Is a virtual hospital the new normal?

Is a virtual hospital the new normal?

June 8, 2022

Inga Shugalo

Healthcare Analyst

Aiming to carry out digital transformation, healthcare providers have cooperated with IT vendors extensively. As a result, medical organizations have obtained a substantial toolset that promotes patient service digitization and fosters the rise of digital health care. Here’s an overview of digital healthcare tools offered by providers in 2021 from Statista’s study:

Digital tools deployed by US providers in 2021

This toolset allows organizations to update their service delivery models and provide digitalized care. But what is a virtual hospital and how can healthcare software development assist with promoting it further? Let’s explore this topic.

What is a virtual hospital?

A virtual hospital is a full-scale hospital that has no physical location, meaning a patient can’t submit analyses or have surgery performed in such a facility. On the other hand, such a hospital can offer a range of online consultations, helping patients to avoid both traveling to a location and waiting in line.

Interestingly, the concept has been around for several years, but it still doesn’t have a clear definition. Even professionals have difficulties defining a virtual hospital, either referring to telemedicine apps or other telehealth technologies in use. Nevertheless, one aspect that sets a virtual hospital apart is its remote nature. The exact modality of care delivery, in this case, is for the actual actors to decide. We present the three popular types below.

Virtual hospitals: 3 common types

1. A general hospital. This type of facility works as a full-scale remote hospital providing their patients with the opportunity to book an e-visit with a specialist doctor without the need to wait for the appointment. In the US, this wait time is one of the major pain points accountable for patients’ health deterioration. According to the OECD report on health policies in the selected countries, 28% of US patients wait for their appointment for over a month.

In such situations, telemedicine solutions can be a viable alternative, as they reduce not only the wait time but also the time and expenses for travel. While travel time is crossed out of the equation, the wait time rarely exceeds 20 minutes.

Example. Mercy Virtual Care Center operating in St. Louis, Missouri since 2015 is a bright example of this model. Its creators’ goal was to reduce the appointment duration and eliminate the need for very sick patients to come into hospitals frequently. The Center’s service offer goes beyond e-appointments and encompasses Care Management and Mental Wellness. With expert teams working side by side with local caregivers providing skillful monitoring and management, the hospital successfully manages health risks for many people.

2. Chronic сondition management hospital. There are virtual hospitals dedicated to managing chronic diseases, from which 60% of US adults suffer according to Centers for Chronic Disease Control and Prevention (CDC):

Chronic conditions in the US

There are several virtual hospitals dedicated to remote management of diabetes, cancer, chronic lung and kidney disease, and other conditions.

Examples. Seeking to provide neurology treatment and care to patients, Massachusetts General Hospital (MGH), Boston, launched specific Telestroke and Teleneurology services. The hospital teamed up with smaller providers to help them treat and manage urgent and chronic neurological conditions. The two services offer 24/7 access to neurologists seven days a week. Besides, smaller hospitals can also leverage MGH’s technology and toolset to provide the local virtual coverage themselves.

3. Teleparamedicine hospital. Such hospitals have a team of doctors operating in a call-center environment, just like 911 specialists. The team takes incoming telecalls and consults clinicians and paramedics in the field, helping resolve complex clinical issues.

Teleparamedicine proves to be a lifeline for small or rural hospitals that have a shortage of specialist doctors on-premises. The external team can supervise the hospital staff and guide them through medical procedures in case of an emergency or when a patient is in a life-threatening state. Besides, medical specialists working at such virtual hospitals can assess a patient’s condition on the go and offer an adequate treatment plan without delays.

Example. One of the virtual hospitals offering this model is GlobalMed. This virtual hospital operates globally, and teleparamedicine is among their numerous service offers. Relying on teleparamedicine, field practitioners can find the needed medical specialist to improve diagnosing and triaging and reduce the risk of condition deterioration or death.

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The architecture of a virtual hospital 

It is clear that a virtual hospital should work seamlessly with no bottlenecks or sudden outages, just like a brick-and-mortar healthcare facility. Hence, internal and external healthcare systems require smooth integration, with which qualified developers can assist. But what systems to integrate?

