensive hospitalizations that expose patients to more stress, infections and other dangers.
As the country moves to brake escalating health care costs, hospital systems that want to stay in business will have to follow this heavily software-dependent model. “One night in the hospital in the U.S. costs $4,600 on average, just for the bed,” said Eric Topol, director of the Scripps Translational Science Institute and author of several books on the future of medicine. “You can get a lot of data plans and devices for that amount of money.”
A Virtual Hospital doctor in regular contact, however, can distinguish a true crisis from a baseline reading that might seem alarming but is normal for that patient.
Because “frequent flyers” hate going to the hospital—often a traumatic place for the old and infirm–they’re often in denial about any symptoms they may have, which, ironically, raises the risk that things will get to a critical point if no medical staff are watching.
“A lot of times patients say, ‘I feel fine,’ but I can see on the monitor that they are struggling to breathe,” says one doctor. There’s a trust factor at first. Sometimes it takes a trip to the ER to vindicate us.”
Telehealth and remote monitoring cover patients and hospitals inside. Part of the attraction is the backup a Virtual Hospital provides to hospitals that serve uninsured or low income patients and can’t afford to staff up to levels that might be desirable.
It would be ideal to have a doctor in each every real hospital unit 24/7, but even then they can’t be looking at the analytics the way a Virtual Hospital does. A Virtual Hospital has critical care-trained nurses and doctors looking patient data and even the patient, 24/7. They can camera in and count the pores on someone’s nose.”
THERE’S ONE THING A VIRTUAL HOSPITAL DOESN’T HAVE: BEDS
A single nurse practitioner can oversee 450 patients, including those suffering from severe lung and heart diseases, by monitoring them at home through wireless medical devices and video consults.
There are those who say that even an intensive care unit could, in principle, be brought to a patient’s home. But for now, the future looks like this: Hospitals will keep doing things like deliveries, appendectomies and sewing up the victims of shootings and car wrecks. They’ll also have to care for people with diseases like diabetes, heart failure and cancer when they take bad turns. But in the future, the mission of a Virtual Hospital will be to keep patients from coming through their doors in the first place.
Studies of Virtual Hospitals show fewer patient days on ventilators, fewer readmissions and better patient survival.
There are still administrators traditional hospitals who see fewer admissions and days in the hospital and aren’t particularly happy about it. One study participant noted “There is an awkwardness in this time. But enough people with vision recognize this is the right way to go.”
A few of the Virtual Hospitals nurses, most of whom had years of experience before coming here, are sometimes a bit nostalgic for the bedside, with its immediacy and adrenaline. “You’re used to being in charge. Here you’re part of a team,” said one ICU Nurse. “If you think something is not being done you have to be polite”.
“And there’s no way I can put a price on being able to put my hand on a patient and say, ‘My name is Riba”.
But after the recent Coronavirus outbreak, she’s seems more willing to accept less risk and earn far more money that go alongside a Virtual Hospital.