MORE AND MORE hospitals and health systems are moving to launch—or consider launching—a telehospitalist service. Many of those programs are being designed to bring much-needed night (or day) coverage to small, rural hospitals that can’t recruit or can’t afford onsite providers.
Even larger hospitals now are turning to telehospitalist services to flex up staffing on days when census surges. But those larger institutions face the same questions as smaller facilities: What’s the right census for such a service? And if health systems are creating (or hiring) programs to serve smaller affiliated hospitals, how many sites can one telehospitalist safely cover?
The answer to those questions, according to people who work in tele-hospital medicine, is: It depends. It depends on what type of services the telehospitalists need to provide and what types of resources—in terms of providers and expertise—are on the ground in remote sites.
Today’s Hospitalist spoke with four sources who have long experience with tele-hospital medicine about the coverage they provide (or contract for) and how they determine what’s a safe census. Here’s what they all report: Expect wider volume fluctuations, particularly in smaller hospitals, than you may be used to, and stay flexible.
CASE STUDY 1: A hub-and-spoke model
A health system in the Midwest relies on telehospitalists at its main campus to provide a suite of coverage services to five rural facilities. Read more here.
CASE STUDY 2: Growing interest in surge capacity
A national telemedicine company deploys telehospitalists in rural hospitals and in larger ones to manage surging census. Read more here.
CASE STUDY 3: Rural admissions and post-discharge visits
Telehospitalists in a Georgia health system cover not only critical access hospitals but post-discharge follow-up with patients at high readmission risk. Read more here.
CASE STUDY 4: Telenocturnist coverage
A national hospitalist company opts to outsource virtual night coverage rather than grow its now telenocturnist service. Read more here.
Telehospitalist challenges to expect
Challenges include having to navigate different formularies and figuring out how to spark hospitalist interest in telemedicine. Read more here.
Combining telemedicine with in-person care
A hospitalist enjoys making virtual patient connections while maintaining skills treating higher-acuity patients inhouse. Read more here.
Phyllis Maguire has been Executive Editor of Today’s Hospitalist since 2006. Based in Bucks County, Pa., her health care interests are hospital medicine and long-term care options. She also likes zydeco, hiking, and reading memoirs and romances.
