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MedSitter's Guide to Remote Patient Observation via Telemedicine Carts

MedSitter helps overburdened clinicians to meaningfully improve patient safety and satisfaction without straining staff resources. All with the best-in-class technology for our telemedicine carts.

Stop Patient Falls in Hospitals Before They Happen

No one goes to a hospital expecting to fall. A safe hospital stay is a reasonable expectation of every patient. Tragically, patient falls in hospitals can lead to an extended hospital stay and even significant injury.

Every year, 700,000 to 1,000,000 patient falls occur in US hospitals with roughly 250,000 of those falls leading to injury (Source: NCBI). A fall may result in fractures, lacerations, or internal bleeding, leading to increased health care utilization. However, research shows that close to one-third of falls can be prevented (Source: Agency for Healthcare Research and Quality). You can stop patients falls before they happen—with remote patient observation.

Remote Patient Observation: What Is It?

A hospital is a place of healing. Within hospital walls, healthcare providers, pharmaceuticals, and technology all come together to improve the health and outcomes of patients. Unfortunately, there are still dozens if not hundreds of things that can go wrong during a hospital stay. In order to prevent as many bad outcomes as possible, hospitals lean on patient sitters for patient safety and satisfaction.

The primary function of a patient sitter and patient observation is to observe a patient with an elevated risk and prevent a bad outcome for that patient. The most pressing and preventable negative outcome is a patient fall. A widespread literature review recently found that virtual sitting via video monitoring was associated with a decrease in falls, from which we can conclude that virtual sitting is very effective. (Source: Journal of Nursing Education and Practice). And that is where MedSitter comes in.

The MedSitter Difference

When we founded MedSitter, we were addressing an important issue within the marketplace. The issue at the time was patient falls. Patient falls, despite being deemed a never event by the Centers for Medicare and Medicaid services, still occur every day in hospitals across the nation. And when it comes to patient falls, most healthcare providers are forced to be reactive. The patient to staff ratio is never 1:1, leaving patients ample time alone to suffer an accident. In most cases, patients are not assigned a 1:1 sitter until they have already demonstrated risky behavior or suffered an accident – and that is if the nursing team has a 1:1 sitter available

MedSitter is a remote patient observation solution that puts one observer in front of up to ten patients at one time, essentially making patient sitters 10x more effective. Both the MedSitter hardware and software were designed for clinicians and include some innovative features that are not seen anywhere else in the market. These features (along with many others) truly set the MedSitter solution apart:

  • Persistent Video

With MedSitter, the connection between the patient and the observer is always on. If the observer needs to speak to the patient, they can appear onscreen on the MedSitter telemedicine cart with the click of a button. This instantaneous connection goes a long way in preventing adverse events. The video is particularly important, considering that the addition of nonverbal, contextual, and behavioral information leads to more effective communication in a healthcare environment when compared to audio-only communication. (Source: NCBI).

  • Full-Field Night Vision

The sitter-controlled camera covers the entire patient room, regardless of the light conditions or the time of day.

  • Cross-Language Communication

Not every patient requiring observation speaks English, and so the MedSitter software contains pre-recorded messages in more than 60 languages for quick communication with limited English proficiency patients. The system also includes a full library of pre-recorded video messages in American Sign Language, which helps healthcare facilities to fulfill their language access requirements as outlined by The Joint Commission. (Source: Joint Commission).

Read more about what sets MedSitter apart here.

The features listed here are completely unique to the MedSitter product and go a long way in helping remote observers be as effective as they can in preventing patient injury. But MedSitter’s design also helps to reduce sitter fatigue that can come with remote patient observation.

How MedSitter Reduces Patient Sitter Fatigue

MedSitter was designed for clinicians by a dedicated development team that worked in close proximity with RNs and CCRNs. We wanted to create our system for the observers. We took observer experience and potential fatigue into consideration when designing MedSitter. This led to our choice to use larger screens, prioritize ease-of-use, and limit the number of patients under observation to ten.

Fatigue is all too common when it comes to computers, and in particular, with patient sitters. In research of our sitters, we noticed that when a monitor larger than 32-inches was in front of them, sitters had to push back in their chair and kick their head back in order to take in the entire monitor. If a sitter is constantly moving their head back and forth to see the entire screen, that will cause more fatigue.

Every MedSitter observer is interacting with the software on a 32-inch monitor. We specifically use that size to maximize central and peripheral vision. 32-inches falls into a persons’ peripheral viewing area, allowing one sitter to take in the entire screen at once, edge-to-edge. Within the software we have two different patient viewing panels: a larger video window called the interaction zone and ten smaller video windows called the monitoring zone.

The interaction zone is meant for central vision, and the observer gets to select which patient is in the interaction zone at any given time. While a patient is in the interaction zone, the observer can unmute their microphone to communicate with the patient, signal onsite staff, and even ring the bedside alarm. While this is happening, the other patients are under peripheral observation in the monitoring zone—which means that no one is going completely ignored. Since the observer can view everyone at once, there is less risk of fatigue.

While patient safety is our priority, it is just one of many reasons to adopt virtual patient observation. Let’s see how else MedSitter can offer solutions for your organization.

Nursing Shortages/Release Valve for Nurses

The story of healthcare staffing shortages is nothing new. What began in the 1930s, due to multiple technology, economic, and health care-related events, is something that seems to be a never-ending tale.1 The demand for nurses has simply grown so high that the United States is having a difficult time keeping up. Add this to a global pandemic, and current staffing shortages are no surprise—though it is a huge concern. Nurses and the challenges they face continue to be at the forefront of the national conversation. And for good reason: they are the backbone of our health system and critical in fighting COVID-19. (Source: Incredible Health). COVID-19 didn’t create the healthcare staffing shortage, but the impact is worsened because of it. (Source: Medical Economics). According to a report from Incredible Health, over a third (34%) of the nurses surveyed reported that it is very likely that they will quit their job by the end of 2022. 44% cited burnout and a high-stress environment as the reason for their desire to leave. (Source: Incredible Health).

