CNOs must look at metrics that will help them leverage virtual nursing through the future and continue to improve the experience for nurses and patients.

On this episode of HL Shorts, we hear from Jennie Van Antwerp, director of digital acute care at OSF OnCall, about the ROI metrics CNOs can use to make a financial case for virtual nursing. Tune in to hear her insights.

Hospitals are testing AI in the Emergency Department, where clinicians face high rates of burnout and need tools to help them create a better medical record.

Generative AI is proving it's value in the doctor's office, where the doctor-patient encounter is usually structured and quiet. Now healthcare leaders want to apply that technology to the Emergency Department, where very little is controlled.

At Atlanta's Emory Healthcare, ED clinicians are using Abridge Inside for Emergency Medicine, a generative AI tool designed to organize, maintain and update the patient's medical record through the disjointed and often interrupted journey from admission to discharge.

Tricia Smith, MBBS, MPH, FACEP, an emergency physician at Emory University Hospital Midtown, says the technology has the potential to reduce time spent gathering disparate patient data, giving clinicians a more efficient path to diagnosis and treatment.

And that's a critical pain point in a hospital's most stressful environment.

"If you have a complete story on the first encounter that you have with the patient, you're able to streamline your workflow," Smith says. "It seems like a minute here, a minute there, but those things really add up in a chaotic environment."

Emory is one of a handful of health systems that have integrated the AI tool into the Epic EHR platform for ED use over the past three months. Abridge officials say the technology taps into Epic's ASAP module to capture the salient points of the conversation, identifying key words and different speakers, and create a medical record that a clinician can drop into and out of as needed.

One of the bigger challenges of the ED is the disparity of the information needed to treat a patient, especially one who may not be conscious or able to communicate. Clinicians in this environment are gathering data from paramedics and EMTs, family members, visual exams and whatever they can find that's already in the EMR. They're developing a medical record out of these unstructured pieces of data, while also stepping in and out of the room to deal with other concerns.

Smith says that workflow extends to the end of this journey as well, when the patient is either discharged or admitted. That medical record needs to be complete for the next care provider, either in the hospital or at home, as well as the patient's insurer and the hospital's revenue cycle department. And AI can help organize that process.

"I have to write these words in this order in this context so the patient can understand exactly what I mean, so the insurer can understand exactly what I mean," Smith points out. And right now we haven't hit that sweet spot for emergency care to make sure that the note has all of those check buttons matched just yet."

Smith says it's likely the technology will need to be fine-tuned as it spends more time in the ED, encountering as many different distractions and roadblocks as possible. That includes making sure the technology is really helping clinicians—burnout rates for this group are among the highest in the hospital setting, running from 50% to 70% in several recent studies.

Smith says ED clinicians face unique challenges, exacerbated by the environment. There are many different points of pressure on their cognitive workload, and it can easily be more difficult to gather and organize the right information than to make a diagnosis. The right tool for them isn't necessarily the one that will help make the diagnosis, but will help them on the path to that diagnosis.

After hearing all the stories about how AI is helping the clinician capture the patient conversation, Smith says she's grateful the C-Suite is looking beyond the doctor's office and into the ED.

"To be quite frank, we felt a little bit left out of the AI conversation," she says. "The majority of these generative AI tools that were being developed were developed for clinic settings, for office settings, where you have a 15-minute encounter. There's a back and forth and there's a neat and tidy conclusion all wrapped up within 15 minutes. But in the ED you're trying to make order out of chaos."

Prioritizing wellbeing requires leadership and individual commitment, says this nurse well-being thought leader.

The term "well-being" is a broad term defined in many ways today, depending on the person and their environment.

For CNOs, well-being programs and initiatives can focus on employee mental health, physical wellness, finding solutions to combat burnout, and creating healthy work environments.

For Diane Sieg, RN, CYT, CSP, the definition is simple.

"Well-being is how you feel about yourself and what you do every day," Sieg said. "Self-leadership is making the best decisions for yourself that supports your well-being."