Logically, a virtual hospital contains three blocks – the patient side, the provider side, and the place where they interact, or a telemedicine solution. Each major block encompasses several sub-blocks:

Virtual hospital architecture

As the main aim of a virtual hospital is providing quality care outside the traditional hospital setting, the solution is typically integrated with patients’ home-based devices and health wearables. The tools securely transmit the data to EHR or EMR where the patient’s health records are stored, available to physicians and medical specialists.

When a virtual hospital can also provide emergency care, a remote patient monitoring solution on the patient’s side should be implemented to notify the call center and the hospital about a potentially dangerous situation.

On the provider’s side, it would also be reasonable to integrate the virtual hospital with clinical decision support software to facilitate diagnosing and improve the patient experience. Besides, proper care delivery also calls for integrating with data analytics solutions. These tools enable doctors to track a patient’s health status over time and make well-grounded treatment decisions.

Efficient care provision also requires a 360-degrees patient view, for which the data provided by remote patient monitoring tools is not enough. This is why a typical virtual hospital also is integrated with labs and medical service facilities, which provide them with patient-generated health data (PGHD).

It looks like virtual hospitals are all set for quality health care delivery. But are they really needed when we have virtual care in stock? Let’s draw some lines.

How relevant are virtual hospitals?

As we know, during the pandemic non-urgent care was shifted from hospitals’ premises to the virtual space. Having acknowledged the critical situation, medical professionals decided to deliver quality care to their patients at all costs. Here’s how a health expert puts it:

Our future is technology. We have to be at the forefront and provide care where our patients are; we need to go to patients instead of patients coming to us.

Reetu Singh

Reetu Singh

MD, MBA, Senior Medical Director and Chief Medical Information Officer at AdventHealth

Virtual care is care delivery via telecommunication technologies. As the pandemic wreaked havoc across the US, patients of all ages opted for receiving their care off their providers’ premises and took up their providers’ virtual care offerings.

The research by OliverWyman shows that from 2019 to 2020, the majority of the US patients received virtual care in one way or another:

Virtual care in 2020-2021 by age

Interestingly, providing virtual care is not only about telemedicine apps, with 25-30% of respondents preferring a phone call and 20% of young adults opting for text messaging or chatting. Besides, patients who lack stable internet connection or a modern communication device supporting video calls often opt for video-free communication methods.

The video-free delivery model meets the needs of rural patients and underserved populations, or about one-fifth of the US population. Here’s how the industry expert evaluates the effects of virtual health on underserved people:

What we’ve seen over the last two years is the largest increase in treatment-seeking behavior among African-Americans and Asian-Americans that we’ve ever seen. That means that people from these backgrounds are beginning to access or seek treatment who have never sought treatment before.

Kevin Dedner

Kevin Dedner

MPH, founder and CEO of Hurdle

If it weren’t for virtual care, these patients wouldn’t have access to care or would cancel their healthcare appointments due to the cost of an in-person visit. This is where an audio-only consultation proves to be more affordable. For example, in California, it cost 65% of the in-office consultation price. As a result, the majority of states with large shares of the underserved or rural population have started providing synchronous audio-only consultations before the pandemic or ever since:

Insurer’s coverage of audio-only telemedicine in 2021, by state

So with so many patient-friendly options at hand, is a virtual hospital necessary? Yes, it is.

First of all, relaxed telehealth regulations that help solve healthcare disparities for underserved patients are only temporary rules. While their effect on patients is positive, it’s for the Senate to decide whether these rules should be prolonged or not.

Besides, the process of qualifying for virtual care compensation is complex. For rural patients, it can involve traveling to a certain care location at a considerable distance. Urban populations may not have the telehealth option available, as there are many providers within easy reach.

Secondly, with the difficulties the healthcare industry faces, another care delivery opportunity is more than welcome. So when is virtual hospital deployment a good decision?

A virtual hospital: when to implement

A virtual hospital can help resolve many challenges the healthcare industry faces today. The most prominent of them include the shortage of doctors and the stable growth in the aging population in need of care. Here’s how a virtual hospital can alleviate these issues.

