How does virtual clinician coverage reduce ER transfers?

Many after-hours ER transfers happen because no clinician is available to see the resident. Virtual coverage puts a licensed clinician on video within minutes, so the nurse gets a real assessment instead of defaulting to a transfer. Residents who can be treated safely in the building stay there, while emergencies are still escalated right away.

Why after-hours transfers happen

At night and on weekends, many skilled nursing facilities have no physician or advanced practice clinician in the building. When a resident's condition changes, the nurse calls an on-call physician, who has to decide based on a verbal description. With no way to see the resident, a transfer to the emergency department becomes the cautious default, even for problems that could have been managed on site.

What an avoidable transfer costs

An emergency department visit is hard on an older adult. Residents can spend hours in a loud, unfamiliar setting, and hospital stays raise the risk of delirium, falls, infections and loss of function. Each transfer also pulls a nurse away from the rest of the unit to prepare paperwork and coordinate transport.

For the facility, hospitalizations and emergency department visits count in the quality measures behind CMS star ratings, and readmissions factor into the SNF Value-Based Purchasing program.

How virtual clinician coverage changes the decision

With virtual coverage, the nurse requests a consult from a tablet and a licensed Third Eye Health clinician joins by video in 2 to 5 minutes on average. The clinician sees the resident, talks with the nurse, and reviews what has changed. That real-time assessment is what separates a resident who needs the hospital from one who can be treated safely where they are.

When treating in place is appropriate, the clinician gives orders and a monitoring plan, and the nurse carries it out with a clinician still available if anything changes overnight. When it isn't, the clinician recommends transfer right away. Either way, notes and orders flow into the resident's chart and the attending physician gets a warm handoff.

Coverage runs nights, weekends and holidays, when an on-site clinician usually isn't available. See how Third Eye Health works and each step of an after-hours consult.

What the results look like

Across Third Eye Health partner facilities, the average treat-in-place rate is 93%, with an average 25% reduction in admissions. Nursing teams also get a clinician on video for the hard calls instead of making them alone in the middle of the night. See the results.

Related: How do Treat-in-Place protocols work in skilled nursing? To see how this would work in your building, request a demo.

Frequently asked questions

Can all ER transfers be avoided?

No, and that isn't the goal. Residents are treated in place only when it is clinically appropriate. Emergencies and higher-acuity situations are escalated right away.

When is virtual clinician coverage available?

Nights, weekends and holidays, the hours when an on-site clinician usually isn't available. A licensed clinician responds in 2 to 5 minutes on average.

Does the attending physician stay involved?

Yes. Third Eye Health clinicians give attending physicians a warm handoff, and daily care coordination summaries keep the facility's care team up to date.