Virtual nursing comes to the forefront: Avera Health (SD) launches at two hospitals, Doccla launches ‘virtual wards’ at home with Up Care Derbyshire (UK)

November 15, 2023 | by

The Perspectives article posted today (below) discusses how telehealth for virtual nursing is being used at hospitals. Coincidentally, this Editor had in the ‘virtual file’ for posting today two articles on how virtual nursing is being used in two settings–and in two countries.

In-hospital virtual nursing has been introduced at two Avera Health hospitals in South Dakota, Avera McKennan Hospital & University Center in Sioux Falls and Avera St. Mary’s Hospital in Pierre. This is very much along the lines of adjuncts to bedside nursing in supporting additional care and time-consuming administrative tasks, such as admission assessment, medication reconciliation, pain reassessments, and second RN availability for independent double checks. For Avera, this answers some of their workforce and workflow problems, such as relieving workload and providing second checks. 

An example is intake assessment which in some cases can take up to 30 minutes. The virtual nurses at their stations (left above) work with bedside nurses not only to ask patient questions but also to relieve their anxiety and answer questions. The bedside nurse introduces the virtual nurse, explains the camera/microphone, and then the virtual nurse picks up the assessment from the bedside nurse, who can move on. The camera can also zoom in on equipment such as IVs or vital signs monitors. Virtual nurses can also call bedside nurses when they are needed. No information is recorded.

Avera is a rural health system of 37 hospitals in South Dakota. They introduced virtual nursing in May in the same two hospitals on one metric–reducing in-hospital falls that happen when a patient at increased risk of falling gets out of bed. The virtual nurse uses the camera and speaker to direct the patient to wait for care team assistance or alert staff to help. This 24/7 monitoring program decreased falls with more than 6,800 redirects between May and October. Avera plans to roll out the virtual nursing program eventually to all of their hospitals. Becker’s, Sioux Falls Business (photo credit)

In the UK, Doccla is partnering with Up Care Derbyshire to set up ‘virtual wards’ for at-home care in Derby and Derbyshire. The NHS has a well-known problem with available hospital beds. Much like the US, a nascent hospital-at-home program is attempting to relieve the situation by moving the patient back home faster without skimping on care in five care areas: palliative, respiratory, frailty, cardiology and hematology (haematology). The patient in the program receives a Doccla box with the tools needed for monitoring and coordinating care: a pre-configured smartphone with an easy-to-read large font for the app, plus wearable medical devices to monitor vital signs such as heart rate, respiration rate, body temperature, blood oxygen levels, and blood pressure that are connected to the smartphone. Clinicians monitor the patients at dedicated hubs and call in home health nurses when needed. The program will be at five locations initially within Up Care Derbyshire’s integrated health system (ICS) to enable local NHS hospitals to discharge eligible patients and has a peak capacity at present of 200. One objective is faster patient discharge, but the second is to reduce the need for hospitalization for patients with long-term or chronic health conditions. One area that isn’t apparent is if the camera is used as part of evaluations or contact.

Doccla is now in one-third of integrated care boards (ICBs) and more than 25 NHS Trusts, with a patient compliance rate of over 95% and an independently verified saving for the NHS of £3 for every £1 spent on Doccla. DigitalHealth.net

Thursday news roundup: FTC now investigating Cerebral, Balwani’s Theranos trial rests at last, Proscia pathology AI $37M Series C, health data breaches pile up

June 16, 2022 | by

Telemental health Cerebral’s miseries pile on. The Federal Trade Commission (FTC) is now investigating Cerebral on deceptive advertising and marketing practices. The Wall Street Journal (may be paywalled) reviewed the 1 June letter sent to the company. The letter requests the usual preservation of documents and asks ‘dozens of questions’ related to their business. Of particular interest to the FTC is the ‘negative option’ practice that continues the subscription fee unless the subscriber takes positive action to cancel it. Subscribers have complained that Cerebral did not cancel their subscriptions after repeated attempts to do so and did not refund their money. Reuters, FierceHealthcare

Also of interest to the FTC will be the dodgy advertising claims about ADHD and obesity which ran on TikTok and Instagram [TTA 10 May]. The WSJ reported that their ad spend topped $65 million for this year–$13 million on TikTok alone from January to May this year, making Cerebral the third-largest advertiser behind HBO and Amazon, according to research firm Pathmatics.

