This appeared last week:
Making virtual hospitals the norm
By Amy
Sarcevic
Tuesday, 27 July, 2021
When Sydney’s RPA Virtual Hospital (rpavirtual) first opened its doors in February last year, few could imagine the success story that would unfold.
Treating upwards of 13,000 patients to date, the country’s first metropolitan virtual hospital has won a Premier’s Award for Excellence in Digital Innovation, proven pivotal in the state’s COVID-19 response and has ambitious growth plans in the year ahead.
“When we were first planning the model, there was some cynicism about what virtual care could offer — but that was pre-pandemic,” said General Manager Miranda Shaw.
“Since then, confidence among medical specialists has grown enormously — and we now have them approaching us about opportunities to extend the model further. In fact, we’re about to launch a clinical trial in collaboration with surgical services, to assess how we can virtually manage patients with acute diverticulitis in the community,” she added.
Patients, too, are happy with the model, in which treatment is delivered at home, with vital signs monitored in real time by ICU-grade devices.
rpavirtual’s survey of more than 800 patients revealed that 88% felt their healthcare needs were met when tended to virtually; 85% rated their care as ‘very good’ or ‘good’; and 98% would use virtual services again if given the choice.
Extending the model
With these benefits now widely documented, virtual hospitals are expected to grow in popularity in years to come. But despite rpavirtual’s high-profile success story, there may be a way to go before the virtual model becomes mainstream.
Dr Stephanie Allen, Head of Healthcare at Deloitte, said that whilst there are examples of best practice, like rpa, for virtual care to take off on a broader scale, various factors must be considered. The first step, she said, is to create an end-to-end vision of the virtual patient journey, using technologies as an enabling platform to bring that vision to life.
“It is tempting to let new innovations drive conversations around virtual health care. But really the conversation should start with the healthcare vision we are trying to achieve and then finding the tech to support it,” Dr Allen said.
“I have seen many organisations buy new technologies and try and stitch them together, creating a Frankenstein-like experience for clinicians and patients that often doesn’t make sense.
“rpavirtual, however, has gotten its approach right. Starting with the healthcare model it wants to achieve, and finishing with its technology shopping list.”
More info and pictures here:
There is closely related information here:
Telstra Health tapped for virtual health monitoring of international travellers in Tasmania
Adam Ang | 30 Jul 2021
Telstra Health's virtual health solutions have been deployed in hotel quarantine sites in Tasmania to remotely monitor the conditions of international travellers under mandatory quarantine.
During their 14-day stay, guests are asked to conduct daily checks of their temperature, pulse and oxygen saturation, as well as blood pressure, weight, and glucose levels if required.
Their data are then uploaded via Bluetooth to the Telstra Health MyCareManager application which stores them in a hosted monitoring platform. To avoid complications with technical support requirements, the Tasmanian government hands out pre-paired mobile devices to the quarantined travellers.
Through the MyCareManager dashboards, clinicians are able to review observation trends, variations, alerts and guests' overall usage of the digital health devices. A care team is immediately prompted if an individual shows signs of needing immediate medical attention.
Additionally, guests who require more care can seek follow-ups and mental health support through videoconferencing.
WHY IT MATTERS
In a statement, Telstra Health said it quickly deployed its digital health solutions following a request from the Australian federal government to support returning travellers, including seasonal workers. The suite of health solutions is capable of supporting up to 350 concurrent guests, according to Diane Campbell, business development manager of Telstra Health's Hospitals Division.
Enabling travellers to monitor and submit their own health data eases the burden of health teams who are working in "such difficult and high-risk environments", said Dr Stephen Ayre, executive director for Medical Services at Royal Hobart Hospital Tasmania, the state's largest hospital. They are hitting a daily health check compliance rate past 90% from about 150 guests, noted Kim Ford of Telehealth Tasmania and the Australian Telehealth Society.
Moreover, Telstra Health emphasised that remotely monitoring their conditions via digital devices helps minimise COVID-19 transmission among clinical staff, hotel employees and other quarantined quests.
THE LARGER TREND
Telehealth is among the digital health services that the Tasmanian government hopes to implement in the future. It recently engaged professional services firm KPMG Australia to help in developing its digital health strategy.
In March, the Tasmanian health department partnered with another digital health firm Cardihab to roll out the latter's health app across public hospitals in the state. The app was said to have enabled patients with heart disease to undergo rehabilitation programmes and receive medical advice weekly via phone calls and video consultations.
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It seems to me that this is an application or a range of proven clinical technologies that if provided with good clinical supervision has a long way to go.
In the US we have already seen very positive clinical results. Here is an example:
Remote Patient Monitoring Program Shines in Treating COVID-19
Using remote patient monitoring to treat COVID-19 can help patients avoid hospitalization and recover quickly, according to Kaiser Permanente Southern California researchers.
July 30, 2021 - Remote patient monitoring for patients with COVID-19 proved to be effective in preventing hospital admissions and improving recovery from the virus, according to a Kaiser Permanente study.
The California-based health system launched an RPM platform to treat infected patients at home, rather than in over-stressed hospitals and clinics, during the height of the pandemic. To evaluate its effectiveness, researchers at Southern California Permanente Medical Group studied 13,055 patients who were diagnosed with COVID-19 and participated in the program between April 13, 2020 and February 12, 2021.
Patients who tested positive for COVID-19 and had moderate risk were eligible to enroll in the program, which monitored them at home. Like many remote patient monitoring systems, the program required patients to enter daily symptoms through an mHealth app, which care providers could monitor at the hospital.
Prior to participation, patients and caregivers received instructions via handouts and videos to ensure they understood how to use the technology. Kaiser Permanente provided some assistance to those who needed help understanding or accessing the technology.
The home monitoring kit included a pulse oximeter and thermometer and access to the app, which also supported video visits. With these resources, patients monitored key vital signs and symptoms that could identify the improvement or deterioration of their health and could connect with care providers when needed.
Providers, meanwhile, could monitor daily oxygen levels and temperature, as well as symptoms such as a cough or shortness of breath, to determine whether home-based care was working or if the patient should visit a hospital.
Depending on the severity of their symptoms, patients could receive additional diagnostic testing, oxygen, or treatments like remdesivir, all from home.
According to the study, only about 10 percent of the 13,055 patients, (1387 patients) were admitted to the hospital based on their reported symptoms. A very small percentage (0.2 percent) of patients died while participating in the remote monitoring program; these patients were usually 60 or older and more likely to have had existing comorbidities, such as obesity or hypertension.
Meanwhile, 95.5 percent of the patients recovered from COVID-19, completing the RPM program in an average of 9.2 days.
More here:
https://mhealthintelligence.com/news/remote-patient-monitoring-program-shines-in-treating-covid-19
Done right this looks to be reasonably technically straightforward, useful, safe, clinically effective, acceptable to patients and even cost-effective.
I would there was much more in the Digital Health space that could make similar claims!
David.
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