2025
2025
From easing discharge and enhancing safety to scaling Hospital at Home and solving workforce gaps, HealthLeaders Virtual Nursing Mastermind participants are leading a quiet revolution.
From easing discharge and enhancing safety to scaling Hospital at Home and solving workforce gaps, HealthLeaders Virtual Nursing Mastermind participants are leading a quiet revolution.
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Today’s virtual nursing strategy, as defined by participants in the 2025 HealthLeaders Virtual Nursing Mastermind program, sponsored by Microsoft, is to expand platforms to create multiple points of value. Why? Well virtual nursing has quickly grown from a tightly scoped experiment into an enterprise-wide movement.
In some systems, it’s ballooned into a care coordination command center, a 24/7 telesitting service, a discharge coach, a patient-family liaison, even a remote workforce infrastructure. What was once a nurse-led innovation is now a proving ground for the entire health system's digital future.
And while some see scale and success, others are confronting hard questions: What’s the sustainable funding model? Who owns the technology? How do we protect the original mission? And how do we prevent virtual nursing from becoming just another layer of complexity that nurses have to manage?
In this report, HealthLeaders reconnects with the CNOs and virtual care champions within our Mastermind program to examine what’s changed, what’s working, and what’s getting dangerously lost in translation since last year’s program. The answers point to a future that’s bigger—and riskier—than anyone predicted.
TAKEAWAYS
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What started as a narrow support tool has exploded into a digital command center impacting everything from discharge planning to telesitting, chronic care, and remote workforce strategies.
- Even as virtual nursing improves workflows and patient engagement, CFOs still ask the hardest question: where’s the ROI?
- CNOs aren’t just digitizing care, they’re reimagining it. By shifting tasks across disciplines and pushing tech into homes, virtual nursing could be the lever that redefines healthcare delivery as we know it.
New Year, New Goals
This time around in the program, the participants have several new goals, and a few new frustrations. The name of the game now is expansion – whether that be into other areas in the health system, or sending the technology home with patients in hospital at home programs.
Here are some of the more popular expansions to the virtual nursing strategy:
- Consults – many programs are including or have included consults, enabling clinicians (including specialists) to meet virtually with patients.
- Family and friend visits – a virtual platform could facilitate visits with family and friends who might have difficulty getting to the hospital. The platform can also be used to bring family and friends into a virtual visit between the patient and doctor, enabling the doctor to explain care management tasks and better prepare everyone for when the patient goes home.
ChristianaCare
Non-profit
HQ: Wilmington, Delaware
Coverage area: Delaware and parts of Pennsylvania, Maryland and New Jersey.
3 hospitals, 1,430 beds, and a network of primary care and outpatient services, home health care, urgent care centers, a freestanding emergency department, a Level I trauma center and a Level III neonatal intensive care unit, a comprehensive stroke center and regional centers of excellence in heart and vascular care, cancer care and women’s health.
Emory Healthcare
Formed 1888
Non-profit, formed 1905.
HQ: Atlanta
Affiliated with Emory University
11 hospitals, the Emory Clinic and 250+ provider locations
25,000 staff, 2,000+ physicians in 70 subspecialties
Geisinger
- Sitting and safety – some health systems are incorporating visual monitoring to give the floor nurse an “extra set of eyes” on the patient and the room. A virtual nurse could then spot something that the floor nurse might be overlooking or missing, from a device that needs calibrating to a patient showing signs of combativeness or distress. The virtual nurse can also watch over the patient when no one else is in the room, preventing falls and other mishaps.
- Patient education – this is already an integral part of many virtual nursing programs and should only grow as these programs incorporate follow-up care and other home-based services (including remote patient monitoring and Hospital at Home). Having a virtual nurse on hand to explain discharge instructions, care directions and medications, as well as answering any questions a patient or family member may have, goes a long way towards ensuring that the patient follows doctor’s orders at home and doesn’t end up being rehospitalized.
- Post-discharge programs, from RPM to rehab. Most executives agree that the future of virtual nursing will tie closely into programs outside the hospital, especially as health systems look to move more services to the home. Virtual nurses can help ease the transition for patients going home, while also making sure those patients keep to their care management plans. And as remote patient monitoring and Hospital at Home strategies gain momentum, the virtual nurse could be the primary care coordinator.