Sieg, who is a registered nurse, author, coach, and creator of the Well-Being Coaching Initiative, explained to HealthLeaders that nurses traditionally don't always prioritize their own wellbeing, since they are so focused on patients, families, and their communities. Nurses know what to do to take care of themselves, they just don’t often do it.

However, there are major quantitative and qualitative benefits to CNOs and other nurse leaders focusing on nurse wellbeing.

"When nurses that feel good about themselves and what they do every day, they are less stressed and  more connected, engaged, and energized in their work and in their life, which is what wellbeing can do for us," Sieg said.

The ROI of wellbeing

According to Sieg, the quantitative benefits of well-being can be found in improving retention and the bottom line. Through a pilot of the Well-Being Coaching Initiative started during the COVID-19 pandemic, Atrium Health reported a 30% improvement in stress, burnout, and engagement that correlated to a 30% reduction in turnover and $3 million in savings in one year.

There is also qualitative value in wellbeing.

"I have witnessed these nurses transform in their careers and lives," Sieg said. "They get promoted, create new positions, go back to school, and engage in and lead projects, because when you prioritize yourself, you have more to give, period."

To measure the ROI for well-being, Sieg recommended using standard validated assessments to measure burnout, engagement, stress and self-compassion. As with any new initiative, it's important to track metrics before, during, and after implementation.

"We measured self-compassion," Sieg said, "and then lastly was self-leadership, because we want to understand where [the nurses] start and where they are immediately after [intervention], in our case it was the coaching."

Prioritizing well-being requires leadership and individual commitment. Well-being initiatives must be supported by leadership as a benefit to recognize, acknowledge and value their nurses and the vital role they play in patient experience and outcomes, Sieg explained. Nurses need to commit to making changes by practicing self-leadership with the skills, structure and support provided.

The CPR method

For CNOs who want to prioritize wellbeing and self-leadership for their workforces, Sieg suggested "CPR," but not in the traditional sense of the term.

"This CPR stands for compassion, presence, and recovery," Sieg said. "It's not the CPR that nurses are familiar with, but [it's] just as lifesaving because it infuses more energy, purpose and meaning in your work and life."

The practice of compassion, according to Sieg, specifically refers to compassion for yourself. Nurses can have very high expectations of what they can accomplish in a shift, and when they don't meet those unrealistic expectations, are critical of themselves, Sieg explained. explained.

"Nurses have plenty of compassion for others, but what we don't have is compassion for ourselves," Sieg said. "Being kind to yourself is giving yourself a break, literally and figuratively, because you are human and require it."

The second practice is presence, which, to Sieg, is slowing down to experience the present moment fully. When nurses are focused on all their unfinished tasks, they can't engage with themselves or their patients as effectively, and this leads to more stress, exhaustion, and feeling overwhelmed.

"To be present to yourself is to realizing when you're overwhelmed, hungry, or grumpy, and then asking for help," Sieg says. "This focusing on yourself first, supports you to give your best to everyone and everything else." 

The third practice is recovery, which to Sieg means finding ways to re-energize yourself, not just on vacation, or days off, but every day.

"[It's the] idea of filling yourself back up, doing things that help you feel good about yourself, that bring you joy," Sieg said, "not for hours, but even a few minutes of listening to your favorite music, creating some quiet space, moving, or getting outside to help you reset and renew yourself."

Incorporating these practices into nursing must begin with leadership. 

"It's very important for nurse leaders to role model and support these practices for themselves and their staff" Sieg said. "Leaders need to treat themselves with kindness and not run themselves ragged, slow down to engage with staff, and prioritize their own recovery to support their staff to do the same."

For CNOs who are just starting a new wellbeing program, Sieg emphasized the importance of fully committing to it.  

"Whatever you start and initiate, I encourage the nurse leaders to continue, so it is not a one-and-done program," Sieg said. "Well-being is about culture change and it takes time, consistency, and commitment, but it is so worth the investment to empower our nurses."

To learn more about the Well-Being Coaching Initiative, you can contact Diane here: diane@dianesieg.com. 

