The effectiveness of Western NSW Local Health District’s (WNSWLHD) vCare Virtual Support model of care as a safety net for patients in rural and remote hospitals is to be evaluated in a new project coordinated by the Digital Health Cooperative Research Centre (DHCRC) along with the University of Sydney’s School of Rural Health and Menzies Centre for Health Policy and Economics.

WNSWLHD introduced the proactive Virtual Support model of care in 2019, an additional function within the existing vCare service. Virtual Support was specifically designed to provide an additional safety net for patients in 35 WNSWLHD rural and remote hospitals where between 2016 – 2019, failure to recognise and timely management of clinical deterioration was deemed to be a contributing factor to several serious incidents. The Virtual Support model of care allows remote clinicians to recognise clinical deterioration and guide management as an extension of rural/remote clinical teams.

Prior to the introduction of the vCare Virtual Support service, rural clinicians solely relied on a one-way self-referral to vCare service to escalate, or refer their patients requiring higher level of care than health resources locally available, which could mean delayed referrals, delayed transfers or missed treatment opportunities to provide the right care at the right time and avoid unnecessary patient harm.

“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,” said Amanda Hunter, General Manager of vCare in WNSWLHD.

WNSWLHD is one of the largest LHD’s in New South Wales. It covers some 250,000km2 and is home to a population of approximately 276,000 people. The virtual service helps to overcome this tyranny of distance by incorporating improved clinical escalation and communication pathways, and advanced remote monitoring utilising alerts and algorithms for clinical decision support by the team of dedicated 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,” Ms Hunter said.

The project seeks to generate new evidence on remote monitoring systems in rural and remote healthcare settings by evaluating the patient, family and carer expectations with virtual care, as well as clinician experiences and the impact on patient outcomes. The project will also evaluate the economic implications of the service including utilisation and sustainability of resources, compared to traditional care.

DHCRC CEO Annette Schmiede said understanding the benefits, and challenges, of the virtual support service had significant repercussions for rural and remote healthcare.

“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,” Ms Schmiede said.

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