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Virtual Sitting & Nursing 2023
An Early Look at Promising Outcomes
Author
Schafer Jackson
Author
Ciera Walker
Virtual sitting and virtual nursing solutions are receiving attention from healthcare organizations. Although the use of virtual nursing especially is not yet widespread, and although both use cases often require a significant up-front investment in equipment, organizations are interested in their potential to improve patient outcomes, alleviate staffing shortages, and reduce costs. This report—KLAS’ first about virtual sitting and nursing—is an early look at customer experiences and the positive outcomes (clinical, financial, and operational) organizations are seeing in this space. Broad market insights are also shared. KLAS will continue collecting data on virtual sitting and nursing software and share insights as the market grows.
Note: KLAS measures virtual care platforms that offer broad capabilities for virtual care, including functionality for virtual sitting and nursing. However, this report examines solutions that are primarily focused on virtual sitting and nursing. KLAS plans to publish insights on virtual care platforms with broader capabilities in a future report.
Market Definitions
Virtual sitting
Software that allows healthcare organizations to observe patients, prevent adverse events that would have negative clinical and financial impacts, and scale patient observation capacity to a one:many sitter-to-patient ratio. Technology includes in-room video and audio hardware; cameras can be permanent room installations or portable carts.
Virtual nursing
Software that allows remote nurses to perform knowledge-based nursing tasks—such as discharge planning or documentation—to aid bedside nurses. Technology includes in-room video and audio hardware; cameras can be permanent room installations or portable carts.
Longtime Vendor AvaSure Drives ROI via Patient & Staff Safety Outcomes, though Some Respondents Mention High Hardware Costs
AvaSure is an established, recognizable name in this market—customer respondents have been live on the solution for an average of five years. The majority are large organizations using the solution for virtual sitting. Respondents are satisfied with the product’s ability to drive outcomes, saying that in addition to reducing patient falls, they are reducing tube/line interferences, preventing patients from taking outside drugs, and ensuring staff safety by preventing patient aggression. There are also financial outcomes from being able to scale sitters’ capacity to observe patients and prevent adverse events. Customers appreciate the system’s insightful analytics, the two-way communication with patients, and the pre-recorded messages in multiple languages. Some also like that AvaSure is a one-stop shop with their available equipment.
One concern AvaSure respondents have is the system’s cost—several feel nickel-and-dimed for cameras and necessary equipment. For now, all respondents still plan to stay with AvaSure because of the ROI and outcomes they have realized. However, their decision to stay is contingent on one major factor: having manageable ongoing costs around equipment longevity, equipment replacement, and scaling across the organization. Additionally, some respondents who aren’t currently integrated with their EHR say integration may be a factor in future decisions. Feedback around support is mixed; some say that amid AvaSure’s growth, support has become slower and less proactive. Several respondents also note challenges with equipment. The portable cameras have a large footprint and can be clunky to navigate in smaller rooms. Further, when equipment needs to be repaired or returned, it can be expensive and difficult to ship.
Collette Health* (formerly MedSitter) Offers Responsive, Ongoing Support; Respondents Want More Analytics
Respondent organizations using Collette Health* (formerly MedSitter) vary in size, and most use the solution for only virtual sitting. Customers highly value the vendor’s strong relationships and helpful, responsive support; the ongoing support is especially crucial, as technological issues directly impact organizations’ ability to observe patients. The most frequently mentioned outcomes are reduced patient falls and the ability to circumnavigate staffing shortages and costs that come with 1:1 sitter-to-patient virtual sitting. Multiple customers say the system is better suited to observing bigger, more noticeable movements (e.g., a patient falling), as users can’t always see smaller details (e.g., tubes) because of the lower video resolution or the video’s small screen size when multiple patients are being observed. Some customers want more reporting and analytics, especially as organizations seek to demonstrate the ROI of virtual sitting and nursing programs. Additionally, a few respondents note the system isn’t integrated with the EHR and would like improved alerting functionality between observers and responders.
*Limited data
A Look at Other Validated Vendors
care.ai: Founded in 2019. KLAS interviewed 4 unique customer organizations, some of which are large organizations. Vendor is the only one in report to have all customer respondents using solution for virtual nursing. All respondents are in early stages with solution but say implementations have gone well so far.
Vitalchat: KLAS interviewed 2 unique customer organizations, which are both using the solution solely for virtual sitting.
Wachter: Cross-industry vendor with a healthcare division (Wachter Healthcare Solutions). KLAS interviewed 4 of Wachter’s 10 customer organizations. Respondent organizations are small or midsize and use solution for a mix of sitting and nursing. No major concerns have been reported to date.
Market Insights
What about AI?
KLAS asked respondents about how they are using AI in this market. However, respondents report low awareness of AI features in their solutions.