The FTC action follows the Department of Justice (DOJ) investigation of their prescribing of controlled (Schedule 2, high potential for abuse) substances such as Adderall and Xanax, CVS and Walmart refusing their prescriptions, the unceremonious booting of the CEO and co-founder, and a wrongful dismissal lawsuit by a former VP of product and engineering, Matthew Truebe. Certainly, its investors led by SoftBank, which raised $300 million in December less than six months after a raise of $127 million, are unhappy at watching their $4.8 billion baby crash and burn.

The second “rerun” Theranos trial of Sunny Balwani rests. This much-muted trial is winding towards its close. Receiving much less breathless and near-sensational coverage than Elizabeth Holmes’, Theranos president Balwani was tried in the same San Jose Federal district court, with the same prosecutor (Robert Leach), just about the same charges (12 counts of wire fraud), and Judge Davila presiding. Holmes was convicted and her sentencing is scheduled for September.

The prosecution rested on 20 May and the defense on 9 June. The trial took some delays due to at least two jurors falling ill from Covid. The defense strategy rested on Holmes’ founding and operating the company without Balwani for a few years and that he never sold his shares, making him as victimized as any ordinary investor. The prosecution is relying on how close Holmes and Balwani were, that he had great power at Theranos–and used it, plus in his position was well aware of the problems with the lab machines and deliberately sought to defraud investors by covering it up. Unsurprisingly, Holmes did not testify at his trial, although she was a looming presence at his as he was somewhat at hers, especially in her testimony about their relationship. Closing arguments took place on Tuesday (14 June) and the jury will be charged after their conclusion. NBC Bay Area, New York Post, Wall Street Journal

Happier news comes from Proscia, a pathology software company, funding a $37 million Series C. Highline Capital Management, Triangle Peak Partners, and Alpha Intelligence Capital led the round along with participation from five earlier investors. Their total funding is up to $72 million. Their AI-enabled Concentriq platform combines “enterprise scalability with a broad portfolio of AI applications to accelerate breakthroughs and unlock clinical insights that advance precision medicine.” Clients include 10 of the top 20 pharmaceutical companies as well as the Joint Pathology Center, Proscia release, Becker’s 

Adding to the tally of healthcare data breaches are several this week. The year-to-date winner, of course, are the 2 million at Shields Health Care Group in Massachusetts [TTA 10 June], but this week, reports have been breaking out like late spring roses:

  •  A clinical guidance software vendor’s breach reported 10 June has exposed the protected health information (PHI) of patients at Omaha, Nebraska-based CHI Health and Sioux Falls, South Dakota based Avera Health. Avera has about 900 exposed patients, but the number at CHI is not yet known. MCG Health is the vendor. Becker’s
  • Yuma (Ariz.) Regional Medical Center reported an April ransomware attack that while short in duration, exposed PHI of 700,000 patients. An unauthorized user removed files from the hospital’s system that included patient health information such as names, social security numbers, health insurance information, and limited medical information relating to care. The hospital went offline until it was resolved, including reporting to law enforcement. Becker’s, Healthcare Dive
  • UChicago Medicine had its employee accounts hacked in March by an unauthorized user. It exposed about 2,500 patient records that included patient first and last names, social security numbers, health information, legacy Medicare beneficiary identification numbers, health insurance policy numbers, and driver’s license numbers. Becker’s
  • And Kaiser Foundation Health Plan of Washington had about 70,000 patient PHIs exposed on 5 April when an unauthorized user gained access to one employee’s emails with information on patient first and last names, dates of service, laboratory test information, and medical record numbers.

Short, but certainly not sweet, and expensive.

Tyto Care partners with Avera eCARE for telehealth delivered to medically underserved populations

October 23, 2019 | by

Following on last week’s announcement of Tyto Care‘s partnership with Novant Health, Sioux Falls SD-based telemedicine provider Avera eCARE will be introducing Tyto Care’s professional version, TytoPro, into its telemedicine service using high-definition video for virtual consults. What TytoPro will add is remote diagnostic capability and collection via the TytoVisit platform, using the TytoApp and Clinician dashboard. Avera will use TytoPro’s hand-held device with exam camera, thermometer, otoscope, stethoscope (with volume, bell, and diaphragm filters), and tongue depressor adaptors.

In a test of Avera eCARE plus Tyto Care in an assisted living community, the pairing of the two systems reduced emergency department transfers by 20 percent, with 93% of residents treated in place.

Avera eCARE, a part of Avera Health, provides telemedicine services to medically underserved populations via local healthcare systems, rural hospitals, outpatient clinics, skilled nursing facilities, assisted living communities, schools, and correctional facilities. It has over 400 providers in its comprehensive virtual health network across the US. A ‘white paper’ on the Avera/Tyto Care partnership is here. Release