While the market will not change overnight, some of the technological advancements like MedSitter can provide a viable solution to the shortage, stress, and burnout that nursing departments are facing. MedSitter helps alleviate healthcare staffing shortages by making one sitter ten times more effective. We are the technological solution that nursing departments have been looking for. Designed for clinicians specifically, MedSitter’s 32-inch UX-designed monitor makes it easy to turn one patient observer into ten.

How to Reduce Patient Sitter Costs with MedSitter

The use of 1:1 patient observers can put a terrible strain, not only on nursing staff, but on nursing budgets, as well. It is also very disruptive to operational workflow; you are either hiring beyond your capacity, or you are pulling people from other duties to provide enhanced observation services. ​The industry average shows that sitters make $15.97/hour (Source: Zippia), and most hospitals maintain 24-hour sitters for 3.5% of their Average Daily Census. 

Sitter management often falls within the nursing department. However, remote patient observation has begun to emerge as an optimal solution. The financial impact of remote patient observers can be incredibly substantial. Simply putting observer in charge of multiple patients saves in payroll, tax, management, and worker’s compensation expenses. You can take a look at some hypothetical scenarios here.

With MedSitter, more patients can be observed without requiring more staff members. If you want to maintain your current coverage percentage, you can reallocate your sitting staff to perform other vital duties throughout the hospital.Sitters can also be used for suicide/self-harm watch, while CNAs with patient care experience can be used to observe patients with MedSitter to provide remote patient care.  

Remember, you are paying $16/hour for one observer regardless of whether they are watching one patient, or ten. Maximize your observer’s efficiency while providing additional coverage and care with MedSitter.

Patient Mental Well-Being in Isolation

When people think about being in a hospital, they mostly think about being physically well—bones healing, sickness diminishing, recovery from surgery. However, a patient’s mental well-being is important, as well.  The mental burden of any illness or injury that requires hospitalization is intense – and studies have shown that anxiety and depression plagues patient families as well. (Source: OJM International Journal of Medicine). Patients in isolation are particularly vulnerable to feelings of depression, anxiety, and anger. (Source: NCBI). 


Fortunately, MedSitter remote patient observation has ways to improve those feelings and the mental well-being of patients. Healthcare providers that use virtual observation with tools like MedSitter have begun leveraging many of the features to help with the emotional highs and lows that come with being in the hospital, such as instantaneous communication, language translation (including sign language), and sitters who are specifically trained to interact socially with patients.


Isolation is one of the most harrowing aspects of hospitalization. With MedSitter, you are never alone. In fact, our logo is an angelfish because angelfish are never found alone in nature. They always move in pairs. We want our solution to provide companionship to your patients so that they never feel truly alone during their hospital stay.

Leverage MedSitter Across Your Organization

While patient safety is our priority, there are surprisingly many other reasons to use MedSitter, that can, in turn, also produce cost savings.

Many times, we find nurses overly focused on trying to replace 1:1 patient sitters with MedSitter. While this is important, and what MedSitter was created for, this can also result in overlooking additional patients who would be appropriate for MedSitter. Below are a few real-life examples from many of the hospitals we’ve seen, leveraging remote patient observation for other departments across your organization.

  • Observation in Acute Care: Orthopedics & Neurology

Think of patients that are on mobility limitations. Maybe they're not supposed to be using their right arm but keep doing so. How nice would it be to have someone to remind them, every time they go to use their right arm, to not use it? Often times, nurses just don’t have the time to stay in the patient’s room to tell them not to use their right arm every five minutes. This example could be applied to any limb, or even a post lumbar puncture patient. The more we can keep patients from doing harmful things, the faster they can heal. Their length of stay should therefore decrease, which, in turns, saves the hospital money, as well

  • Observation in Diagnostic Care Areas: Virtual Witness

MedSitter could also be used as a virtual witness for staff that are performing diagnostic exams independently—especially when those exams or procedures may compromise patient dignity.

Think of different instances where a patient makes accusations against a health care worker. Until the health care worker is proven innocent or guilty, there’s time off work, an investigation, loss of wages, and so much more. Or what about an aggressive patient that puts the nursing staff at risk for injury, themselves? How nice would it be to know that, as a clinician, you have that extra set of eyes to back up what you're doing?

  • Observation in the Emergency Department

The emergency department is such a busy area of a hospital. Patient status can change dramatically at any given moment. Is your patient a frequent flyer? Is this a drug seeking patient? Is this a trafficking situation that requires extra eyes? The non-frequent flyer emergency department patient is unfamiliar to hospital staff. Imagine you’re caring for a patient that’s having back pain, COVID-19 respiratory distress, or a broken arm. You never know when you're going to get a trauma patient called in that takes you away. Wouldn't it be nice to have an extra set of eyes on your patients, especially if you are unfamiliar with them? What if you just have a feeling that something’s off about the situation? Until a full work up is completed, it can be helpful to visually monitor emergency department patients. Once admitted to the hospital, the MedSitter observer can also help the nurse give a detailed report.

These are just a few of the additional reasons your patients need remote patient observation. If you are interested in seeing more examples of how patient observation can be leveraged in other areas such as geriatrics, pediatrics, rehabilitation hospitals, nursing facilities, behavioral health hospitals, and more, you can watch our recently recorded webinar here.

If you are interested in installing MedSitter in your healthcare facility, visit our Contact Us page now.