At HealthLeaders’ Virtual Nursing Mastermind event this week in Atlanta, chief nursing executives discussed how the health system of the future will use technology to reinvent the care team.

As healthcare organizations look to transform care delivery, their innovation plan had better begin with the nurse.

Virtual nursing is one of the more popular concepts in healthcare these days, with health systems and hospitals trying out a wide variety of technologies and strategies focused on reinventing care delivery. And at a recent HealthLeaders Virtual Nursing Mastermind live event, it became clear that this is where healthcare leaders want to start when they talk about the health system of the future.

For the roughly 10 nursing executives attending the Mastermind event this week in Atlanta, the path to transformation begins with the nurse, who is most often closest to the patient, and any meaningful change that reduces waste and cost and boosts outcomes has to focus on improving the patient’s healthcare journey.

The challenge, then, is figuring out how a nurse should fit into the patient’s care journey, and how today’s healthcare ecosystem gets that wrong. Beginning with inpatient care, from the ED to the hospital room, nurses are currently called on to do many things they really don’t have to do. Technology like AI can take on those tasks and give nurses back the time they need and want to care for patients.

That new nursing workflow, Mastermind participants said, should be part of a much larger reinvention of the care team.

Indeed, a growing number of health systems don’t even want to call the platform virtual nursing, and are instead focusing on care coordination and management, a strategy that pulls in all the members of the care team, from clinicians to specialists to pharmacists to technicians.

In that model, technology becomes the foundation upon which each member of the care team can do the tasks they were meant to do—clinicians providing care to patients, and others providing support or handling education and administrative duties. A virtual care platform would then be more like a call center, handling incoming requests and directing them to the right care team member.

According to the Mastermind participants, as healthcare leaders develop the hospital of the future, that virtual care platform will extend outside the hospital, coordinating services that extend to other healthcare sites, even the home. But this platform will only work if the technology sits in the background, gathering and assessing data and handling the tasks that would normally put nurses and other care team members in front of computers instead of patients.

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 accelerating 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 exchange@healthleadersmedia.com

Nurse leaders should leverage both virtual nursing and multidisciplinary care teams to remove burdens from the bedside nurse, say these nurse leaders.

Virtual nursing will continue to become the standard of care in health systems across the industry.

However, there are still several roadblocks that stand in the way of virtual nursing becoming the perfect solution for staffing and care delivery issues.

The HealthLeaders 2025 Virtual Nursing Mastermind program participants met earlier this week in Atlanta to discuss their virtual nursing programs and the outcomes they have achieved so far. There are two key points that CNOs can take back to their health systems to help fine tune their own virtual nursing programs.

Involving multidisciplinary teams

From the beginning, the selling point for virtual nursing has been that it will remove burdens from the bedside and give time back to nurses. However, the Mastermind participants made it clear that virtual nursing is not going to solve every problem that nurses are facing in the industry. Nurses are burnt out, and while the addition of a virtual nurse can help offload administrative tasks such as admissions and discharges, there are still plenty of tasks that could be outsourced to other departments in a heath system.

Since nursing is the largest part of the workforce, it has become easy to pass things off to nurses. However, according to Derek Godino, senior program director of nursing at Geisinger and Mastermind participant, nurses should be able to rely on multidisciplinary teams to support them and remove some of their burden. The participants emphasized that not every task currently being completed by a nurse needs to necessarily be done by RNs.

To Godino, it's time to reimagine workflows at a system level.

"We have to disrupt the health system model, not individual care team models," Godino said.

To the participants, leaders should consider relocating tasks to multidisciplinary teams in addition to assigning them to virtual nurses. CNOs and other nurse leaders should also look at other industries to see how they are successfully integrating technology and try to adapt some of those strategies into their own healthcare workflows.

Reimagining the bedside model

The second takeaway from the participants is that the traditional models of care at the bedside are no longer going to be enough to sustain nursing. The nursing shortage will continue unless nurse leaders are able to incentivize people to become nurses and stay in the workforce. Virtual nursing can be one solution for that, along with incorporating other technologies such as AI and ambient listening that can further remove tasks and documentation burdens.

