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How UCSF Health is Building Off Telemedicine to Boost Virtual Nursing Capabilities

Analysis  |  By G Hatfield  
   July 03, 2024

Previous telemedicine processes are now helping this health system implement virtual nursing, says this nurse leader.

While virtual nursing programs are new to several health systems, the concept of telemedicine is not.

Kay Burke, chief nursing informatics officer at UCSF Health, shared the four areas where their virtual nursing program is having an impact, and how the health system has built off their telemedicine model to improve virtual nursing workflows.

Burke is a part of the HealthLeaders Virtual Nursing Mastermind program, in which several health systems are discussing the ins and outs of their virtual nursing programs and their goals for implementing this new strategy.

Areas of focus

According to Burke, there are four key areas where UCSF is implementing their virtual bedside virtual care program. The first pilot was completed on one adult inpatient acute care services unit. The next will be in the birth center.

"[We are] kicking off a pilot in which we are virtually proactively educating patients who are scheduled for a C-section," Burke said. "So that's an exciting use case that we're exploring."

UCSF is also expanding the program to additional adult care units and into the pediatric space.

"We are dipping our toe into the pediatric space," Burke said, "exploring one unit that is focused on the assessment of our social drivers of health."

Starting with telemedicine

Virtual nursing is not entirely uncharted territory, Burke explained.

"While the program as launched last year is targeting several inpatient units," Burke said, "we've really been doing telesitting and nurse triage via telemedicine capabilities, eICU, [and] virtual consultation for years."

According to Burke, the COVID-19 pandemic opened the door for many virtual capabilities.

"I want to always sort of demystify that this is brand new." Burke said, "And while the care model is becoming more and more well-defined, there are so many different use cases and instances of virtual nursing that have been in the clinical care setting for many, many years."

Burke explained that UCSF modified the EHR using data that was already in their production system to create a queue or work list for the virtual nurse to work off of, so that the nurse understands which patients are eligible for a virtual nurse.

One example of an eligibility criteria is that all of a patient's discharge requirements have been met. For instance, a patient could have an order to go home, a ride set up, and their medications already set up in their DNE, but they haven't had their patient education completed.

"We know that the discharge education now, through the electronic health record, signals as outstanding," Burke said, "so that falls to the work of the virtual nurse."

UCSF also configured their clinical communication platform by doing a directory design, so that the virtual nurse and the directory nurse can communicate.

"Sometimes even though there is an outstanding task that needs to be completed, the patient is not willing to connect with a virtual nurse or is just not available or ready to do so." Burke said, "So that communication configuration was also something that we need to figure out."

The last step was incorporating the technology. Burke said they already had iPads in the clinical setting as a result of the pandemic, which enabled virtual medical interpretation, visitation, and consultation.

"We just leveraged those to additionally carry out the patient-nurse interaction via video," Burke said, "and the telemedicine capability that we had in place already."

The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives. This Virtual Nursing Mastermind series features ideas, solutions, and insights on excelling your virtual nursing program. Please join the community at our LinkedIn page.

To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at

G Hatfield is the nursing editor for HealthLeaders.


UCSF Health is implementing virtual nursing in both adult and now pediatric care units.

Health systems can use previous telemedicine processes to enable virtual nursing, by leveraging technology and the electronic medical record.

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