Hospital leaders evaluate virtual care companies on six criteria: clinical workflow fit, open integration, hardware flexibility, pricing and total cost of ownership, performance at scale, and the vendor's partnership model after go-live.
Feature lists look similar across vendors. The differences that decide a program's cost and reach show up in architecture, pricing mechanics, and how the vendor works with a health system once the contract is signed.
Key Takeaways
- The strongest vendor evaluations bring clinical, operations, finance, and IT leaders to the table from the first demo, since each group owns a different part of the risk.
- Open architecture is the criterion with the longest tail. A platform that integrates with the EHR, nurse call, and devices a hospital already uses keeps every future unit a configuration project.
- Hardware cost is one of the most common limits on scale. BayCare Health System's chief nurse executive told Becker's Hospital Review that "the cost of the hardware itself limits how quickly we can scale."
- Pricing models vary widely. Per-endpoint pricing ties cost to the rooms a hospital enables, independent of how many clinicians log in.
- Switching vendors is rare. In KLAS Research's 2023 Virtual Sitting & Nursing study, 98% of customers said they planned to keep their current solution, which makes the first selection a long-term one.
What Do Virtual Care Companies Actually Sell?
Virtual care companies sell some combination of software, in-room hardware, and clinical services that let a remote nurse or observer support patients through two-way audio and video. Most vendors fall into one of three models, and the model shapes cost, flexibility, and the IT lift long before any feature comparison begins.
| Vendor model | What the hospital buys | What it means for the buyer |
|---|---|---|
| Hardware-led system | Proprietary cameras or carts bundled with the vendor's software | Predictable setup, with each new room or capability tied to the vendor's devices and roadmap |
| Software-led, open platform | Software that runs on certified, standard clinical hardware and integrates with existing systems | Faster expansion on equipment already installed, plus room to add best-in-breed tools over time |
| Managed service | Remote nurses or virtual sitters staffed by the vendor, often on the vendor's technology | Quick access to staff, with less control over the care model and higher ongoing labor cost |
Many health systems blend models, for example running their own remote nurses on a software platform and contracting overnight virtual sitting coverage. Knowing which model a vendor represents makes every later answer easier to compare.
Who Should Be on the Vendor Evaluation Team?
A complete evaluation team includes the CNO or CNIO, an operations or finance leader, and IT, with frontline nurses involved early. Each group sees a different failure point.
As a CNO, you need your IT partners, you need your financial partners... You have to have that pre-implementation data early.
Marcia Murphy, MSN, RN, AGACNP-BC, ANP-BC, NE-BC, CCRN, CPHNChief Nursing Officer, Vitalchat. Roughly 17 years of tele-ICU and virtual care experience.That cross-functional view matters because the work is harder than it looks from a demo.
Every hospital wants to put a virtual nursing program into place, but it's complex and can be expensive.
The Six Criteria Hospital Leaders Use to Evaluate Virtual Care Vendors
The scorecard below maps each criterion to the leader who usually owns it, the question to ask, and what a strong answer sounds like.
| Criterion | Primary owner | Question to ask | A strong answer includes |
|---|---|---|---|
| Clinical workflow fit | CNO, nurse managers | How does this fit how our nurses already work? | Configurable workflows for admissions, discharges, rounding, and observation, designed with bedside teams |
| Open integration | CNIO, IT | Which systems does it connect to today, and how? | Live integrations with the EHR, nurse call, and entertainment systems, plus a path to add third-party tools |
| Hardware flexibility | IT, facilities | Can it run on the cameras and screens we already have? | A certified peripheral list and a site assessment that starts with existing equipment |
| Pricing and total cost of ownership | CFO, operations | What does the next unit cost, all in? | Transparent pricing that scales by room, with hardware, support, and upgrades itemized |
| Performance at scale | IT, operations | Who runs this hospital-wide today? | Reference customers live across full hospitals or systems, with measured outcomes |
| Partnership model | Executive sponsor | Who do we call six months after go-live? | Direct access to the product and clinical teams, plus a co-development process for new features |
1. Clinical Workflow Fit
Clinical workflow fit measures how easily remote nurses and bedside nurses can share work without adding steps to anyone's shift. Ask vendors to walk through a full admission and a full discharge, including handoffs, documentation, and how the bedside nurse knows the remote nurse is in the room. Programs built with frontline input tend to see stronger adoption, and the best vendors expect bedside teams to help design the workflow.
2. Open Integration
Open integration describes how well a platform connects to the clinical systems a hospital already runs. At minimum, buyers should expect EHR integration for documentation and patient context, nurse call integration, and support for in-room entertainment systems. A 2026 qualitative evaluation in JMIR Nursing found that workflows forcing staff to toggle between separate systems added friction, while full EHR integration supported smoother programs.
Ask how the vendor adds third-party capabilities, such as fall-risk analytics or translation services. An open platform lets a health system bring in best-in-breed tools as priorities change, and it keeps the hospital in control of its own roadmap.
3. Hardware Flexibility
Hardware flexibility is a platform's ability to run on standard, certified cameras, screens, and devices, including equipment a hospital already owns. It has a direct effect on how fast a program can grow.
Equipment often works in a test environment, but hospital systems need platforms that have no delays.
Ask vendors for a technical assessment of current equipment before any hardware quote.