According to Stephanie Johnson, executive director of system virtual care for UnityPoint Health and Mastermind participant, CNEs, CNOs, and other nurse leaders must advocate for investment in technology as tools that will allow nursing to continue as a profession. The pitfalls of not investing in technology will greatly outweigh the potential savings.

"The CNE needs to be able to envision virtual nursing and other augmented resources as the way in which we will remain viable as a nursing workforce," Johnson said.

To the participants, an ideal virtual nursing program would involve consolidated technology with a streamlined user interface that allows the nurse to follow the patient throughout their entire care journey. It would take into account best nursing practices, get other disciplines involved, and ultimately enable nurses to do their jobs more efficiently and effectively, while recentering their time with patients as the focal point of the profession.

There's more to come from the 2025 Virtual Nursing Mastermind program, so stay tuned for more coverage and the final report.

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 accelerating 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 exchange@healthleadersmedia.com.

Congress has extended telehealth and Hospital at Home waivers through September. This may be the healthcare industry’s last chance to prove their value.

Telehealth and Hospital at Home advocates are once again celebrating an extension of key pandemic-era waivers with last week’s funding bill passage.

But the six-month extension isn’t making things any easier for healthcare execs looking to plot long-term strategies. And while supporters are taking heart in the fact that Congress has consistently kept these programs in view, they also know that the cycle of kicking the can down the road has to end. Either Congress or the Centers for Medicare & Medicaid Services (CMS) makes these waivers permanent, or they end them once and for all.

This gives healthcare leaders the summer to make their case for permanent CMS support of telehealth flexibilities and the Acute Hospital Care at Home (AHCAH) program. That means finding and showing data that proves these flexibilities are saving money, reducing complexity and improving clinical outcomes.

Are we ready for the Summer of Telehealth?

Supporters, beginning with the American Telemedicine Association (ATA) and extending to the hundreds of advocacy groups, healthcare organizations and lawmakers that have signed so many letters calling for waiver permanence, have long lobbied for a multi-year extension of anywhere between two and five years. That time frame, they argue, is necessary for healthcare leaders to conduct their studies and pilots and gather the data they need to support these programs.  

That’s particularly true of the Hospital at Home movement. Close to 400 health systems and hospitals across the country are following the CMS model, which qualifies them for Medicare reimbursements but is quite complex. Others are forgoing reimbursements to develop their programs to treat patients with acute care needs at home (or, in some cases, a SNF or rehab center).

Stephen Dorner, MD, MPH, MSc, Chief Clinical and Innovation Officer of Mass General Brigham’s Healthcare at Home program, says the regulatory uncertainty is slowing down growth, and he worries what will happen if the waivers are ended. But at the same time, the fact that so many healthcare organizations have invested in this strategy means it does have value.

“We’re in this journey to build out the whole continuum of care in the home” he said at the recent HIMSS 2025 conference and exhibition in Las Vegas.

Dorner is part of a Hospital at Home program that’s widely considered to be one of the best in the country, with services that impact a growing number of patient populations, from those with chronic care concerns to veterans. Supporters point to the published studies by the health system showing how the program saves money and improves clinical outcomes; critics, meanwhile, note those studies are small and hyper-focused, and there’s no guarantee the program can be scaled and sustained.

Dorner says the industry needs time to prove its value—and to tinker with the model to find the right mix of efficiency and outcomes.

“I don’t think that the way it’s structured now is necessarily that way it will be structured forever,” he said. “We need more of a critical mass of information” to prove what works and what doesn’t.

The same goes for the collection of pandemic-era waivers on telehealth expansion and use. Virtual care comprised a small percentage—roughly 15%--of all healthcare interactions before the COVID-19 crisis, at which point providers scrambled to put as many services as possible onto a telemedicine platform to help overcrowded hospitals and enable patients and providers to connect and isolate at the same time.

