Upping the ante with virtual care

We have been a little late to the party reporting on eHealth NSW and the state's Agency for Clinical Innovation's establishment of a virtual care accelerator to co-ordinate the deluge of new technologies and models of care arising from the coronavirus pandemic, but it appears to be going great guns. eHealth NSW has had a whole host of projects on the go this year, backed up by enormous amounts of cash that other health services can only dream of.

Some of these projects have come to the fore during the pandemic, not the least of which is the roll out of telehealth in the acute care sector. Where telehealth was often previously viewed with suspicion, it is now being embraced, and as eHealth CEO Zoran Bolevich says, it is with gusto.

The first wave of COVID earlier this year spurred eHealth NSW into rolling out some new technologies and infrastructure in a hurry, including a digital triage tool deployed in the state's Cerner electronic medical record. A COVID-19 mobile app was developed in nine days, a state health emergency operations centre was stood up in three days, and COVID-19 dashboards were built for Premier Gladys Berejiklian's office, along with a critical intelligence unit with dashboards for the secretary of the Ministry of Health.

Sydney Local Health District's rpavirtual service has received a lot of attention, but NSW has been putting some serious infrastructure into telehealth for several years and it now seems to be paying off. It has followed Victoria's lead in rolling out a statewide telestroke service, is finalising its statewide virtual care strategy, and even its much-maligned electronic medical record is being harnessed for what it can do.

The Cerner eMR might be proving its worth, as it is being used for quite a few projects including rpavirtual and the child digital health record that NSW Health and Queensland Health are working on. Alcidion's Miya Precision platform is about to go live at rpavirtual's Care Centre to help with the remote monitoring of patients by displaying their status in near real-time alongside other relevant data drawn from the eMR. Looking beyond COVID, you can see the extensive applications that these technologies can bring.

Alcidion's technology is also rolling out in Queensland to help with referral management and specialist wait lists as part of Queensland Health's integrated Referral Management Solution (iRMS) program. Alcidion is a reseller for NextGate's technology, which is also rolling out in Victoria for its unified patient identifier project. Queensland has an ambitious program for reducing waiting lists, again backed up by quite a substantial amount of funding, and this project seems to be ticking along nicely.

Venture capital is also pricking up its ears when it comes to digital health. These sums aren't huge but Coviu announced this week it had raised $6 million towards funding its international growth, and oral health start-up Pearlii has picked up $1.5m to keep feeding its machine learning engine. It will be a very tough gig for both to break out internationally but if there has ever been a time to be in the digital health game, this is it.

That brings us to our poll question for the week:

Will the embrace of virtual care continue beyond the pandemic?

Vote here and feel free to leave your comments below.

Last week we asked: is the announcement of Medtech Global's FHIR API a positive development? Most were positive it was positive: 84 per cent said yes, 16 per cent said no.


0 # Oliver Frank 2020-12-12 08:44
GPs embraced virtual care years ago, but weren't doing much of it because there was no support from Medicare or from other third party funders of care for it. As a result, apart from a few ventures such as OzDocs Online which provided a model of being paid for email consultations, most virtual care that GPs provided was gratis or pro bono.
0 # George Margelis 2020-12-12 09:49
The rapid rise of virtual care after many false starts in the past has been fascinating to watch having been around for many of the spectacular failures of the past. It seems the primary reason is that, unlike in the past, there was a personal driver for the clinicians in avoiding infection versus patient or societal drivers.
The challenge will be if this driver is removed, will they maintain it?
We need to ensure that all parties involved have drivers to adopt and continue its use. This includes the payers who will have to stop and evaluate whether their drivers are being met. We need to prepare for this by developing an evidence base for its value as well.
0 # Oliver Frank 2020-12-12 15:21
Personal protection for GPs might be one driver, but as I said, GPs have been asking in vain for years for Medicare and other third party funders of care to support telehealth. I am a GP in contact with many other GPs through a number of organisations and groups, and it is clear that many or most GPs feel that telehealth has always been a valuable complement to in-person consulting that deserved support.
+1 # George Margelis 2020-12-12 17:10
Oliver, we need to be careful not to confuse our technology-focu sed groups with the rest of the healthcare system, Whilst many would have paid lip service to telehealth, very few of us were actively involved in pushing it forward. Once we became the "at risk" group many more became active. I say this not as a criticism, just a reflection of the past.
My concern is once that driver is gone, we may fall back into complacency. Even more dangerous, if the drivers for other stakeholders, in particular payers, don't deliver they may pull the virtual carpet out from under us.
+1 # Kylie El-Sheikh 2020-12-12 11:09
I don’t think the problem has really been the medical industry, we have been trying to push forward for two decades, it has been the regulatory bodies that have quashed innovation out of fear. Australia has one of the best health care systems in the world, we spend almost 10% of GDP on healthcare, we have been saying for decades we can do it more effectively and cheaply. This seems like the first step towards us catching up with China, India, UAE and every Africa with innovation.

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