Physician Experiences With Implementing a Virtual Observation Unit in Emergency Medicine

Physician Experiences With Implementing a Virtual Observation Unit in Emergency Medicine

Authors: Olivia S Jung, Xi Zhu, Lauren M Nentwich, Benjamin A White, Emily M Hayden
Journal: Annals of Emergency Medicine, 2025

Conclusion:

• Physicians had largely positive experiences staffing the Virtual Observation Unit.
• Key benefits included enhanced patient connection, interprofessional collaboration, and improved physician job satisfaction.
• Challenges such as technological hurdles and patient selection processes were identified but seen as surmountable with refinement.

Implications for Practice:

1. Support Physician Wellbeing: VOUs can enhance job satisfaction and prevent burnout among ED physicians.
2. Optimize Technology Integration: Streamline telehealth platforms to reduce friction in patient monitoring and virtual consultations.
3. Clear Patient Selection Criteria: Develop standardized protocols for identifying patients suitable for VOU care.
4. Encourage Collaboration: Foster interdisciplinary teamwork to improve the efficiency and quality of care delivery.
5. Policy and Funding: Policymakers should prioritize funding telehealth initiatives and models like the VOU for broader implementation.

Methods:

• Design: Qualitative study using semistructured in-depth interviews.
• Setting: An academic hospital with a newly launched Virtual Observation Unit.
• Participants: 10 emergency physicians who worked in the VOU.
• Analysis: Thematic analysis was conducted to identify key patterns and insights from the interviews.

Results:

Three major themes emerged from physician experiences:

1. Deeper Connection With Patients:

• Physicians reported stronger bonds with patients due to the extended time spent during virtual visits.
• Observing patients in their home environments allowed physicians to gain contextual insights into their health and living conditions.
• This enhanced patient-centered care and improved trust and communication between physician and patient.

2. Enhanced Interprofessional and Interspecialty Collaboration:

• Physicians appreciated the chance to work closely with nurses, paramedics, and primary care physicians in a collaborative model.
• The VOU fostered team-based care and allowed for better integration of diverse healthcare perspectives.
• The experience highlighted the importance of coordination and clear communication among healthcare professionals in virtual care settings.

3. Programmatic Challenges (Surmountable):

• Technological Complexity: Physicians noted initial difficulties navigating multiple technology platforms for telehealth and monitoring.
• Patient Selection: Identifying patients suitable for VOU care based on their clinical condition and acceptance of home-based care was challenging.
• Despite these challenges, physicians believed these were manageable with time and better resource allocation.

Outcomes:

• Positive Patient-Physician Interactions: Physicians described improved rapport and higher-quality interactions with patients.
• Increased Job Satisfaction: The unique care setting and improved professional collaboration led to greater job fulfillment for physicians.