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Digital & Innovation

Embedding virtual in regional care: Case evaluation in NSW

Health Industry Hub | June 13, 2024 |

Digital & Innovation: Provision of critical care in rural areas is challenging due to geographic distance, smaller facilities, generalist skill mix and population characteristics. The effectiveness and sustainability of the Western NSW Local Health District’s (WNSWLHD) vCare Virtual Support model as a safety net for patients in rural and remote hospitals is set to be evaluated in a new project.

This initiative, coordinated by the Digital Health Cooperative Research Centre (DHCRC), University of Sydney’s School of Rural Health and the Menzies Centre for Health Policy and Economics, was introduced in 2019 with the Virtual Support model designed to enhance patient safety in 35 WNSWLHD rural and remote hospitals.

Between 2016 and 2019, several serious incidents were linked to the failure to recognise and manage clinical deterioration in a timely manner. The Virtual Support model aims to address these issues by allowing remote clinicians to identify and manage clinical deterioration, effectively extending the capacity of rural and remote clinical teams.

Before the implementation of vCare Virtual Support, rural clinicians had to rely on a one-way self-referral system to escalate patient care needs, often leading to delayed referrals, transfers, and missed treatment opportunities.

Amanda Hunter, General Manager of vCare in WNSWLHD, highlighted the importance of this service.

“Delayed or failure to recognise and timely response to clinical deterioration as per the ‘Between the Flags’ system and delayed referrals to vCare for transfer to a higher level of care of critically ill patients were key reasons for introducing vCare Virtual Support service,” she stated.

WNSWLHD, covering 250,000km² and serving approximately 276,000 people, uses the virtual service to overcome geographic challenges. The service improves clinical escalation, communication pathways, and remote monitoring through alerts and algorithms, supported by a dedicated team of virtual care clinicians.

“With a 24/7 dedicated team, the virtual care model allows us to have an additional set of eyes and ears supporting patients with advanced virtual care and remote monitoring technology across rural and remote facilities,” Hunter added.

Following an initial evaluation, this new project aims to generate new evidence on remote monitoring systems in rural and remote healthcare settings. It will assess patient, family, and carer expectations of virtual care, as well as clinician experiences and impacts on patient outcomes. Additionally, the project will evaluate the economic implications of the service, including resource utilisation and sustainability compared to traditional care.

DHCRC CEO Annette Schmiede emphasised the broader significance of the research.

“This research will help us to understand both patient and clinician experiences of this new model of care and how virtual care programs, such as this one, can contribute to a more equitable and sustainable healthcare system, potentially enhancing statewide rapid response systems, and ultimately advancing the quality of care delivered in rural and remote settings,” Schmiede commented.

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