4. Pricing and Total Cost of Ownership
Total cost of ownership covers software, hardware, installation, support, upgrades, and the cost of every future unit. The pricing section below breaks down the most common models.
Price the first unit and the tenth unit side by side
Ask each vendor for both numbers. The gap between them often says more about long-term value than the initial quote.
5. Performance at Scale
Performance at scale is proof that a platform runs reliably across full hospitals and health systems, measured in real outcomes. Ask for references at organizations running the platform hospital-wide, and ask what those customers measured before and after go-live. Video quality, latency, and uptime matter most at peak census, so ask how the platform performs when every room on a unit is active.
6. Partnership Model
The partnership model defines how a vendor supports a health system after implementation, including access to product and clinical teams. Because so few customers change vendors, the support relationship will likely last as long as the program does.
Three questions for the partnership conversation
- Who owns the account after go-live?
- How do feature requests move into the product roadmap?
- Does every customer receive the same level of service?
How Are Virtual Care Programs Priced?
Virtual care programs are typically priced through one of five models. Many contracts combine two or more of these.
Questions about virtual sitting camera cost come up often in these conversations. The clearest comparison combines device cost, installation labor, and the number of rooms each device can realistically cover over its lifespan.
Do You Have to Replace Your Hardware for a Virtual Care Program?
Many hospitals can launch a virtual care program on cameras, screens, and network infrastructure they already have, as long as the platform is software-led and supports standard clinical peripherals. The answer depends on the vendor's architecture more than on the hospital's rooms.
Is a Virtual Care Program Worth the Investment?
Published results suggest virtual care programs pay off when they target time-intensive tasks such as admissions, discharges, and observation. A University of North Carolina Kenan-Flagler Business School study of 28,000 inpatient encounters found a virtual care program staffed by remote nurses cut average length of stay and lowered readmissions.
Health systems report similar gains. Becker's Hospital Review's December 2025 roundup of results at 10 systems includes:
How Vitalchat Approaches the Evaluation Criteria
Vitalchat is a unified clinical intelligence platform built for the criteria above: software-led, hardware-flexible, and open by design.
The results hold up at scale. At North Mississippi Health Services, remote nurses support a 400-bed flagship hospital and seven community hospitals.
University Hospitals expanded from a six-unit Phase 1 to whole-hospital coverage at UH Lake West.
We've seen in the last six months about a $10 million return in savings.
See how Vitalchat measures up
Schedule a Demo to see how Vitalchat measures up against your evaluation criteria.
FAQ
Is virtual care worth it?
For many hospitals, yes. A University of North Carolina study of 28,000 inpatient encounters found a virtual care program cut average length of stay by more than 7% and lowered readmissions by about 2%. Results are strongest when remote nurses take on admissions, discharges, and observation, which returns time to bedside nurses.
What should we ask a virtual care vendor?
Ask how the platform fits existing nursing workflows, which EHR and nurse call systems it integrates with today, whether it runs on hardware you already own, and what the tenth unit costs compared with the first. Also ask for references running the platform hospital-wide and who supports you after go-live.
How is virtual care priced?
Vendors typically price by bed or room subscription, per endpoint license, per user or seat, hardware purchase plus software license, or managed service hours. Per-endpoint pricing ties cost to the rooms a hospital enables. Compare the full cost of ownership, including hardware, installation, support, and future expansion.
What integrations should we require?
Require EHR integration for documentation and patient context, nurse call integration, and support for in-room entertainment systems. Ask how the vendor adds third-party tools such as fall-risk analytics or interpretation services. Research in JMIR Nursing found that toggling between separate systems adds friction for staff, so integration directly affects adoption.
Do we have to replace our hardware?
Often, no. A software-led platform can run on cameras, screens, and network infrastructure many hospitals already have, as long as the equipment meets the vendor's certified peripheral standards. Hardware-led systems usually require proprietary devices. A technical site assessment should start with existing equipment before any hardware quote.
Sources
- Carbajal, E., and Twenter, P. "How 6 systems are tackling virtual nursing's growing pains," Becker's Hospital Review (Feb. 21, 2025)
- Twenter, P. "Virtual nursing at 10 systems: 23 results to know," Becker's Hospital Review (Dec. 29, 2025)
- Walker, C., and Jackson, S. "The Promising Future of Virtual Sitting & Nursing," KLAS Research (Oct. 17, 2023), summarizing the KLAS Virtual Sitting & Nursing 2023 report
- "Virtual Nursing Pilot in the Inpatient Setting: Qualitative Evaluation," JMIR Nursing (2026)
- "Hospitals address shortage with virtual nurses," University of North Carolina at Chapel Hill (Aug. 2025), on research by Blair Liu, Yuqian Xu, and Brad Staats of UNC Kenan-Flagler Business School
- "Virtual nursing on the rise: Insights from the FutureCare 2025 survey," Telehealth.org (April 2025), summarizing Wolters Kluwer's 2025 FutureCare Nursing survey
- "North Mississippi Health Services' Virtual Nursing Model Returns 600 Hours Each Month," Becker's Hospital Review
- North Mississippi Health Services virtual nursing case study, Vitalchat
- University Hospitals Collaborates with Vitalchat to Set National Standard in Virtual Nursing, Vitalchat (Sept. 2025)
