About the Hospital
Looking to replace its current telemedicine provider with a company that offered a dedicated remote care team, Iowa Specialty Hospitals & Clinics, located in north-central Iowa, turned to Eagle. The hospital system offers specialized care at their 25-bed Critical Access Hospitals in Clarion and Belmond, Iowa. The hospitals serve residents of this farming region due north of Des Moines and Ames. Today, both hospitals utilize Eagle’s TeleHospitalist services.
The Need
Physician Retention and Hospital Medicine Continuity
Iowa Specialty Hospitals & Clinics faced growing pressure in its Hospital Medicine program as physician retirements and workforce constraints strained overnight care.
As Hospital Medicine becomes a higher priority for health systems and hospitals, strong overnight care is essential to maintain continuity and reduce avoidable transfers.
Key obstacles included:
- Several physicians nearing retirement
- Remaining providers managing 24/7 call alongside daytime workloads
- Difficulty maintaining consistent overnight care continuity across inpatient services
- The need to improve physician work-life balance to support retention
- Pressure to reduce avoidable transfers to tertiary facilities
- A new internal medicine physician requiring reduced overnight demands for long-term retention
To address these challenges, Iowa Specialty Hospitals & Clinics explored options to strengthen its overnight Hospital Medicine capability while maintaining its commitment to quality care.
Challenge
Finding the Right Overnight Hospital Medicine Model
The health system explored an overnight telemedicine model to strengthen night coverage, but an initial solution did not meet operational or clinical expectations.
The model relied on a large rotating pool of physicians, which created inconsistent clinical relationships and fragmented communication with on-site care teams.
Their first attempt with a night-time remote care team wasn’t a good fit. The telemedicine system worked with a large number of providers, and every call involved a different provider. “We never got the same provider twice,” says Robyn Paulsen, Director of Telehealth, Community, and Business Development. “The technology was also inadequate, simply a small iPad attached to an IV pole,” she says. “It was very hard for the team to manage patients with that process, and the technology felt unrefined.”
For a system with a strong culture of service excellence and high patient experience standards, consistency and integration were essential requirements that the prior model failed to deliver.
Gaps in overnight Hospital Medicine coverage often led to delayed clinical decision-making, increased patient transfers, and added strain on care teams. Over time, these challenges could impact care quality, operational stability, and provider retention across health systems and hospitals.
Solution
A Dedicated Nocturnist Physician Partnership Model
Iowa Specialty Hospitals & Clinics partnered with Eagle Telemedicine to build a dedicated nocturnist physician partnership model to strengthen overnight Hospital Medicine operations.
Instead of rotating providers, Eagle embedded a consistent team of five TeleHospitalist physicians across both hospital sites. This created continuity across night shifts and improved coordination with on-site care teams.
Eagle worked as an integrated partner, aligning with existing workflows and sharing accountability for overnight clinical and operational outcomes.
The program was supported by enhanced clinical capabilities, including technology Eagle helped recommend and configure for the facility:
- High-resolution video for remote evaluation • Audiovisual tools for real-time communication • E-stethoscope functionality for higher-acuity decision-making
The result was a more stable overnight Hospital Medicine environment with:
- Consistent physician presence
- Better coordination with on-site teams
- Faster clinical decision-making
This approach established a durable nocturnist infrastructure designed to support long-term
HospitalMedicine continuity rather than a short-term fix.
Benefits & Outcomes
- Fast Response Times
- Nursing Support
- Fewer Patient Transfers
