Virtual clinics provide high-definition masterclass in medicine

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The University of Wollongong’s Graduate School of Medicine has conducted two high definition “virtual clinics” across three campuses up to 1500km apart as part of a project to assist in the training of students in rural and remote locations.

Part of a wider project that will also involve training students in how to conduct telehealth conferences, the virtual clinic project involved staging a consultation between a psychiatrist, a GP and an actor playing the role of a patient.

UoW senior lecturer in educational development, Michelle Moscova, said the virtual clinic was essentially a “masterclass in medicine”. It can be delivered to students thousands of kilometres away – in this case to campuses in Armidale and Shoalhaven – through relatively inexpensive equipment.

“We have a GP who hosts the clinic and on the same set we have a specialist,” Dr Moscova said. “In the clinics done so far, the specialist is a psychiatrist, and in this case we used a patient actor for privacy reasons. Future clinics will consider using real patients where appropriate.”

The school is broadcasting the virtual clinic using production software called Wirecast, which is streamed onto the Ustream commercial streaming platform.

“From the user end, it's like using a YouTube channel for medical practice,” Dr Moscova said. “The user end is really simple because you don't need to download anything – you just go to a weblink and log in. For some of the consultations where they are sensitive, you may have to enter a password that we will provide, but once you are there you just watch.”

The University of Wollongong team was able to broadcast in high definition and the quality was good enough that it will be appropriate for diagnostic procedures and surgical images, she said. “We are going to trial transmitting ultrasound in one of the virtual clinics next year.”

The project is supported by a number of universities including Wollongong, New England, Newcastle, Deakin and Notre Dame Australia, along with training providers GPSynergy and CoastCityCountry General Practice Training.

Funded through the NBN-Enabled Education and Skills Services Program, the project required participants on the broadcasting end to be hooked up to the NBN. However, this recently changed under the new government, which has now broadened the focus of the program to include participants on any broadband network that is fit for purpose. To date, the lowest speed tested for viewer connections was 40Mbps.

“While the technology may be able to run on ADSL2, the question is whether the viewer will still be able to get high quality video and the same seamless continuity of transmission without buffering or drop-outs,” Dr Moscova said. “Image and sound quality on this type of virtual clinic is a priority.”

The project has two components, the first of which is virtual clinics, with eight more planned for next year. The second component is to provide training to students about using telehealth.

“We want to provide training for our own students who we aim to train as rural and regional practitioners, so the aim is to get them experienced in how to conduct telehealth,” she said. “We are recruiting practices where our students would be able to work with GPs and conduct those consultations with real patients.”

The team is investigating the use of ConsultDirect, which runs a secure, proprietary platform for telehealth provision.

Project leader Andrew Bonney holds a chair in general practice at the Graduate School of Medicine and is a rural GP. He said the trial was part of a larger project that aims to give medical students and junior doctors virtual access to specialist teaching using existing infrastructure.

“By giving rural and remote practitioners access to this technology and the new level of expertise and additional support it brings, we can help retain doctors in rural Australia,” Professor Bonney said.

“Normally this kind of interactive session requires expensive dedicated proprietary technology at both ends costing tens of thousands of dollars, high definition cameras, a full studio set-up and enormously expensive equipment for transmission.”

“We were able to deliver a high definition interactive virtual teaching clinic to campuses in Wollongong, Armidale and Shoalhaven in a session taught by a practising psychiatrist, a general practitioner and a patient at a very low cost.

“Through this technology there is the potential to create a community of remote doctors and specialists who will work together and support each other with a full understanding of the issues that rural GPs face.”

The university understands this is the first time in Australia students from the three rural campuses were able to connect online to participate in a clinic of this kind.

Posted in Australian eHealth

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