With the end of the pandemic, many patients expressed a desire to see their providers in person again, swinging the telehealth pendulum in the other direction. Some mistakenly assumed this would be the end of telehealth, but the technology had done enough to reduce access pain points and improve outcomes that patients still asked for it and providers found a way to integrate virtual and in-person care. As a result, the waivers were continued.

Which brings us back to the road ahead. With the waivers extended until September 30, the healthcare industry has the summer to prove the value of these flexibilities. They know the extensions won’t go on forever, and with each passing Congressional action the drumbeat is growing to end them and move on.

Supporters can’t keep recycling thank you notes to Congress and the White House for these extensions and vow to continue working to make them permanent. They’ve been doing that for the last two years, and nothing has changed.

CNOs should partner with their technology leaders and IT departments, according to this ANO.

On this episode of HL Shorts, we hear from Sandy Alexander, associate nursing officer at Vanderbilt University Medical Center, about how CNOs can choose the right technology for their virtual nursing programs. Tune in to hear her insights.

The 2025 Virtual Nursing Mastermind program is well underway as participants brainstorm the future and potential of virtual nursing.

As healthcare technologies progress, virtual nursing is becoming the standard of care throughout health systems across the country.

In systems big and small, nurse and innovation leaders are making strides to integrate technology into nursing in ways that will benefit nurses, patients, and their families, while remaining cost effective.

The HealthLeaders Virtual Nursing Mastermind is now in its second year of the program. The participating health systems are meeting this week, from March 17-18, in Atlanta to discuss how far they've come in their virtual nursing programs and where they are going next.

Where it started

In 2024, according to the program final report, the goals of each health system were to improve the nursing workflows on a broader scale, and to address workforce shortages and burnout. Nurses are heavily burdened with administrative tasks that take away time spent with their patients, and virtual nursing can help remove many of those tasks.

According to the program survey last year, 72 % of the health systems reporting being in the early (36%) to mid-stages (36%) of their virtual nursing journeys, with only 27 % reporting being in the mature stage. The early stage is when a program is still in ideation and testing, the mid-stage is when there is some adoption and promising outcomes, and program maturity is reached when a program is becoming systemwide.

For most of the participants (91%) in 2024, virtual nursing had an impact on their medical surgical departments, followed by the ICU (64%), behavioral (18%) and chronic care (18%) departments, outpatient (9%), rehab (9%), and ED/follow up (9%). 

The response was overwhelmingly positive from staff, patients, and leadership. While 89% of the participants reported less than 5% of the nursing budget being attributed to virtual nursing, 80 % of participants also reported they expect their health systems’ virtual nursing labor budget to increase between 10% and 25% over the next three years.

Where it's going

This year, many of the returning participants as well as the new health systems in the program are much further along in their virtual nursing journeys. While many began with carts, several have moved toward in-room technology with built-in cameras and televisions. The goal now is to consolidate technology to optimize the experience for both nurses and patients.

AI has a bright future in virtual care. The participants what to incorporate ambient listening technology into patient rooms for verbal documentation and, where possible, into the electronic medical record (EMR). AI has the potential to optimize tasks, such as searching for information in the EMR.

The participants also have plans to expand virtual care technology beyond just med surge units and nursing. Many want to expand into the emergency department, which has several roadblocks, as well as acute care at home programs. For the virtual nurses themselves, several organizations want to make working from home a viable option, rather than having all the virtual nurses in a centralized location.

There is much more to come from the 2025 Virtual Nursing Mastermind program, so stay tuned for more coverage.

The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives focusing on pain points that matter most to you. This Virtual Nursing Mastermind series features ideas, solutions, and insights into excelling your virtual nursing program. 

To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at anorris@healthleadersmedia.com. 

 

Today’s healthcare innovation landscape is chaotic, and the C-Suite needs to adjust to keep up. Are we ready for a Chief Storyteller or Chief Collaborator?

The chaotic pace of innovation is forcing CIOs to become a jack-of-all trades.

During a recent CHIME panel at ViVE 25 in Nashville, Andy Crowder, CHCIO, CDH-E, SVP, Southeast Region CIO and Enterprise Chief Digital Officer for Advocate Health Care, traced the evolution of the CIO back to the pandemic, when virtual care was all the rage and health systems were scrambling to be innovative.

