Can my hospital capture my vitals during a virtual visit?

The widespread adoption of virtual visits has fundamentally altered healthcare delivery, but the clinical depth of these remote encounters often falls short of their in-person counterparts. A video call can facilitate a conversation, but it historically lacked the ability to capture the objective, physiological data that underpins clinical decision-making. For health system leaders, this data gap has been a persistent challenge, limiting the scope of conditions that can be managed effectively through telehealth. The core question has evolved from if virtual care should be offered to how it can be made as clinically robust as a traditional office visit.

"In 2022, telehealth utilization had stabilized at 38 times higher than pre-pandemic levels, but the lack of integrated, real-time patient data remains a primary barrier to broader clinical application." - McKinsey & Company, 2022

The technology enabling this shift is remote photoplethysmography (rPPG). For rPPG health systems, this represents a strategic move to deepen the clinical value of virtual care. rPPG is a contactless monitoring technique that uses a standard digital camera, the same one found in a patient's smartphone or laptop, to detect subtle changes in light reflection from the skin's surface. These changes correspond to the blood volume pulse, allowing for the calculation of vital signs like heart rate, respiratory rate, and blood pressure. By integrating an rPPG software module into a telehealth platform, a health system can empower providers to initiate a vital signs measurement during a live video encounter, without requiring the patient to own any special hardware or wearables. This transforms the virtual visit from a subjective conversation into an objective clinical assessment.

The Rise of rPPG in Health Systems

The integration of rPPG technology is a direct response to the need for more data-rich virtual encounters. Health system CIOs and clinical informatics leaders are tasked with building a virtual care infrastructure that is Scalable. Clinically defensible. Without objective vitals, providers are often forced to rely on patient-reported information, which can be inaccurate or incomplete. This is particularly problematic for managing chronic conditions, conducting post-discharge follow-ups, or triaging acute concerns where physiological data is essential for risk stratification.

For rPPG health systems, the implementation is less about deploying new hardware and more about software integration and clinical workflow design. The technology typically resides within the telehealth application, activated by the provider during the visit. The process involves a brief, guided video scan of the patient's face, during which the software analyzes the pixel data to extract the photoplethysmographic signal. The results are then displayed to the provider and can be automatically documented in the electronic health record (EHR), creating a seamless flow of objective data into the patient's chart.

| Feature | In-Person Vitals Collection | Virtual Vitals via rPPG | | :--- | :--- | :--- | | Patient Equipment | Clinical-grade cuffs, oximeters, thermometers | Standard smartphone, tablet, or computer with a camera | | Workflow Location | In-clinic, during the rooming process | Anywhere with a stable internet connection | | Data Capture Method | Manual measurement and entry by clinical staff | Automated analysis of video stream via software | | Clinical Staff Action| Hands-on patient interaction and device operation | Guide patient positioning and initiate scan via software | | Data Availability | Available after measurement and manual documentation | Real-time during the live virtual encounter | | Infrastructure | Physical clinic space and calibrated medical devices | Software integration with existing telehealth platform |

Industry applications for camera-based vitals

The ability to capture vital signs remotely opens up new possibilities for enhancing virtual care programs across various service lines. The use cases extend beyond simple convenience, directly addressing clinical quality, patient safety, and operational efficiency.

### virtual triage and urgent care

In urgent care and triage settings, objective data is critical for rapid assessment and decision-making. A patient's heart rate and respiratory rate can help a nurse or provider determine the severity of an illness, such as a respiratory infection, and decide whether the patient can be safely managed at home or needs to be directed to an emergency department. Integrating rPPG into virtual triage workflows provides a layer of objective data that was previously unavailable, improving the safety and effectiveness of remote assessments.

### chronic condition management

For patients with chronic diseases like hypertension or heart failure, regular monitoring of vital signs is essential. While remote patient monitoring (RPM) programs using connected cuffs and sensors have existed for years, they often suffer from low patient adherence. Camera-based vitals capture offers a lower-friction alternative, allowing providers to gather key data points during scheduled virtual check-ins. This facilitates more consistent monitoring and timely intervention, potentially reducing hospitalizations and improving long-term outcomes.

