TeleHospitalists at Providence increase timeliness of care

[5 MIN READ]

In this article:

• TeleHospitalists at Providence make exceptional care more timely, equitable and accessible.

• Providence TeleHospitalist providers cared for over 17,500 patients in 2024, covering 14 hospitals in four states.

• The Providence TeleHospitalist care model is built to support all sizes and locations of hospitals, partnering with the local team to ensure high-quality seamless access to care for all patients.  

TeleHospitalists increase timeliness of care 

Many smaller hospitals have limited providers on staff at any given time, especially overnight. Hospitals that partner with Providence’s TeleHospitalist program can count on 24/7 full physician coverage, making care more timely, equitable and accessible, helping to improve the patient experience. 

TeleHospitalist services include: 

• Initial patient exam
• Electronic medical record reporting
• Virtual rounds to monitor the patient 

In 2024, Providence TeleHospitalist providers cared for more than 17,500 patients, covering 14 hospitals in four states.

How the TeleHospitalist program works

A TeleHospitalist provider offers the same expertise, experience and empathy as an in-person physician and works seamlessly with on-site care teams.

“Whenever we go to a new site, there are a lot of meetings and discussions,” says Brandon Ong, M.D., medical director of the TeleHospitalist program at Providence. “We try to integrate into the workflow of how the hospital normally functions. Our goal is to do the exact same things they do, but instead of being there in person, we’re on video. We’re not there to really reinvent the wheel for what already works for that hospital.”

Most communication and consultations occur on a web-based portal tied to a physician’s cell phone or pager. When a hospital sends a message, the physician can use the portal to see a new task or a change in a patient’s condition.

Sometimes, a patient won’t know that a virtual TeleHospitalist is participating in their care delivery simply because the patient never sees the doctor in person.

“That’s not unusual because that would happen in a traditional hospital setting, too,” Dr. Ong says.

For example, a patient in the ER may only require care from a bedside nurse who is in contact with and receiving instruction from a physician, whether they’re in the room next door or in a different state.

“We function just like an in-person physician in the sense that we do all the tasks that an in-person physician would do until a procedure needs to happen,” explains Dr. Ong.

For patients dealing with complex situations, a physician sees and talks to a patient in real-time via a high-quality video. Then, a bedside nurse performs an exam with the virtual physician watching, thanks to high-quality cameras. These nurses typically have years of experience and are clinically trained in performing standardized physical exams. 

“We have a stethoscope that allows us the capability to hear what the nurses hear,” Dr. Ong adds. “So the nurse listens, and I can listen along with the nurse.”

Once the exam is complete, the virtual physician makes recommendations for interventions. In many cases, these recommendations come from providers with expertise and experience in these specialized situations.

For example, a patient recently needed intensive care at a small critical access hospital in Oregon.

“They came in via EMS, and they were really incredibly combative,” says Pita Nims, RN, MN, clinical director of operations of the TeleHospitalist program at Providence. “The TeleHospitalist physician that was on shift that night was in close contact with the nurse. They worked together to calm and support the patient while quickly mobilizing clinical intervention to care for and stabilize the patient. As a nurse with many years of experience, I know how important it is that the care team works together to keep patients safe while ensuring excellent clinical care is provided. It was incredible to see the coordination between the virtual physician and the on-site nurse who appreciated having that support.”

High-quality, timely care

More than 60% of patients come to the ER between 7 p.m. and midnight. Many health systems, as well as smaller critical access hospitals, may only have an Emergency Department physician and don’t have on-site, overnight hospitalists (physicians who care for admitted patients in hospitals). Without TeleHospitalists, some patients may have to wait until a hospitalist begins their shift the next morning or a physician is woken up and drives to the hospital in the middle of the night. As a result, patients may need to be transferred to a different hospital to meet their care needs.

“Typically, our TeleHospitalist providers will address admission requests within 45 minutes, placing orders and getting a patient’s care plan underway shortly thereafter,” says Jessica Wynant, senior product manager for the service. “Comparably, for small critical access hospitals that have limited on-site hospitalist coverage, this same admission can take hours, or even until the next day.”

