Transforming Rural Healthcare Through Virtual Nursing
After achieving remarkable success with its initial virtual nursing implementation, The Guthrie Clinic has significantly expanded its partnership with Artisight to transform care delivery across its rural healthcare network. Building on outcomes that earned industry-wide recognition, including the prestigious 2023 CHIME Innovator of the Year Award, Guthrie’s enhanced virtual nursing program demonstrates how innovative technology can revolutionize rural healthcare delivery while addressing critical workforce challenges.
Early Success: Setting the Foundation
The Guthrie Clinic’s journey with virtual nursing began as a response to the unique challenges of serving a 10,000-square-mile region across rural New York and Pennsylvania. Post-pandemic staffing shortages had hit the health system hard, with care partner vacancy rates reaching critical levels. The situation was further complicated by increasing numbers of high-needs patients requiring one-to-one observation, straining already limited resources. Care partners were frequently pulled from their regular duties to sit with these patients, leaving as few as one care partner for every 20 patients on regular floors. This created a vicious cycle of burnout and turnover that threatened both staff retention and quality of care. For an organization serving 13 counties through six hospital campuses and an extensive outpatient network, maintaining consistent care standards across such a distributed system had become increasingly difficult.
In response, Guthrie partnered with Artisight to launch the Pulse Center, an advanced remote nursing program with a virtual command hub.
The initial implementation yielded impressive results:
- Nurse turnover dropped significantly, from 25% to 13%
- The organization achieved $7 million in cost savings
- Nurses saved more than 30 minutes per shift on EHR data entry
- Job satisfaction increased markedly among nursing staff
These outcomes earned multiple industry accolades, including the CHIME Innovator of the Year Award notably the first time this recognition was jointly awarded to a health system and technology partner. The program also received the 2023 ECRI Health Technology Excellence Award for AI-driven remote monitoring and was named among Modern Healthcare’s Top 2023 Innovators.
“When implementing a new healthcare technology, it’s essential not only to understand your current use case, but also to have a clear vision of where you are going,” said Terri Couts, chief digital officer and EVP at The Guthrie Clinic. “With Artisight, we have a partner who can offer a comprehensive solution to the challenges we are facing.”
Expanding the Vision: The Enhanced Virtual Nursing Program
Building on this foundation of success, Guthrie has significantly expanded its virtual nursing initiative. The enhanced program represents a comprehensive approach to care delivery that leverages Artisight’s Smart Hospital Platform across multiple care settings, with particular focus on the organization’s flagship Robert Packer Hospital.
The expanded solution combines sophisticated technology infrastructure with a carefully designed nursing support system. Every patient room is now equipped with hardwired video and audio capabilities, integrated seamlessly with the Epic EMR system for streamlined documentation. The platform’s AI powered monitoring systems and multi-sensor network capture real-time data, enabling immediate response to patient needs.
A Two-Tiered Approach to Virtual Nursing
The expanded program employs a sophisticated two-tiered approach that addresses the unique needs of different care settings. In the ICU, virtual nurses maintain continuous patient monitoring through a third-party system that provides real-time access to vitals, labs, and rhythms. While separate from Artisight, this system’s AI capabilities enable trend analysis of patient status, allowing for early intervention when needed.
For acute care areas, the program provides on-demand support for bedside nurses, utilizing high-resolution camera technology for detailed patient assessment. All virtual nurses bring at least five years of bedside experience to their role, ensuring high-quality support for their colleagues.
Comprehensive Task Management
Virtual nurses now handle a wide range of critical tasks that previously consumed bedside nurses’ time. They manage admission, transfer, and discharge documentation; support medication verification and administration; conduct patient monitoring and surveillance; develop care plans; and provide real-time documentation assistance. They also ensure protocol compliance, communicate with families, and offer valuable education and support for novice nurses.
Enhanced Program Results
The expansion of Guthrie’s virtual nursing program has yielded impressive results across multiple dimensions:
Quality and Safety Improvements
Building on the initial program’s success, the expanded implementation has driven further improvements in patient safety outcomes. Hospital-acquired pressure injuries dropped from 49 in FY23 to 36 in FY24, while fall rates decreased from 4.45 to 3.63 per 1,000 patient days. The HAPI rate improved from 1.04 to 0.77, demonstrating enhanced patient safety outcomes.
