First virtual ward for cardiac and haematology patients, but jury still out on patient safety

MedTech & Diagnostics News: In an effort to reduce hospital and patient costs while addressing workforce shortages, healthcare services are increasingly adopting out-of-hospital care models, despite mixed results. Austin Health’s Virtual Ward is the first in Victoria to provide at-home care for leukaemia patients and those recovering from cardiac surgery through the use of wearable devices.

Initially piloted during the pandemic in 2021 with funding from the Department of Health, the Hospital in the Home & Virtual Care (HITH-VC) Virtual Ward services have now become a standard practice at Austin Health.

Currently, up to 10 patients can be monitored in the Virtual Ward at any given time. The service supports early discharge after cardiac surgery and manages patients with acute leukaemia, heart failure, and cardiac rhythm disturbances. These patients require close monitoring due to their high clinical acuity, necessitating prompt escalation of care if their condition deteriorates.

A significant challenge for virtual care patients is the need for rapid hospital access in case of an emergency. With current emergency department (ED) congestion and ambulance ramping, this poses a risk for patients who may need to return to the hospital quickly.

“Patient safety is always our first priority,” said Dr Mark Horrigan, Medical Director of HITH-VC. “We look for patients with a realistic expectation of steady recovery who will thrive at home, and who have supportive relatives to participate in their care.”

Hospital-in-the-home care has seen mixed views from stakeholders. An Australian systematic review and meta-analysis of short-stay programs for total hip and knee replacement concluded, “there is insufficient high-quality trial evidence to support the 90-day safety profile of short-stay joint replacement programs compared to usual care.”

Additionally, a nationwide study indicated that while health professionals and hospital administrators find short-stay programs moderately feasible, they are of little appeal to carers responsible for managing patients’ daily activities.

Angela Sullivan, Nurse Unit Manager of Austin HITH-VC, explained that patients have regular teleconference calls with a multidisciplinary team. Data from the BioBeat wearable devices is integrated into the electronic medical record, accessible by hospital ED or inpatient ward staff.

This care model may be particularly beneficial for patients in rural and remote areas, allowing them to return home sooner while still receiving some level of clinical oversight.

“It’s replicating what happens in a hospital ward: nurses check vital signs three times a day and patients call us if they feel unwell,” said Sullivan.

Desi Iliopoulos, a leukaemia patient, received her care from home with virtual care.

“It’s been a game changer for me. It changed my whole psychology. I can get through this and not have to spend so much time in hospital,” she said.

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