“I think the role of the CIO or Chief Digital Officer … has been [as] a strategic advisor, part of the C-Suite, tied to strategy,” he said.  “We put our feet on the accelerator, and nobody’s taken that off.”

 “Because of those disruptions and because of that focus, now you’re a force-multiplier,” added Aaron Miri, MBA, FCHIME, CHCIO, Baptist Health Jacksonville’s EVP and Chief Digital & Information Officer. “It changed the lexicon of CIOs to be talking more like a CFO, or a COO, or a Chief Human Resources Officer. I spend part of my day looking at recruitment, part of my day looking at P&L [profit and loss], part of my day looking at futuristic digital transformations and what we can do [to be] disruptive, as well as strategically, where are we going as a health system?”

With the promise of AI on the doorstep and against a backdrop of declining workforces, quality and cost problems, razor-thin margins and an uncertain federal response, CIOs and their colleagues are in a tough spot. And many are eager to accept the challenge.

“We want to be that first-stop shop” for innovative ideas, Miri said. “We want to help you co-develop, and more importantly, imagine the art of the possible.”

At a time when healthcare organizations are looking to cut costs, and in some cases culling their C-Suite, the idea of a fluid job description for the CIO might seem like job security. But at a time when innovation needs a hard and fast ROI, it’s incumbent upon CIOs, Chief Transformation Officers, Chief Digital Health Officers and Chief Strategy Officers to gain a better understanding of what it takes to push through a good idea.

And it’s not limited to CIOs. CFOs and those in Revenue Cycle Management need to better understand the clinical side of the organization to develop tools and strategies that benefit both the patient and the purse strings. CMOs want to work with CNOs—and vice versa—to create better relationships between doctors and nurses.

Collaboration has become a necessity, as health system and hospital leadership looks for new ideas that address more than just one pain point or niche problem.

During the CHIME panel, Tressa Springman, SVP and Chief Information & Digital Health officer for LifeBridge Health, said CIOs can’t just sit at their own desks and wait for things to come to them. They have to be storytellers, understanding the environment and the competitive landscape of vendor relations, looking beyond the shiny new toys and hype to assess whether something really will transform healthcare.

“I see myself as the educator,” she said. “I am the person who is the glue in the organization. I am constantly educating my peers on what their peers are doing.”

“I spend most of my day thinking about, OK, how am I going to improve this business function, how are we going to partner to make this improvement, and will technology help that particular function or not?” she added.

This is where HealthLeaders is headed with its new Chief Digital Executive Exchange, scheduled to take place December 4-5 in Washington DC. Designed to bridge the gap between CIOs and their counterparts, this event aims to give digital and information executives the knowledge they need to collaborate and give new ideas the best chance for sustainability and scalability.

Recruitment is underway for this event. Please contact me for details.

Exclusive sponsorship opportunities are also available. For more information, contact Sales@healthleadersmedia.com.

Nurse leaders need to focus on getting nurses engaged early in their careers, according to this CNO.

Dr. Amanda B. Shrout is a seasoned nursing executive with extensive expertise in clinical care, evidence-based practice, and leadership.

With a Doctor of Nursing Practice (DNP) from Ohio State University, Dr. Shrout has led efforts to improve nursing outcomes through evidence-based initiatives, policy development, and a collaborative leadership style. 

In the nearly 10 years she has been a part of the team at LifeBridge Health, Shrout has taken on roles of increasing responsibility, including clinical nurse specialist, director of clinical excellence, director of emergency departments and observation, and most recently, interim chief nursing officer.

Now, Shrout serves as vice president of patient care services and chief nursing officer at Sinai Hospital & Grace Medical Center in Baltimore, Maryland. There, she has driven significant advancements in patient care and nursing leadership. 

On our latest installment of The Exec, HealthLeaders sat down with Shrout to discuss her journey into nursing, and her thoughts on trends in the nursing industry. Tune in to hear her insights.