Physician Experiences with Implementing a Virtual Observation Unit in Emergency Medicine

Physician experiences with new care models like the virtual observation unit (VOU) in emergency departments (EDs) can offer important insights. VOU leverages telehealth, remote monitoring, and mobile integrated health, to enable home-based ED-level care. We explored physicians’ experience with delivering care in the VOU and perceived impact of this new model. We conducted semi-structured in-depth interviews with 10 ED physicians who staffed the newly launched VOU in an academic hospital. We conducted a thematic analysis, which involved identifying and examining codes that describe important themes in the data. Three themes emerged in terms of ED physicians’ experience with the VOU: (1) forming a deeper connection with patients as the VOU 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 VOU presented opportunities to work closely with nurses, paramedics, and primary care physicians, and (3) (surmountable) programmatic challenges related to dealing with multi-pronged 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 VOU. Physicians who staffed the VOU 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 VOU.