### post-discharge follow-up

The transition from hospital to home is a vulnerable period for patients. Virtual follow-up visits are an effective way to monitor recovery, but their value is enhanced significantly with the inclusion of vital signs. A post-surgical patient's heart rate, for example, can be an early indicator of complications like infection or dehydration. By capturing this data during a post-discharge televisit, health systems can intervene earlier and prevent readmissions.

Current research and evidence

The clinical and scientific communities are actively engaged in validating the accuracy and utility of rPPG technology. Research from academic institutions and national standards bodies is crucial for building the trust required for enterprise-wide deployment in rPPG health systems.

A foundational body of work in this field comes from researchers like Wim Verkruysse and his colleagues at the University of Washington, whose 2008 paper was among the first to demonstrate the feasibility of extracting a pulse signal from video recordings of the human face. More recently, studies have focused on refining the algorithms to account for variables like skin tone, lighting conditions, and motion.

Researchers at institutions such as the Massachusetts Institute of Technology (MIT), led by W.K. Matusik, have published extensively on computational methods to improve the signal-to-noise ratio in rPPG. Their work, often presented at major computer vision conferences, demonstrates advanced techniques for separating the subtle blood flow signal from environmental noise. Philips Research, with key contributions from scientists like G. de Haan, has also been a major force, publishing numerous papers on the underlying physics and signal processing that make camera-based monitoring possible. A 2020 study published in Nature Communications by a team at UCSF showed high correlation between rPPG-derived measurements and those from conventional devices under controlled conditions.

Furthermore, organizations like the National Institute of Standards and Technology (NIST) are developing standardized testing protocols to evaluate the performance of camera-based vital signs technology, which will be critical for regulatory and clinical acceptance.

The future of televisit vital signs

The trajectory for camera-based vitals points toward deeper integration and expanded capabilities. As the technology matures, it is expected to move beyond the current set of core vital signs. Researchers are actively working on methods to measure blood oxygen saturation (SpO2) and even cuffless blood pressure, which remains the most significant technical challenge.

For health system CIOs, the future involves planning for the data integration and governance of these new streams. The value of rPPG data is maximized when it is seamlessly integrated into the EHR, populating flowsheets and triggering clinical decision support alerts. This requires a robust data architecture and close collaboration between clinical informatics and IT teams. Looking ahead, we can anticipate a future where a virtual visit is not just a conversation but a comprehensive data collection event, enabling a level of remote care that is proactive, precise, and deeply integrated into the fabric of the health system.

Frequently asked questions

• How does rPPG technology integrate with our existing telehealth platform and EHR?

• Most rPPG solutions are designed as software development kits (SDKs) or APIs that can be integrated into a health system's existing virtual care platform. Data flow to the EHR is typically handled via standard protocols like HL7 or FHIR, allowing vital signs to be filed directly into the patient's chart.

• What is the clinical validation process for deploying rPPG in a health system?

• Deployment should be treated like any other clinical technology adoption. It typically involves a pilot phase in a controlled department, where measurements are compared against the health system's own calibrated medical devices. This internal validation builds provider trust and helps refine clinical workflows before an enterprise-wide rollout.

• Is this technology a replacement for traditional remote patient monitoring (RPM) devices?

• Not necessarily. Camera-based vitals are best suited for capturing data during a live, attended virtual visit (an episodic measurement). Traditional RPM is designed for continuous or intermittent unattended monitoring between visits. The two technologies are complementary, serving different clinical needs within a comprehensive virtual care strategy.

As health systems continue to build out their virtual care infrastructure, the integration of objective data streams is the next frontier. The ability to capture clinical-grade vital signs transforms a simple video call into a meaningful clinical encounter, enhancing provider decision-making and patient safety. Circadify is actively working with provider organizations to address this space by embedding vital signs capture into existing telehealth workflows. To learn more about our approach to clinical workflows and health system deployment, explore our solutions for telehealth at circadify.com/solutions/telehealth.