For example, before a 25-bed critical access hospital in Montana partnered with Providence’s TeleHospitalist program, the average wait time for a patient to be admitted was more than 10 hours due to limited on-site staffing.

“After launching the TeleHospitalist service, the average admission time dropped to 52 minutes,” Wynant explains. “Delayed admissions can also occur in large metro hospitals that are understaffed or inundated with a surge of critically ill patients. Our TeleHospitalist care model is built to support all sizes and locations of hospitals, partnering with the local team to ensure high-quality seamless access to care.”

Once a patient is admitted, bedside nurses typically hear back from their assigned TeleHospitalist provider within five to 10 minutes of asking a question or making a request.

“This rapid response time ensures care continuity, comfort for the patient, and efficiency for the nursing team,” Wynant adds.

Treating the whole person

Recently, a woman in her 30s with cancer started chemotherapy. She began to have complications with her chemotherapy treatment. 

“She came to this small, rural access hospital and, under normal circumstances, she may have been too sick to stay at that hospital,” Dr. Ong says.

Instead of transferring her to a hospital with an oncology unit several hours away, Dr. Ong served as a virtual doctor on call. Having been a TeleHospitalist physician for more than a decade, he was familiar with how the small hospital operated.

“I’ve seen complex cases like these a number of times,” he says. “We were able to keep her at her local hospital so she could stay closer to family, while still ensuring she had access to the level of care she needed." 

Instead of traveling and delaying treatment for hours, the woman received the same level of care in her hometown as she would have received at a larger hospital with an oncology department on site.

“There’s equity in the sense that there’s access to care, but there’s also an efficiency of getting care started immediately,” Dr. Ong adds.

There’s also health equity in empathy. Many patients and loved ones who walk through a hospital’s doors are in distress. TeleHospitalist providers are well-versed in providing compassion and understanding, whether in person or on camera.

“I’ve been involved in telemedicine and with telehospitalists for a while and I do have a small number of experiences when I was the nurse on the other end,” Pita explains. “And it was incredible in terms of how surprising the technology faded away.” 

Physicians who work in telemedicine often have a different skill set than traditional physicians.

“The pace is a little bit slower, so it requires more patience from the physician,” Dr. Ong says. “When you communicate via video, it requires a physician who communicates well with patients. Because of the distance, there are fewer cues to pick up on not being at the bedside, both for the patient and the physician. To succeed, you have to have a good bedside manner and you have to be patient. It’s hard to have a fast visit via video where you kind of just see the patient, run in, do what you need to do and then leave. Because everything needs to be done a certain way it slows the process down so that there’s more time to talk to the patient, to listen to the patient, and to connect with the patient.”

Reducing provider burnout

The TeleHospitalist program also benefits providers as well.

“Pre-pandemic, hospitalist burnout rates were already relatively high, with about 40% of hospitalists reporting symptoms of burnout,” Wynant says. “Burnout rates surged to nearly 60% during the height of the pandemic in 2020-2021, stabilizing around 50% in 2022-2023.”

Addressing burnout related to physician shortages can lead to a healthier, more resilient workforce, ultimately improving patient care and patient outcomes. A TeleHospitalist role will often support a more balanced workload, reduce travel fatigue and support a providers’ ability to practice medicine, Wynant explains. This, she adds, often restores joy in medicine for clinicians, giving them opportunities to care for patients with less added stress. And it helps with retention.

Dr. Ong agrees.

“You’re helping patients. You’re meeting them where they’re at and providing care to people who wouldn’t normally have access to that care,” Dr. Ong says. “I think that’s what a lot of physicians strive for. It’s just trying to be helpful.”

Contributing caregivers

Brandon Ong, M.D., is the medical director of the TeleHospitalist program at Providence.

Pita Nims, RN, MN, is the director of operations of the TeleHospitalist program at Providence.

Jessica E. Wynant is a senior product manager at Providence.

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Related resources

Providence’s inpatient telemedicine programs pack a powerful punch

Telehealth after dark: Relieve clinician workload with nighttime virtual care

Leveraging Telehospitalists in the age of COVID-19

This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.