A mixed-methods implementation evaluation reported that virtual family-centered rounds in the NICU improved participation and communication, particularly for families facing structural barriers. However, the study also found provider-dependent adoption issues and digital barriers that could undermine equitable, sustained rollout. The analysis points to operational constraints as the main risk for scaling “virtual bedside” interventions: uptake depends on workflows, staff engagement, and family access to technology. Even where virtual rounds increase reach, inconsistent implementation may dilute impact. For hospital and health-technology developers, the study underscores that benefits are not purely technical—real-world effectiveness hinges on implementation design and accessibility planning.