Improving the In-Patient Experience (For Both Patients and Nurses)
According to Derek Godino, senior program director of nursing at Geisinger, the health system's virtual nursing program will serve as a critical connector between inpatient discharge and outpatient follow-up, specifically for care coordination, chronic condition management, and the Geisinger at Home program.
"By embedding virtual nurses into these models, we can provide continuous, proactive support and reinforce care plan adherence, reducing unnecessary readmissions and improving patient satisfaction," Godino said.
At Sanford Health, the virtual nurse acts as an extra set of eyes and ears for the floor nurse. That includes keeping an eye on patients and identifying signs of distress or aggression.
“Can we prevent some escalation of patient behaviors,” says Erica DeBoer, the health system’s chief nursing officer, “[and] get additional help to the patient room to support our team on the floor?”
Indeed, some health systems are either incorporating separate sitting programs into the virtual nursing platform or adding those services as they integrate video technology.
Maria Brown, nursing excellence manager at ChristianaCare, told HealthLeaders that they plan to shift towards having a fully staffed virtual nursing model. The next goal is to expand further and see how virtual nursing can impact other areas.
Houston Methodist
Non-profit, opened 1919
HQ: Houston
1 academic medical center (907 beds, 2767 beds total), located in the Texas Medical Center; and 7 community hospitals; affiliated with Weill Cornell medical College
5,000+ physicians
Jefferson Health
Non-profit, founded 1995 (Jeferson Hospital originally founded 1825)
HQ: Philadelphia
Affiliated with Thomas Jefferson University
Flagship hospital: Thomas Jefferson University Hospital, 32 hospitals and physician practices, 200+ care sites.
3,867 beds, 42,000+ employees, 5,900+ physicians, 1,900+ faculty
"We hope to evolve to all other kinds of settings, meaning potential ICU type areas and EDs," Brown said. "We are doing some pilots in different types of areas, like an ambulatory space to kind of see how nurses could function that was as well."
At Houston Methodist, some 70% of the health system’s virtual nurses now work from home, according to Steve Klahn, clinical director for virtual medicine. And that number may rise to 90%.
"We are currently shifting more of our teams to remote work, as space in our virtual operations center is at a premium," he says. "Our strategy remains for direct hire exceptional staff nurses (no-outsourcing to contracted teams), as well as supporting nurses in times of short-term light-duty assignments."
In terms of pain points, most of the participants expressed the desire to consolidate technology into a single vendor solution that can provide all of the necessary software and hardware to make investments easier. Brown said that at ChristianaCare, patience is key, due to the significant cost of switching technologies and their plans to incorporate new innovations.
"I don't know if we've found that perfect technology that does everything, and so we wanted to wait and see what we can do with what we have," Brown said. "By the time we are able to decide on a technology, I think we would include things that have AI technology, maybe some ambient listening, [and] maybe some ways to use predictive analytics."
Another ongoing challenge is sustainability. In many cases nursing leaders are able to list a number of benefits to the program, from improved nursing workflows to better patient engagement, but can’t easily translate those gains into something the chief finance officer would appreciate.
“One of the biggest challenges we’ve faced with the virtual nursing program is securing sustainable funding,” says Laura Gartner, AVP and nursing informatics officer at Jefferson Health. “There is strong interest in implementing virtual nursing across various units, as the benefits—such as improved workflow efficiency and enhanced patient support—are widely recognized. However, integrating a virtual nurse into staffing models requires a financial investment, and identifying consistent funding sources has been a barrier. Aligning financial priorities with program expansion remains a key focus.”
Medical University of South Carolina
Founded 1824
HQ: Charleston, South Carolina
MUSC Health is the healthcare system of the Medical University of South Carolina
16 hospitals (owned or governing interest), 4 more in development, 2,700+ beds, 750 care locations, 350+ telehealth sites
26,000 faculty, physicians, students and staff
Mount Sinai Health
Created in 2013 from the merger of Mount Sinai Medical Center and Continuum Health Partners (first hospital, The Jews’ Hospital, founded in 1852).
HQ: New York City
Encompasses 8 hospitals in NYC metropolitan area, Icahn School of Medicine at Mount Sinai, and Mount Sinai Phillips School of Nursing, 13 ambulatory surgery centers, 30 affiliated community health centers and hundreds of ambulatory practices.
