Building a virtual nursing program for success | HIMSS 2025

Las Vegas – Nearly two years ago, The University of Texas MD Anderson Cancer Center launched its virtual nursing program.

With the virtual nursing program, nurses engage with patients via video for steps such as the admission process and preparing for discharge.

The program is designed to give patients some more assistance with key parts of the hospital stay, including what they need to know when they leave the hospital. It also is designed to relieve some of the pressures of the nurses who are actually on the floors of the hospital, giving them more time for patients who need attention.

Since the launch in April 2023, Lavonia Thomas, nursing informatics officer at The University of Texas MD Anderson Cancer Center, says she’s encouraged by the program’s success.

“At MD Anderson, we're really pushing the envelope of what virtual nurses can do,” she tells Chief Healthcare Executive®.

“We have had excellent results, both from a perspective of nurse feedback on the efficiency improvements as well as our patient engagement and the patient's feedback on the use of the technology,” Thomas says. (See part of our conversation in this video. The story continues below.)

MD Anderson Cancer Center now employs a group of 16 virtual nurses to guide patients, answer questions and help them get ready to leave the hospital. Those nurses have 10 to 25 years of experience of providing direct in-patient care, and they’ve also gained experience of virtual care as well, Thomas says.

The nurses in the virtual program don’t just possess experience by the bedside, but they bring years of work caring for the unique needs of cancer patients.

“Our nurses have a lot of oncology experience that are staffing the program,” she says.

The nurses who are on the floor have embraced the program. “It truly has helped lighten the load, based on the feedback from the frontline nurses,” Thomas says.

She’s encouraged by the responses of patients who have been engaged with the virtual nursing team. Nurses on the floor may be interrupted to deal with more urgent needs and don’t always get as much time as they’d like to answer patients.

“The patients have given us feedback that they get the opportunity to ask a lot of questions,” Thomas says.

“They’re sharing much more information,” she adds. “They feel more comfortable, they don't feel rushed.”

The virtual nursing has recently gone live in MD Anderson’s emergency department to begin the admissions process.

“The virtual nurse is doing all that administrative work before the patient ever gets to the floor, so that the nurse on the floor is not burdened with doing that,” Thomas says. “They can take the patient in right away, have a lot of information, get right to their assessment, right to the care of their patient.”

The virtual nursing team is also working to identify patients who could develop sepsis, a condition when the body struggles to fight an infection, raising the possibility of organ damage or death. MD Anderson developed an algorithm that identifies patients at risk and the virtual nurse is engaged.

“The virtual nurse will then step in do a deeper dive based on our algorithm and then alert the provider and the frontline nurse of their findings,” Thomas says.

The cancer center’s nursing staff has played a key role in the development of the program, and Thomas says that’s crucial for the program’s success, and for any major initiative involving patient care at a hospital.

“Nursing is really driving the development of the virtual nurse program at MD Anderson,” Thomas says.

Some nurses expressed concerns when the program was being developed, but Thomas says those nurses provided valuable feedback.

“A nurse is there to protect their patient and to take safe care of their patients,” Thomas says. “So anytime something new comes along, you want those people that are questioning it, because we've had to refine some of our processes related to that. But what we've done is we've gotten out in front of it with a lot of discussion, a lot of explaining our workflows, explaining what we're going to do, explain how we're going to do it.”

Nurses grew more comfortable as they saw their feedback was included.

“Nurses have always seen themselves as the last layer of defense,” she says. “Once you let a nurse drive the process and you design it based on their feedback, you do receive less resistance.”

The virtual nursing unit isn’t live in all units of MD Anderson yet. But Thomas says the enthusiasm has grown to the point that nurses are asking when they see the virtual nursing program added to their units.

When MD Anderson began the virtual nursing program, the cancer center opted to use iPads to allow patients to talk to the remote nurses, rather than investing in a lot of extra technology such as large, smart TVs.

“I'm so grateful that we didn't move forward with all the technology and that we did start where we were, because we learned a lot about what we do need and maybe what would be a nice bell or whistle, but it wasn't what we needed,” she says.

MD Anderson is looking to incorporate virtual nursing in other areas, including ambulatory treatment.

“We have we have plans in the future as we branch out even further to really push the envelope for what we can do,” Thomas says.

But she says the growth of the program will be driven and guided by MD Anderson’s nurses.

The cancer center’s nurses, including its virtual team, are “helping us devise how we're going to go forward,” Thomas says.