VIRTUAL ROUNDINGThe User Experience

Virtual Rounding | Purpose

Engaging the patient’s family- recognizing the family as an essential member of the healthcare team who provide key input into many crucial decisions

Sharing of key information “at the bedside”- communicating during the patient encounter- bypassing the need for the family member to be there during early morning rounds

• Lack of family availability during the early morning call

• Lack of family preparation for the call, e.g., no iPAD in hand

• “Who’s calling?”; “What do they want?”

• Too many voices in the background

• Poor imaging: unsteady camera, shaky or dizzying visuals, loss of speaker sight-line, ceiling views

• Poor wireless connection, with image graininess, image freezing, loss of connection

• Technical illiteracy → frustration for both parties

Virtual Rounding | Challenges

Educating the patient’s family

Standardizing the format

Addressing technical issues

Virtual Rounding | Solutions

Set realistic expectations for the family member• Confine session to 2-4 minutes• Save issues requiring discussion for another time• Preclude conversation between patient and family member• Familiarize family member with use of the technology prior to the call• Ensure family member is ready when the physician calls

Educating the patient

Develop an enrollment process for family members, to facilitate and standardize the encounter

- Avoid physician calling family members who are not ready for the call• Develop enrollment process that affords reliable contact numbers, ensures family has required technology at home and know how to use it, and sets clear expectations

• Create a ‘sign-in’ system, wherein the family member calls in before rounding starts and physician can see when the family member is connected and ready to talk

Opening comments• Physician’s name and title• Physician’s location within the hospital• Context and goal of the conversation• Reminder of 5-minute limit – questions at other settings

New information from physician to family member• Key new clinical findings or developments

New information from family member to physician• PMHx, SHx, FHx, Allergies, Meds• Social support system

Standardizing the format

Clip-on microphone• Limits talk to one person at a time• Reduces background noise

Mounted iPad• Prevents shaking, ceiling view• Frees physician’s hands for note writing and showing the chart• Prevents viewing of other patients in 2-patient rooms• Keeps speaker in view of the camera

IT preparation• Consult for family member who are less technology savvy• Tech assistant can join rounds and connect to family before doc

enters room• Essential to have a wired connection or strong wireless, won’t

freeze or disconnect

Addressing the technical issues

• Prevents shaking, ceiling view• Frees physician’s hands for note writing and showing the chart• Prevents viewing of other patients in 2-patient rooms• Keeps speaker in view of the camera• Is connected via wired internet connection, much more reliable than

wireless• Battery never dies• Can be bolted to wall to prevent theft• Cost: iPad: $700- $1,100 Video Phone: $40 - $250

Using a video phone rather than an iPad

Concerns….

•Can the doctor give a reliable time window for the family to be ready?

•With this system, the doctors’ primary connection to the family will be in the presence of the patient, allowing him/her to hear things that would have been better discussed separately (not to upset, scare or confuse the patient). Will the doctors find a good way to balance this?

Effective Teamwork

Effective Communicatio

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