Canadian ‘virtual sitter’ technology expands as hospitals look to improve patient safety and ease staffing pressures

Canadian hospitals are increasingly turning to remote patient observation technology as they look for new ways to protect patients at risk of falls and other adverse events while making better use of limited frontline staff.

A Canadian-developed system known as HALO – Human Attended Live Observation – combines bedside audiovisual technology with trained remote safety observers who continuously monitor patients considered at elevated risk.

The technology originated at University Health Network (UHN) in Toronto, where it was developed by clinicians to address the challenge of providing continuous observation for patients who might fall, wander, remove oxygen or other medical equipment, or otherwise require close supervision.

Traditionally, hospitals may assign a staff member to remain at the bedside of one patient requiring constant observation. The approach can provide important protection, but it also ties up healthcare workers who could otherwise be providing direct patient care.

HALO takes a different approach. A portable device equipped with cameras and two-way communication is placed near the patient’s bedside. Trained virtual safety observers monitor patients from a centralized command centre and can communicate directly with a patient if they identify potentially unsafe behaviour.

If further intervention is required, the observer alerts the patient’s care team.

According to HALO, one observer can monitor as many as 12 patients simultaneously. The company says the technology is now deployed at approximately 30 healthcare sites across Canada; more recent industry reporting places its footprint at 34 sites.

The system has grown considerably from its beginnings within UHN.

At UHN, virtual observation has become part of routine patient care across inpatient services. UHN describes the technology as a health human resources tool that can help allocate nursing and other healthcare staff where they are most needed while maintaining continuous observation of eligible patients.

Expansion has also moved well beyond Toronto.

Recent deployments or agreements have included Unity Health Toronto, Waterloo Regional Health Network, Niagara Health, Oak Valley Health, St. Joseph’s Healthcare Hamilton and Georgian Bay General Hospital. Deployments at Sunnybrook Health Sciences Centre and Montreal’s Jewish General Hospital are also planned for late 2026, according to recent reporting.

Newfoundland and Labrador represents one of the technology’s most significant expansions.

NL Health Services first introduced the system in four acute-care hospitals and healthcare centres in 2024. At the time, the health authority said the technology could help care teams identify changes in patients’ conditions and intervene when necessary while making more efficient use of healthcare personnel.

That deployment has since expanded substantially. Recent reporting says HALO now supports 11 hospitals and six long-term-care homes in Newfoundland and Labrador, including rural and remote communities where maintaining one-to-one patient observation can be particularly challenging.

The technology may also offer measurable patient-safety benefits.

Recent Canadian Healthcare Technology reporting says one Western Canadian hospital experienced a 75 per cent reduction in high-risk patient falls during its first year using the system. At UHN, HALO is reported to have reduced the need for one-to-one constant observation by an average of approximately 40 per cent.

Privacy and consent remain important considerations whenever cameras are introduced into patient-care environments.

UHN says the HALO system provides a secure livestream of images and sound rather than recording patients. Patients are informed about the monitoring and can decline the service.

The technology does not eliminate the role of nurses or other frontline caregivers. Instead, remote observers provide another layer of continuous surveillance and alert the clinical team when bedside intervention is required.

For Canadian hospitals facing simultaneous pressures around patient safety, workforce shortages and rising costs, virtual observation represents one example of how technology developed inside the healthcare system is moving from a local innovation to a broader model of care.

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