CODE: What’s Next: Scaling the Digital Hospital – Addressing Hardware and Connectivity Challenges

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Rachelle Longo, AVP, Telemedicine – Ochsner Health

Lisbeth Votruba, MSN, RN, FAONL, CAVRN, Chief Clinical Officer AvaSure

As health systems embrace virtual nursing, virtual sitting, remote specialty consults, and digital-first care models, infrastructure gaps—particularly hardware limitations, outdated connectivity, and insufficient broadband access—are emerging as key barriers to scaling these solutions effectively.

To unlock the full potential of virtual care, we must modernize the foundational technology within hospitals, ensuring seamless integration, reliable performance, and enhanced security.

It’s More Than Just a Camera: Multi-Functionality for Virtual Care

The Problem:
There is a temptation to underestimate the complexity of supporting hospital-based virtual care. Health systems that attempt a DIY solution quickly realize they lack the capabilities needed for multi-purpose virtual care workflows, including:

• Virtual sitting to continuously monitor monitor at-risk patients for falls and other adverse events
• Virtual ICU surveillance
• Virtual nursing to support clinical documentation and mentor novice nurses
• Virtual specialists consultations and hospitalist rounding
• Multi-disciplinary virtual visits such as pharmacy, case management and wound ostomy specialists
• Language interpretation

The Impact:

• Managing camera end-of-life, software testing and patching is an unanticipated IT resource burden for already stretched teams.
• Separate systems built for single-use such as epilepsy monitoring, telestroke, virtual sitting and virtual consultations create inefficiencies.
• Tablet or iPad solutions rely on patient’s technical ability to operate and often require the bedside clinical team to manage recharging, locating and rebooting inevitably leading to poor adoption.
• Inability to support group calling for family or interdisciplinary virtual visits
• Optical zoom limitations or lack of 360° view creates safety risks and limited clinical assessment
• Inadequate audio creates poor two-way communication and limitations for current and future ambient listening use cases.
• Cameras lack AI-powered monitoring, limits to traditional use cases
• Closed proprietary devices stifle innovation opportunities and create difficulties for integrations.

The Solution:
Upgrade hospital cameras to multi-functional AI-enabled devices that support:

• Continuous uptime monitoring for virtual ICU and virtual sitting
• Episodic clinical interactions through secure video streaming
  Implement AI-driven motion tracking and predictive analytics to enhance patient safety without requiring constant human monitoring.
• Ensure cameras are interoperable with telehealth platforms for seamless care coordination between security teams, nurses, and physicians.

Network Realities: The Hidden Bottleneck to Scalable Virtual Care

The Problem:
As hospitals scale virtual care programs, reliable video and data transmission is critical—but increasingly difficult to maintain. The issue isn’t the cabling in the walls, it’s the architecture of the network itself. Many systems still rely on RTSP-based streaming, which routes media from on-prem devices to remote data centers and back, all in under 150 milliseconds to avoid service interruptions. Security layers, bandwidth-intensive applications, and dispersed infrastructure often make that timeline hard to hit.

The Impact:

• Dropped feeds or lags during continuous safety monitoring for virtual sitting can lead to serious safety events such as falls and self-harm
• Dropped video feeds and lag during virtual patient monitoring and telehealth consults
• Delays in AI-driven clinical workflows that depend on real-time insights
• VPN and security tools designed for protection—not speed—slowing down time-sensitive communications
• Overstretched IT teams focused on short-term fixes instead of long-term network optimization

The Solution:

• Adopt peer-to-peer streaming protocols like WebRTC to bypass latency-heavy VPNs and deliver faster, encrypted video
• Deploy edge computing to process clinical data locally and reduce dependency on cloud roundtrips
• Prioritize a network strategy designed for high availability (up to 99.999% uptime), especially for safety-critical virtual care tools
• Empower IT teams with the support and resources needed to build resilient infrastructure, not just respond to outages

Modernizing In-Room Televisions for a Seamless Experience

The Problem:
Hospital room televisions often run on outdated, unupgradable operating systems, preventing them from supporting modern digital health applications like:

• On-demand patient education and care dashboards
• Integrated virtual visits and teleconsultations
• Bedside ordering for meals, prescriptions, and non-clinical services

The Impact:

• Patients cannot easily access their care teams from their bedside.
• Inconsistent user experiences make it difficult for hospitals to provide the seamless, dignified care that patients need—especially in high-stress situations like hospital stays, where a hotel-like experience with intuitive digital engagement can offer comfort, control, and a sense of normalcy during a vulnerable time.
• Limited support for multilingual options, accessibility features, and patient education tools.

The Solution:
Replace aging in-room televisions with smart, cloud-enabled models capable of running modern healthcare apps and communication tools.
Implement TV-based patient engagement systems that allow:

• Virtual nursing consultations
• AI-powered symptom checkers
• Direct communication with the care team
• One-touch ordering for meals, medication, and entertainment
• Ensure TV interfaces are mobile-friendly and integrate with EHRs, so care teams can push real-time updates, video check-ins, and appointment reminders to patients seamlessly.

Closing Broadband Gaps: Eliminating Dead Zones & Access Deserts

The Problem:
Despite the rise of digitally connected hospitals, many health systems struggle with connectivity gaps, including:

• Dark spots in older hospital wings where wireless access is weak.
• Insufficient broadband in rural and underserved facilities, limiting virtual care expansion.
• Network congestion during peak usage times, causing telehealth interruptions and delayed EHR access.

The Impact:

• Dropped virtual visits impact patient-provider communication.
• Latency or drops during continuous virtual sitting or virtual ICU monitoring can lead to adverse events
• Slow network speeds degrade the quality of high-resolution wound care imaging and remote patient monitoring.
• IoT medical devices struggle to maintain connections, limiting real-time data transmission.

The Solution:

• Upgrade hospital broadband infrastructure by expanding fiber-optic coverage and deploying 5G-enabled connectivity to eliminate dead zones.
• Implement dedicated virtual care network segments to prioritize telehealth bandwidth over non-critical data traffic.
• Deploy Wi-Fi 6 access points across all hospital units to support high-density device usage and prevent network congestion.
• Expand satellite and hybrid broadband solutions for rural hospitals to ensure continuous connectivity for virtual nursing and remote monitoring.

The Roadmap to a Fully Digital-First Hospital

To sustainably scale virtual nursing, virtual sitting and digital care pathways, health systems must prioritize infrastructure modernization alongside care delivery transformation.

Immediate Priorities:

1. Upgrade hospital broadband and wiring to enable real-time, high-resolution virtual care.
2. Replace outdated in-room televisions to support modern patient engagement and communication tools.
3. Implement multi-purpose AI-powered security cameras to streamline telesitting, virtual nursing, and remote consults.

Long-Term Goals:

• Establish interoperable, cloud-based digital ecosystems that seamlessly integrate patient data, virtual visits, and AI-driven insights.
• Expand 5G and edge computing capabilities to ensure continuous, high-speed connectivity across all care settings.
• Redesign patient room technology to provide a hotel-like digital experience that enhances comfort, engagement, and seamless care coordination.

Final Thought: The Digital Foundation for Next-Generation Care

Digital-first care is only as effective as the infrastructure supporting it. Health systems that proactively upgrade broadband, cameras, televisions, and wiring will:

• Reduce ED bottlenecks with faster virtual admissions
• Enhance patient engagement and satisfaction with smart bedside interfaces
• Improve safety with AI-driven monitoring and virtual sitting
• Eliminate network failures that disrupt care delivery

The future of healthcare is seamlessly connected care. Those who invest in modern infrastructure today will define the next era of patient-centered, technology-driven care.