Respondents’ Long-Term Plans
Very few respondents plan to replace their virtual sitting and nursing solution, with the percent of respondents planning to stay with their solution being well above average. Respondents are seeing enough outcomes to continue with their solution, and many organizations have solutions that are new and still maturing. The number of organizations that plan to replace solutions may change as more solutions mature and the market becomes more competitive.
Respondent Advice for Peers
To be successful with your virtual sitting and nursing program (regardless of what vendor you use), get buy-in from clinical staff and establish strong education and support for users.
Understanding your current staff bandwidth and the bandwidth required for a virtual sitting and nursing program is critical. Include IT in plans to ensure bandwidth requirements are met.
The Impact on Staffing Shortages
Respondents overwhelmingly agree that their solutions have been helpful in addressing staffing shortages. Organizations have increased their observation capacity from a 1:1 sitter-to-patient ratio so that one sitter can now observe several patients. This has helped free up skilled clinical staff who were assigned to sitting roles, allowing them to apply their skills and expertise more meaningfully elsewhere.
Overall Vendor Performance
Early data shows that vendor performance is above average, with no customer respondents reporting dissatisfaction.
† KLAS has published an Emerging Solutions report featuring this vendor. Click links for more details: AvaSure, care.ai, Collette Health.
Vendor-Reported Information
Note: Because virtual sitting and nursing is an emerging market, this section includes vendor-reported information (i.e., has not been validated by KLAS) from vendors covered in this report and other vendors that offer virtual care platforms with virtual sitting and nursing capabilities. KLAS plans to publish insights on these virtual care platforms with broader capabilities in a future report.
Vendors Discussed in Report
Vendors focused on virtual sitting and nursing use cases
AvaSure
How many live unique customers are using your virtual sitting/nursing solution?
About 1,100 accounts
Describe your virtual sitting/nursing solution. Why do customers choose it?
Trusted by over 1,100 hospitals, AvaSure is the most proven, scalable virtual sitting and nursing platform that significantly lowers hospital labor costs while improving patient safety and staff satisfaction. AvaSure’s enterprise platform supports a variety of clinical use cases that integrate virtual nurses and safety attendants into existing workflows, such as virtual sitting, documentation, patient oversight, and mentorship support. The platform includes industry-leading software, devices, data and analytics, implementation services, and life-cycle management, built from over 15 years of expertise.
Customers choose AvaSure because the platform is unmatched in its ability to combine intelligent workflow designs, thoughtful AI enhancements, cloud-based offerings, integrations, and flexible devices at scale, making having a camera in every room a reality. AvaSure’s track record of proven outcomes is evident in over 150 published case studies that showcase ROI from labor cost reduction and improvement in patient safety.
care.ai
How many live unique customers are using your virtual sitting/nursing solution?
7 live health systems and 5+ more in implementation
Describe your virtual sitting/nursing solution. Why do customers choose it?
care.ai provides the industry’s first and only Smart Care Facility Platform that reimagines clinical and operational workflows through AI-powered virtual connections with multidisciplinary caregivers, ambient intelligent monitoring of patients, and care environments to deliver a transformative approach to virtual care models, including AI-assisted virtual sitting and virtual nursing.
Clients choose care.ai because it is the only purpose-built, edge-to-cloud AI platform designed to power Smart Care Facilities, bringing multiple workflows and interactions into a single platform and providing command center views that can effectively scale for any size organization. care.ai virtual care workflows include AI-assisted virtual sitting, virtual nursing, precepting and mentorship, virtual specialist visits and consultations, case management, chaplaincy, pharmacy, and more. Additionally, our ambient monitoring workflows include fall prevention, pressure injury avoidance, staff duress protection, patient and protocol monitoring, and NLP-based ambient documentation.
Collette Health (formerly MedSitter)
How many live unique customers are using your virtual sitting/nursing solution?
151 unique organizations
Describe your virtual sitting/nursing solution. Why do customers choose it?
Collette Health (formerly MedSitter) offers a virtual patient observation solution for acute care, high-acuity patients. The service includes carts, cloud-based software, and virtual clinician observers. The 1:10 observer-to-patient ratio allows observers to speak with patients via the two-way audio and video system whenever assistance is needed. The fully integrated communication allows observers to instantly connect to an on-site nurse’s on-person phone via voice or SMS text to let them know whenever their patient requires help or attention.
Collette Health’s efficient and cost-effective solution benefits healthcare systems by reducing the strain on clinicians, the need for recruitment in the current nursing staff shortage, and—most importantly—the number of costly patient injuries resulting from adverse events like falls. Clients quickly see Collette Health’s impact in improved patient and family satisfaction due to the high levels of comfort and security the solution brings. Collette Health’s easily implemented service is changing the current healthcare landscape for the better.
Vitalchat
How many live unique customers are using your virtual sitting/nursing solution?
