Tablet with health information used for Virtual Advanced Care.

Virtual Advanced Care model making a real impact

Her words burst with excitement:

“Our nurses’ level of enthusiasm is almost over the top now.”

“There’s nothing like this out there.”

“Not by any means is this routine.”

Beth Wharton, MSN, NEA-BC, is operating manager for OSF Virtual Advanced Care, a new model that provides care for people at the highest risk of needing hospital or emergency care. Launched in August 2019 at OSF HealthCare Saint Gabriel Digital Health in Peoria, Illinois, the model already is transforming care for critically and chronically ill patients who typically use the largest share of resources at a hospital.

“Virtual Advanced Care is about taking our resources to the patients instead of them coming to the resources,” Beth said. “It’s all about providing service more efficiently and timely.”

The team

Once a patient is selected for OSF Virtual Advanced Care, they receive an Android tablet and monitoring equipment (such as blood pressure monitor, scale and thermometer) to use in their home. They report their vital signs and any new or worrisome symptoms daily. They have 24/7/365 access to the team via phone, video conference or messaging.

The OSF Virtual Advanced Care team consists of a physician, advanced practice registered nurses (APRN), registered nurses (RN), care manager, social worker, pharmacist, dietitian and clerical support.

Team members share a large, horseshoe-shaped work station.

“You still have to be physically located somewhere,” Beth said. “We’re finding that for coordinated care, this has been energizing because we literally have a social worker or complex care manager sitting right next to the nurse or the pharmacist or the provider. The coordination of care is enhanced by them being in that physical vicinity.”

How virtual care works

An OSF Virtual Advanced Care nurse may be video conferencing with a patient, who asks about their prescription, so the nurse beckons the pharmacist from a few feet away to join the video conference. Or maybe something the patient says raises a concern about their diet, so the dietitian joins the discussion within seconds.

Virtual Advanced Care clinician working at a computerIn a traditional outpatient setting, a person with chronic obstructive pulmonary disease (COPD) might experience swelling or weight gain but not consider going to the doctor. But after a week or so, they also might develop an increased shortness of breath, prompting a trip to the emergency department.

With OSF Virtual Advanced Care, a team nurse will be tipped off by the patient noting the initial symptoms in a daily digital wellness survey. That, or a simple “I’m feeling a little off today” during a conversation, will trigger the nurse to ask a series of follow-up questions. The answers help lead to necessary intervention that can prevent an emergency visit.

“This is very individualized patient care,” Beth said. “Time is of the essence with a lot of the problems these patients face. This program has been able to close the loop for them very quickly. We’re able to tailor what we do based on immediate need.”

Nursing ‘to the fullest scope’

By the end of February, barely six months after the model was launched, more than 50 patients were enrolled. The plan for now is to add about 20 patients per month and eventually expand OSF Virtual Advanced Care to the entire OSF HealthCare Ministry, serving thousands of patients.

Expansion will create opportunities that previously were rare or did not exist.

“One of the biggest things our Virtual Advanced Care nurses are excited about is they get to work to the fullest scope of their training,” Beth said. “In traditional nursing, we don’t always get to clue in to all of the knowledge we have. Here, we are looking more into disease processes and trying to problem-solve what the patient needs.”

When Beth considers a perfect fit for an OSF Virtual Advanced Care nursing position, she’s looking for qualities beyond clinical nursing skills. These nurses must be detail-oriented. They should be technologically savvy, flexible, innovative and excited by change; comfortable with thinking “outside the box.”

Diverse communication skills are huge. OSF Virtual Advanced Care nurses need to be able to recognize verbal and non-verbal cues from patients and have an aptitude for picking up on subtleties. They should have a natural, holistic approach to dealing with patients.

Nursing gets more personal

As with any new program, there was some natural uncertainty when OSF Virtual Advanced Care was launched. It’s impossible to predict exactly how things will look in a year or two. Challenges will arise, but the innovation and flexibility required to find solutions contributes to the excitement.

Beth has watched the energy on the team rise in the short time OSF Virtual Advanced Care has been operating. One of the contributing factors is the opportunity to develop personal relationships with the patients.

“So many times, when you take care of a patient in the hospital, they leave after a few days and you might never know what happens with them. You’re left hanging,” Beth said. “Here, we are getting to know these patients like they’re part of our own family, because we are in touch with them every day, and we’re going to be with them throughout their entire health care journey.

“As our nurses get busier, they’re really appreciating the work they’re doing because they get to see the difference they’re making.”

About Author: Kirk Wessler

Kirk Wessler started work as a writing coordinator for OSF HealthCare in January 2019. A Peoria native and graduate of Bradley University, he previously worked for newspapers in Missouri, Texas and most recently at the Peoria Journal Star.

Kirk and his wife, MaryFrances, have five sons, four daughters-in-law and nine grandchildren. He’s on a quest to master playing guitar and golf. He also loves to travel, especially driving back roads.

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Categories: Working at OSF