42,000 employees, 9,000+ physicians
Where Are We Going Next?
When considering the future of virtual care technology, the participants are dreaming bigger. In addition to using the technology for nursing, it's clear that the next step in the journey will be to involve multidisciplinary teams. If a health system is going to invest in new technology, why not apply it everywhere possible? Once it's been tested and implemented by nurses, of course.
“We can’t expand fast enough,” says Emily Warr, administrator for the Center of Telehealth at the Medical University of South Carolina (MUSC). “Nursing units across the system are demanding the service and are eager to see the benefits in their work area. I think the specialty units will be interesting to explore and will present scalability challenges, but we look forward to problem-solving those while maintaining a focus on outcomes and efficiency.”
Nurses should also be able to rely on multidisciplinary teams to support them, and redirecting extra tasks to other departments via virtual care technology could be a huge help. Godino believes it's time to reimagine workflows at a system level, since not every task nurses are currently responsible for needs to be completed by a nurse.
"We have to disrupt the health system model, not individual care team models," Godino said.
Geisinger has put emphasis on integrating virtual nursing into many different aspects of nursing workflows, according to Godino.
"We've also strengthened our interdisciplinary partnerships and improved the integration of virtual nurses into daily clinical routines," Godino said, "enhancing team cohesion and patient experience."
In addition to relocating tasks to both virtual nurses and multidisciplinary teams, CNOs and other healthcare leaders should look at other industries to see how they are successfully integrating technology and try to adapt some of those strategies into their own healthcare workflows. With the rapid introduction of new technologies to the industry, there is much to be learned from how others are adapting their workflows and choosing what to invest in.
Sanford Health – the largest rural health system in the country – sees virtual nursing as key to supporting small and rural hospitals, clinics and other care sites that may have only one nurse (or care provider) on hand. DeBoer says they’re eager to use this platform in any way that can improve care delivery.
Sanford Health
Non-profit, founded 1996 (first hospital opened 1984).
HQ: Sioux Falls, South Dakota
56 hospitals, 286+ clinics, 147 senior care communities, 130 skilled nursing and rehab facilities, 5 global clinics.
Coverage area: South Dakota, North Dakota, Minnesota, Wyoming, Iowa, Wisconsin, part of Michigan.
2 million+ patients, 425,000 affiliated Sanford Health Plan members
53,000 employees
Annually, 113,000 admissions, 9.7 million outpatient and clinic visits, 230,000 surgeries and procedures.
Sharp HealthCare
Non-profit, founded 1955
HQ: San Diego
4 hospitals, 3 specialty hospitals, 3 affiliated medical groups, one affiliated health plan
19,000 employees, 2,700 affiliated physicians
UnityPoint Health
Non-profit, founded 1993
HQ: Des Moines, Iowa
Coverage area: Iowa, Illinois, Wisconsin
8 million annual patient visits, including 100,000 surgeries
17 regional hospitals, 19 community network hospitals, 390 clinics, 5 affiliated community mental health centers, 3 accredited colleges.
30,000 employees, including 100 physicians
“When looking at capturing KPIs in virtual nursing, workforce optimization can be demonstrated by analyzing metrics such as nurse-to-patient ratios, task completion times, measuring overtime and resource utilization rates. Transparent communication of these findings to stakeholders reinforces the case for virtual nursing programs.”
—Laura Angie Curry, BSN, RN, CCDS, Clinical AI Strategy Executive at Microsoft and sponsor of our 2025 HealthLeaders Virtual Nursing Mastermind Program
“Our philosophy is that we have the technology, we have the platform, now how can we scale it?” DeBoer says. “Let’s try to see what’s going to work, knowing that a mile saved from being on the road means reduced time away from work, school and the comfort of their own homes.”
The HealthLeaders Mastermind series is an exclusive series of calls and events with healthcare executives. This Virtual Nursing Mastermind series features ideas, solutions, and insights into excelling your virtual nursing program. Please join the community at our LinkedIn page. Please join the community at our LinkedIn page.
To inquire about participating in an upcoming Mastermind series or attending a HealthLeaders Exchange event, email us at anorris@healthleadersmedia.com.
Looking for even more on what our HealthLeaders Mastermind participants achieved?
Looking for even more on what our HealthLeaders Mastermind participants achieved?
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