22 customers
Describe your virtual sitting/nursing solution. Why do customers choose it?
Revolutionizing hybrid healthcare, Vitalchat combats labor shortages and provider burnout while improving patient satisfaction with patented, hands-free virtual nursing solutions. Leveraging video AI and seamless integration with other technology partners, Vitalchat is defining the hospital room of the future—cost effectively and at scale—while enhancing the human experience.
The AI-enabled eSitter is simplicity at its best. It allows providers to monitor and treat up to 100 patients from a single workstation, compared to the typical dozen. The cutting-edge virtual visits solution connects remote care teams and families from anywhere with real-time translation, patented privacy features, and more.
Minimizing bandwidth requirements up to twentyfold, these solutions rely on patented video analytics technology to conserve networks and eliminate downtime. Healthcare environments can integrate with virtually any existing device or use Vitalchat’s suite of optimized endpoints to bring a complete inpatient telehealth platform to fruition system-wide within weeks.
Wachter
How many live unique customers are using your virtual sitting/nursing solution?
10 live customers, with 3 others in the implementation phase heading toward go-live
Describe your virtual sitting/nursing solution. Why do customers choose it?
The NOVA solution uses HD cameras with two-way audio and video communication; multi-language features; conference calling; night vision; and pan, tilt, and zoom capabilities to allow trained technicians to visualize the patient environment. Utilization of these features can optimize the treatment of patients requiring isolation, monitor patients at high risk for falls or elopement, and assist nurses in remotely monitoring offline devices such as ventilators, IVs, and drainage systems. Our intervention tracking feature provides nursing staff with data related to patient responsiveness so they can virtually monitor and aid in acuity-based scheduling. Our back-end reporting capabilities provide valuable insight into patient behaviors and trends, nursing care, and the benefit of video monitoring to reduce adverse events. Our customers appreciate our responsiveness with 24/7/365 support as well as our customer engagement initiatives that elicit feedback and facilitate the advancement of our products and services. Additionally, the versatility of our solution and the ability to choose from mobile, portable, fixed, or hybrid devices enhances the flexibility and ease of implementation within any organization.
Additional Vendors Offering Virtual Sitting & Nursing Capabilities
KLAS-measured vendors with broader virtual care platforms that include virtual sitting & nursing use cases but aren’t limited to these use cases. Click the links below for KLAS performance data.
Amwell
How many live unique customers are using your virtual sitting/nursing solution?
6 unique live customers, each with various facilities
Describe your virtual sitting/nursing solution. Why do customers choose it?
Amwell’s solution is unique in the marketplace—weaving in-person, virtual, and automated care to create a connected, patient-centric experience. Amwell’s virtual nursing solutions support the patient and bedside care teams by assisting with admissions, discharges, rounding, patient education, and new nurse mentoring, while eSitters can monitor multiple patients at once. Additionally, Amwell enables the ability to leverage its Carepoint devices directly from the EHR to connect virtual nurses and eSitters with patients and bedside staff. Outside the four walls of the hospital, Amwell’s Automated Care Programs assist with reducing the administrative strain on nurses by helping with patient communications like ED discharge, flagging only patients who need additional support. All of Amwell’s virtual nursing solutions continue to save valuable time for nurses and achieve clinical, operational, and financial outcomes for health systems.
Andor Health
How many live unique customers are using your virtual sitting/nursing solution?
30 health systems under contract with scale deployments of 1,000+ beds being monitored and with virtual nursing being provided. AI-powered ThinkAndor Virtual Sitting and ThinkAndor Virtual Nursing are available to all Andor customers—50% of customers have implemented these capabilities at scale and the remaining are deploying at scale. Andor also has burst capacity staff for virtual nursing and sitting, with 70% of customers leveraging these resources.
Describe your virtual sitting/nursing solution. Why do customers choose it?
ThinkAndor Virtual Sitting and Virtual Nursing revolutionize care by combining GPT-based AI models with highly trained resources to optimize the virtual hospital experience. This innovative approach brings a singular virtual command center to enhance interventions, improve outcomes, scale resources, and reduce operating expenses. The Virtual Sitting module optimizes multi-room inpatient management by allowing up to 16+ rooms to be monitored simultaneously, injecting AI signals and ambient monitoring into any camera. This allows for real-time alerts and escalations for falls, self-harm, and elopement risks while also allowing remote specialty consultations such as telestroke, telepsych, and more. The Virtual Nursing module complements Virtual Sitting and leverages AI to identify and curate patient events requiring on-demand nursing support like admissions, medication verification, LOS, and discharge planning with full integration in the EHR. Together, these modules offer a comprehensive solution that are part of ThinkAndor Virtual Hospital suite.
Caregility
How many live unique customers are using your virtual sitting/nursing solution?