Operational Excellence
The program has achieved remarkable gains in operational efficiency. Over 50% of patients are now discharged within 75 minutes—far better than the national average of 120-150 minutes. Virtual nurse participation in discharges has more than doubled, increasing from 27% to 65% of discharges. The program saves an average of five and a half hours of nurse time per day per unit through virtual nursing support. For the period from June 2023 to June 2024, ICU patient days for Robert Packer Hospital, Corning Hospital and Guthrie Cortland Medical Center were reduced by nearly 1,000 days.
Workforce Impact and Financial Results
Building on the early success in reducing nurse turnover, the expanded program has driven further improvements in workforce metrics. For the entire system, agency staffing requirements dropped dramatically, from 156.9 FTEs to 68.3 FTEs, and at Robert Packer Hospital alone, the reduction was 32.4 FTEs to 6.9 FTEs. The reduction of agency staff by 88.6 FTE’s since the program’s inception is a saving of over $16.5 million dollars annually. Additionally, the program has become a powerful recruitment tool, particularly appealing to tech-savvy Gen Z and millennial nurses seeking innovative practice environments.
Patient experience metrics reflect the program’s continued success, with Top Box satisfaction scores rising throughout the system. At Robert Packer Hospital, scores rose from 60.79% in Q3 2023 to 70.74% in Q4 2024. The program has maintained its strong financial impact, with continued cost savings and reduced excess days through improved throughput.
Keeping Patients Local
Guthrie is a rural health system, covering 10,000 square miles in Pennsylvania and upstate New York, so it is not uncommon for patients who are hospitalized to have to travel great distances when their care becomes more complex.
Through the support of the virtual nursing program in which nurses in the rural hospitals receive support, mentoring, and monitoring of patients from experienced ICU and Med/Surg nurses, more of these patients can safely remain at their local hospital –– closer to family. This is illustrated in the increase of patients staying at their local hospital, At Cortland Medical Center in rural New York the total admissions has increased from 2,781 in FY2023 to a projected 3,440 in FY2025.
Innovation in Practice: Streamlined Workflows
The expanded program has transformed several key clinical processes, demonstrating the power of technology to enhance efficiency while improving care quality. The pre-operative care process, previously hampered by paper-based documentation, has been streamlined through electronic MRI safety sheets, reducing documentation time by up to 45 minutes per patient.
“Our MRI safety sheet process was still paper prior to our virtual nurses doing it, and now it’s a fully electronic process,” notes Jennifer Orbin, DNP, RN-BC, Guthrie’s Senior System Director of Nursing Operations. “Many tasks can take bedside staff up to an hour to complete each. The virtual nurse can do a lot of those now, which is incredible.”
The admission process has been revolutionized, with virtual nurses beginning documentation while patients are still in the ED. This early start enables faster medication reconciliation and accelerates care plan implementation.
Keys to Success
The program’s continued success stems from three core strategies:
- Customized Implementation: Building on lessons learned from the initial rollout, the expanded program features algorithms tailored to specific hospital environments and clear workflows developed for task delegation.
- Strategic Task Selection: The team strategically selected high-impact, time-consuming tasks for virtual nurse management, creating clear protocols for automated, delegated, and dictated tasks.
- Staff Engagement: Staff engagement remained a priority through experience requirements for virtual nurses, clear communication about task allocation, and robust support for novice nurses.
“For our graduate nurses, having that additional support from an experienced nurse, we call it ‘phone in a friend,’ or having that person right there is like saying ‘Hey Siri,’ and they really love that,” says Orbin.
Looking Forward
Following the success at Robert Packer Hospital, Guthrie continues to expand its virtual nursing program across its system. Future focus areas include increased virtual nurse participation in interdisciplinary rounds, enhanced workplace violence prevention, expanded quality metric monitoring, and further optimization of discharge processes.
Conclusion
Guthrie’s journey with virtual nursing utilizing the Artisight Smart Hospital Platform demonstrates the power of building on success. From its award-winning initial implementation to its comprehensive expansion, the program shows how innovative technology can transform rural healthcare delivery. The program has not only improved operational efficiency and patient outcomes but has also created a more sustainable work environment for nursing staff. As healthcare continues to evolve, Guthrie’s experience provides a valuable model for other organizations seeking to enhance care delivery through virtual nursing technology.
