Physician Experiences With Implementing a Virtual Observation Unit in Emergency Medicine

Study objective: Physician experiences with new care models like the virtual observation unit in emergency departments (EDs) can offer important insights. Virtual observation unit leverages telehealth, remote monitoring, and mobile integrated health to enable home-based ED-level care. We explored physicians' experience with delivering care in the virtual observation unit and perceived effect of this new model.

Methods: We conducted semistructured in-depth interviews with 10 emergency physicians who staffed the newly launched virtual observation unit in an academic hospital. We conducted a thematic analysis, which involved identifying and examining codes that describe important themes in the data.

Results: Three themes emerged in terms of emergency physicians' experience with the virtual observation unit: (1) forming a deeper connection with patients as the virtual observation unit allowed them to spend more time with patients and care for patients in the patients' home environment; (2) increased appreciation for interprofessional and interspecialty care as the virtual observation unit presented opportunities to work closely with nurses, paramedics, and primary care physicians; and (3) (surmountable) programmatic challenges related to dealing with multipronged technology and finding the right patient with an appropriate clinical condition and acceptance of home-based care. These experiences then contributed to positive perceptions of patient-physician interactions and increased job satisfaction among physicians who participated in the virtual observation unit.

Conclusion: Physicians who staffed the virtual observation unit in our context reported largely positive experiences. Policymakers and administrators should consider benefits to physician wellbeing and cultivating interprofessional and interspecialty care when making decisions about funding telehealth and care models like the virtual observation unit.