33 virtual sitting customers (iObserver) and 17 virtual nursing customers
Describe your virtual sitting/nursing solution. Why do customers choose it?
Caregility’s virtual care portfolio includes a cloud platform, applications for virtual observation and consultation, clinical-grade telehealth endpoints, and professional services that support current and emerging use cases, including virtual sitting and virtual nursing. Virtual sitters and nurses can continuously observe 12 patients at once or virtually engage patients one-on-one to enhance coverage and safety. Embedded AI further augments clinical workflows to improve outcomes and offset staffing shortages. Third-party integrations include outsourced staffing services for virtual sitting, virtual nursing, and more.
Caregility empowers health systems with a platform they can build on to transform care delivery and improve the patient and clinician experiences. Customers choose us for our clinical and technical expertise. We work alongside customers at every step, from network assessment to workflow design to post-go-live optimization. Key differentiators include deep integration with Epic, sophisticated program administration and fleet management, and a subscription-based model for scaling hybrid care across the enterprise.
Epic
How many live unique customers are using your virtual sitting/nursing solution?
60
Describe your virtual sitting/nursing solution. Why do customers choose it?
EpicCare Inpatient allows clinicians to virtually care for patients across an organization’s departments and hospitals. Virtual nurses use familiar Epic tools—e.g., admission/discharge navigators, flowsheets, and Secure Chat messages—to remotely monitor patients and communicate with bedside staff.
Virtual sitters are assigned to patients from the Epic Monitor to centralize remote observations, allowing them to intervene for an individual patient while monitoring other patients in a population. Virtual sitters record information about patient conditions and interventions they perform in the integrated Epic record. Epic Monitor supports a grid of video feeds for assigned patients. Audio and video communications in inpatient virtual care settings work though integration with third-party video technologies.
Clinicians can receive nurse call alerts, bed alarm notifications, and other patient medical device alerts in Epic’s clinical applications on desktop and mobile. A third-party alert manager receives the alerts from the medical device and then relays the alerts to Epic.
Teladoc Health
How many live unique customers are using your virtual sitting/nursing solution?
12 health systems with 55 hospitals (i.e., multiple sites per health system)
Describe your virtual sitting/nursing solution. Why do customers choose it?
Customers choose our Inpatient Connected Care solution because of its versatility and scalability. This all-in-one design converts inpatient room TVs into a telehealth endpoint, without intervention from the patient or bedside staff. Our partnership with Microsoft offers expanded capabilities and development opportunities for solution enhancements, such as AI-algorithms and digital guardrails. The two-camera design enables both a fixed (sitter) camera and a second PTZ camera to be used simultaneously, with any virtual care team member being able to perform consults without disrupting the sitter view. With unlimited use cases and user access; 24/7 proactive monitoring of all devices; and our professional solution design, workflow customization, change management, and KPI/ROI services included, our clients find partnership with Teladoc to be an essential part of their success. In recognition of the unique challenges bedside teams face both personally and professionally, we offer our Mental Health Digital App at no additional cost to clients.
About This Report
Each year, KLAS interviews thousands of healthcare professionals about the IT solutions and services their organizations use. For this report, interviews were conducted over the last 12 months using KLAS’ standard quantitative evaluation for healthcare software, which is composed of 16 numeric ratings questions and 4 yes/no questions, all weighted equally. Combined, the ratings for these questions make up the overall performance score, which is measured on a 100-point scale. The questions are organized into six customer experience pillars—culture, loyalty, operations, product, relationship, and value.
To supplement the customer satisfaction data gathered with the standard evaluation, KLAS also asked customers the following questions specific to virtual sitting and nursing:
- What impact has your solution had on staffing shortages?
- Do you use your solution for sitting, nursing, or both?
Sample Sizes
Unless otherwise noted, sample sizes displayed throughout this report (e.g., n=16) represent the total number of unique customer organizations interviewed for a given vendor or solution. However, it should be noted that to allow for the representation of differing perspectives within any one customer organization, samples may include surveys from different individuals at the same organization. Ratings from these individuals are aggregated in order to prevent any one organization’s feedback from disproportionately impacting a solution’s score. The following table shows the total number of unique organizations interviewed for each vendor or solution as well as the total number of individual respondents.
Some respondents choose not to answer particular questions, meaning the sample size for any given vendor or solution can change from question to question. When the number of unique organization responses for a particular question is less than 15, the score for that question is marked with an asterisk (*) or otherwise designated as “limited data.” If the sample size is less than 6, no score is shown. Where textual content relies on limited data, the vendor name is marked with an asterisk. Note that when a vendor has a low number of reporting sites, the possibility exists for KLAS scores to change significantly as new surveys are collected.
Writer
Sarah Brown
Designer
Breanne Hunter
Project Manager
Andrew Wright
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2025 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.