Alfred Health is furthering its commitment to impact evaluation, collaborating with the Digital Health Collaborative Research Centre (DHCRC) and Monash University to review the impact and effectiveness of two innovative digital health initiatives implemented across its network of three hospitals in Victoria.

Alfred Health’s COVID Community Pathway initiative was set up rapidly in 2020 to help regulate the workload of the emergency department and improve the management of patients within their own homes, while enabling supported, rapid escalation of care with early signs of deterioration. The approach featured a custom-built platform called “COVID Monitor” to track and triage patient symptoms remotely.

This was part of a state-wide initiative and involved local partners Connect Health, Star Health, South Eastern Melbourne Primary Health Network and, in the later stages, the South Eastern Public Health Unit.

In collaboration with DHCRC and Monash University, Alfred Health will now evaluate the effectiveness of this pioneering COVID Community Pathway model of care to identify how it can apply learnings to support the care of patients with other conditions.

Alfred Health Chief Digital Health Officer Amy McKimm said the project will help Alfred Health understand how home monitoring, web-based platforms and telephone web-based surveys can be used to monitor patients at home effectively and safely in a post pandemic environment, at scale.

“As Australia’s population ages, and the rate of chronic disease increases, the acute hospital model is not appropriate for many patients,” Ms McKimm said.

“Many patients who are currently admitted for exacerbations of chronic disease could be effectively cared for at home rather than in hospital. We were able to do this with COVID patients during the pandemic though our COVID Community Pathway approach. Formally assessing the lessons from this initiative will help us identify best practice and identify a methodology to allow us to monitor patients at home into the future.”

Monash University, with a team led by Professor Helen Skouteris, Dr Tess Tsindos and Associate Professor Ingrid Hopper, will look to document the model of care, the patient and clinician experience and the evolution of the initiative during the COVID pandemic.

“This project will look back on the COVID community pathway, a program novel in its sheer scale and simplicity of its design and look to improve the delivery of care for chronic disease patients in the future,” Associate Professor Hopper said.

Evaluating the positive impact of electronic patient journey boards

A second evaluation project between the partners is being considered to assess the impact and effectiveness of the Alcidion Miya Flow electronic patient journey board.

Patient journey boards are a visual management tool used to provide access to critical information about each patient’s current progress. They display a combination of integrated and directly updated data, replacing physical whiteboards, to enable health service staff to view and make decisions based on available information across the entire patient journey in real-time. They are especially helpful in managing timely discharge which is critical for both optimising hospital bed capacity and improving patient satisfaction.

Alcidion CEO Kate Quirke said the Miya Flow electronic patient journey boards look to directly solve these pain-points by providing greater visibility for clinicians and a more integrated workflow and seamless view of bed capacity and bolttlenecks within and across hospitals.

“We see clear anecdotal evidence that the implementation of the electronic patient journey board into Alfred Health’s three hospital sites will result in access to more accurate and timely information and result in less delays for patients,” Ms Quirke said.

“It will be fascinating to take a deeper dive into the patient and clinician experience and quantify the benefits of this innovation on such a scale,” Ms Quirke said.

“No assessment of the effectiveness of an electronic journey patient board at a large metro health service in Victoria exists so a project like this project would no doubt deliver some strong insights and learnings to inform the continued rollout across more hospitals throughout Australia.”

Evaluating impact critical in digital health

These two impact research initiatives build on an earlier collaborative review of Alfred Health’s home monitoring program for a smaller group of patients with heart failure. This reinforced the benefits that remote patient monitoring programs can offer to patients and clinicians, as well as some of the challenges in implementation.

“The earlier remote monitoring evaluation project demonstrated the key role that these programs can play in health services, and also highlighted the need for ongoing evaluation and improvement so that health services can deliver these services more effectively and efficiently in the future. We have the opportunity to look at this on a larger scale and to support different patient groups,” Ms McKimm said

DHCRC CEO Annette Schmiede said evaluating effectiveness of novel digital health initiatives is critical given the rapid pace of change and innovation the sector has experienced over the past two years.

“The global pandemic transformed the delivery of healthcare with innovation in digital health advancing more in the past two years than over the past decade,” Ms Schmiede said.

“What we need to do now is to ensure that we both continue to innovate and also look back to assess the learnings, understand the effectiveness, and continue to improve and embed digital health models of care in the clinician and patient experience.”

“A core purpose of the DHCRC is to build both capacity and capability of the healthcare sector and evaluating the effectiveness of digital health innovations is critical to this mission. Alfred Health has shown a commitment to evaluating impact and we look forward to understanding the learnings from our approach to COVID care and how it could apply to improve patient care in the future.”

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