How the East Metropolitan Health Service is leading the way with virtual health
Australia’s push towards virtual health is gaining pace, with more than 18 million patients accessing their medical appointments virtually last year, through telehealth. For many healthcare providers, however, a fully-fledged virtual service is a far-off dream.
Technology is yet to cater for all aspects of healthcare delivery, with a wide range of services still requiring in-person assessment. Only 95,000 of Australia’s 642,000 health practitioners delivered a telehealth appointment last year — a large portion of those held back by a lack of virtual aids in their field.
For services that do lend themselves to existing technologies, challenges around data and integration are stunting progress. Not all health systems can talk to each other and electronic records don’t always capture information from every episode of a patient’s care, resulting in a fragmented data ecosystem. This limits the efficacy of technology-based assessments — a vital component of virtual health.
Despite these challenges, the East Metropolitan Health Service (EMHS) in Western Australia is making headway with its virtual offering, known as ‘HIVE’ (health in a virtual environment), which it now uses to monitor 50 inpatient beds across two of its hospital sites — Royal Perth and Armadale — more than 30 kilometres apart.
Its award-winning computer platform digests huge amounts of data from bedside monitors, admission forms, onsite pathologists and a range of other sources, to give a complete picture of the patient’s condition. It alerts staff to signs of clinical deterioration, allowing them to make rapid-fire decisions about who to treat, when and how. Given the breadth of its data repository, there is little room for clinical oversight.
Project Manager Eliza Becker said the technology has helped reduce the length of hospital stays for HIVE patients by an average of 2500 bed days per year. This translates to a reduced risk of hospital-acquired infections, muscle wastage and other undesirable side-effects of extended bedrest.
“HIVE has a dedicated virtual workforce that continuously monitors the technology and contacts bedside teams when an alert is provided. It helps focus their attention on those who are most critically unwell and eliminates some of that noise that comes from a busy hospital environment. This helps the patient to get optimal treatment and, ultimately, get better quicker than before HIVE existed,” Becker told Hospital + Healthcare.
As well as offering real-time insights to clinicians, the data repository is helping the hospital identify retrospective trends and make longer-term decisions. When pulled together, information such as length of stay, vital statistics and key diagnoses are useful tools for developing healthcare initiatives.
“This is a peripheral benefit of HIVE and certainly not part of core business. But, by virtue of the fact we are analysing data for clinical impact, we also have more data to aid research. This helps us see if there are any common themes on which to base new developments; and to care for patients more broadly — not just in the moment,” Becker said.
Meanwhile, HIVE’s advanced audio-visual (AV) system and high-tech camera have been helping to train EMHS staff.
“It’s been a great support tool. Junior doctors and nurses have the option to use the AV to access 24/7 supervision from senior colleagues, who may be elsewhere in the hospital, or off-site. Doctors can just login and talk the juniors through things whenever they need help.”
Solving the integration challenge
Its ability to make sense of data from dozens of different sources has been key to the technology’s success — a feat only made possible with cross-functional teams, Becker said.
“I sit next to an engineer, a mathematician and a data scientist, each of whom are employed permanently by the hospital. We have also had a lot of discussions with people around the bedside and those who deliver care. Doctors and nurses have helped decide how our system looks and have worked directly with technical staff to build a system that’s fit for purpose. It’s the product of months of talking and consultation.”
The blending of technical and clinical teams has also helped the hospital navigate challenges around workflow integration.
“As well as data, there can be difficulties with integrating new ways of working. Having clinicians involved at every step has made this a smoother process. From their perspective, it’s much better to use something they helped design than to get handed a new tool and ordered to change the way they work without consultation. Besides, having clinical ‘allies’ is much more insightful than a project resource ever could be,” Becker said.
Going forward, Becker said the hospital plans to develop its in-house technical skills further.
“Virtual health is only going to get more prevalent, so it makes sense to build this capacity within our organisation and set ourselves up for the future. I would encourage other hospitals to do the same,” she concluded.
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