Why telehospitalist medicine
Why hospitals use telehospitalists.
A telehospitalist admits, rounds and answers the 2 AM page from a remote workstation, working in your EHR with your nurses at the bedside. For a small hospital, that can mean keeping patients you're able to treat instead of transferring them, and keeping your own doctors off the night shift.
The basics
What a telehospitalist does.
A telehospitalist is a hospitalist who works remotely with full access to your EHR. A nurse brings a video cart or tablet to the bedside. The hospitalist talks with the patient and family, reviews the chart, labs and imaging, examines the patient with the nurse's help, then writes the orders and the note. For the rest of the shift, they take the pages.
- Admissions from the emergency department
- Nursing calls and cross-cover overnight
- Daytime rounds with your onsite nurses and APPs
- Discharges, family updates and sign out to the next team
Codes and bedside procedures stay with the clinicians in your building. The telehospitalist joins by video and manages the admission that follows.
The problem
Hospitals can't always hire their way out of this.
A small inpatient census may not support a full onsite hospitalist team, and established programs still struggle to fill certain shifts, nights most of all. The usual answers are locums, a day team that also takes night call from home, or transferring patients who could have stayed. Every transfer sends a patient, a family and the revenue for that stay to another hospital.
An empty shift isn't just a hole in the physician schedule. Nurses still need decisions, the ED still needs someone to admit, families still need updates and the next shift still needs a plan.
Why nights
Nights are where remote work makes the most sense.
A small hospital may see a handful of admissions overnight. Paying an in-house physician to wait through a quiet night costs more than the work brings in, so the night either goes to a doctor on call from home or to the transfer line.
A telehospitalist can handle the admissions and pages for more than one hospital in the same night. In a program covering four rural hospitals, one virtual physician and one onsite APP handled 7 PM to 7 AM, averaging about 7.5 admissions a night across all four.[5]
How many hospitals one telehospitalist can safely take on depends on acuity and volume, including the chance that two need the doctor at the same time.
The data
What published programs have reported.
These are results from other hospitals' programs, published in journals or presented at national meetings.
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Critical access hospital, Iowa
Fewer patients sent out of the ED
After University of Iowa hospitalists began working with a rural critical access hospital by video, transfers out of its ED fell from 16.6% to 10.5%. Length of stay and transfers after admission did not change.[4]
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Four rural hospitals, South Carolina
Nights handled across four hospitals
A tele-nocturnist team admitted more than 2,000 patients in its first 10 months. Compared with the year before, the hospitals reported fewer transfers out, lower mortality, shorter length of stay, more discharges before 10 AM, and more than 10% savings on provider cost versus onsite APPs with locum backup.[5]
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New 25-bed rural hospital, South Carolina
A new hospital staffed by telehospitalists
In its first 18 months, telehospitalists discharged 84% of all admissions. Length of stay was 3.4 days, 30-day readmissions were 8%, and overall performance ranked in the top 25% of comparable hospitals.[6]
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Large health system, Texas
Staff wanted to keep it
A multi-site overnight telehospitalist admissions program logged 1,575 telehospitalist encounters in about 10 months. 86% of surveyed staff favored continuing it, and 75% rated the admission process better than before.[7]
Your current team
It also protects the doctors you already have.
Physician burnout has eased since 2022, but 41.9% of physicians still reported at least one symptom in 2025.[8] For hospitalists, the weight is nights and weekends.
When a remote hospitalist takes the overnight admissions and pages, your day team sleeps, comes in rested and is easier to keep. Recruiting gets easier when the job doesn't include taking call every other night.
Getting set up
What it takes to start.
- Remote access to your EHR
- A video cart or tablet nurses can bring to the bedside. Many hospitals already have one from tele-neurology or tele-psychiatry.
- A way to page or message the telehospitalist: phone, secure chat or your current system
- Medical staff privileges through your normal credentialing process
- Nurses comfortable presenting a patient on camera
Most of the lead time is credentialing and EHR access, which runs on your medical staff office's normal timeline.
It works best with a consistent group of clinicians who learn your resources, your admission criteria and how your nurses communicate.
Questions
What leadership usually asks.
Can a telehospitalist admit patients and write orders?
Yes. With privileges at your hospital and access to your EHR, a telehospitalist admits, writes orders, documents and discharges like any hospitalist on your staff.
Does it replace our hospitalists?
No. It takes the hours and duties your team can't, usually nights, weekends or rounding support, so your own hospitalists aren't stretched thin.
Is it safe?
Published programs have reported fewer transfers, steady or shorter length of stay and strong staff support. Hands-on emergencies stay with your onsite team.
Is it only for rural hospitals?
No. Rural and critical access hospitals feel the shortage most, but large health systems also use telehospitalists for night admissions.[7]
MYG Health Group
Short at night, or transferring patients you'd rather keep?
MYG Health Group provides telenocturnist and telehospitalist services to small, rural and critical access hospitals.
- Phone
- (380) 214-2010
Sources
- Association of American Medical Colleges. The Complexities of Physician Supply and Demand: Projections From 2021 to 2036. March 2024. Projected shortage of 13,500 to 86,000 physicians.
- Society of Hospital Medicine, 2024 Hospital Medicine Workforce Experience Report, as reported in The Hospitalist, 2025.
- Chartis Center for Rural Health, 2026 Rural Health State of the State, as reported in Fierce Healthcare, 2026.
- Kuperman EF, et al. The Virtual Hospitalist: A Single-Site Implementation Bringing Hospitalist Coverage to Critical Access Hospitals. Journal of Hospital Medicine. 2018;13(11):759-763.
- Papo Y, Heincelman M, et al. Open 24/7: The Impact of Creating a Tele-Nocturnist Program to Support Rural Hospitals. SHM Converge 2026 abstract.
- Papo Y, Harvey J, Williams D Jr, et al. Tele-Hospitalist Services to Support the Opening of a New Rural Hospital. Journal of Hospital Medicine. 2026. Results as summarized in Today's Hospitalist, February 2026.
- Nguyen NA, et al. Feasibility and early outcomes of a multi-site TeleHospitalist admissions programme. BMJ Open Quality. 2026;15(2):e003963.
- American Medical Association, 2025 Organizational Biopsy. Physician burnout rate continues to decline. 2026.