Overcoming the shortage of doctors

The number of older Americans is steadily increasing. As reported by America's Health Ranking in their 2021 Senior Report, by 2050, the total number of adults aged 65 and older is projected to rise to an estimated 85.7 million.

At the same time, the number of doctors and mid-level medical staff is decreasing. This is how the AAMC projects the shortage of physicians from 2019 to 2034:

Physician shortage 2019-2034

This situation is detrimental for both patients and clinicians. While the former are likely to be underserved, the latter suffer from burnout and cognitive overload in understaffed healthcare facilities. Besides, young healthcare professionals are reluctant to move to rural regions with few other young professionals or growth opportunities.

A virtual hospital can become an efficient solution to this range of difficulties. Virtual hospital doctors and patients can be located virtually anywhere, and neither of them needs to travel to get to a consultation, needing only good connection, a telehealth solution, and a headset.

But how well does the patients’ experience during such appointments compare to an in-person visit? Telemedicine critics often claim this care delivery model lacks the human touch, since patients and providers communicate through the screen and e-consultations are briefer than in-person visits. Potentially, this can lead to issues with patient satisfaction. However, according to Statista, the overall majority of patients liked their e-consultations in 2021:

Virtual physician consultation experiences in the US, 2021

Besides, doctors are not always perfectly attentive to their patients during in-person visits. According to a study published in the Journal of General Internal Medicine, 80% of specialty doctors don’t even ask why a patient came in during a personal visit. If they did, most of them interrupted the patient’s explanations within 11 seconds.

A version of a virtual hospital can also be deployed in nursing homes to provide quality care for older residents. For instance, telehealth solutions can help streamline care delivery for elderly patients with hip fractures, which CDC reports happens to about 300,000 people older than 65 annually. With telemedicine in place, the patient only needs to visit a medical imaging facility. The needed durable medical equipment can be delivered right to the care facility, which also reduces transportation costs and the associated levels of stress in patients.

Providing care during national emergency

During the COVID-19 health crisis, it was necessary to limit personal contact, so many hospitals deployed virtual assistance to provide services remotely. Thus, Watford General Hospital in Watford, UK formed a team of specialists (consultants, respiratory physiologists, and physiotherapists not directly involved with front-line care) to provide such services. In addition to this, specialists developed a specific model for care provision with regard to patients’ risks:

Virtual COVID-19 hospital workflows

The COVID-19 virtual hospital is a vital part of the virus-combating toolset. It offers patients safety and good clinical care, as well as appropriate escalation and readmission workflows and the means to reduce bed occupancy for healthcare facilities.

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Ensuring cross-boundary care and education

The virtual hospital lets patients seek advice from the world's best experts through secure telemedicine solutions. Moreover, patients can receive not only consultations but also full-fledged treatment.

For example, Proximy, an AR-enhanced telehealth solution from the UK, allowed a top US oncology surgeon to consult his colleagues from London during complex surgery and ensure its success.

Vuzix-VSee, AR telemedicine smart glasses, operates in a similar way. Using this tech solution, clinicians from Osaka Saiseikai Izuo Hospital working in the infectious ward can give and get instructions from their peers located in non-contaminated hospital zones. Besides, using this tool, surgeons can perform complex operations and educate themselves, enhancing their skills. Here’s an educational video for knee replacement surgery:

Closing thoughts

With the spread of digital technologies in healthcare, providers have obtained the opportunity to expand their services and solve some ever-lasting industry challenges. Virtual hospitals can help streamline emergency care delivery adding on-the-spot telemedicine consultations with medical specialists from the needed field. With such teleparamedicine services, paramedics can prevent health deterioration in a timely fashion.

A virtual hospital can also help mitigate the increasing shortage of physicians and other specialists. With a virtual hospital available, patients may choose not to travel to a certain location for a consultation, but instead get it without leaving their home. Besides, virtual hospitals have no boundaries, so any patient can get help from a qualified expert at a reasonable price.