Making virtual hospitals the norm

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.

The TempTraq dashboard displays temperature results on nurses’ screens.

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.”

One of RPA’s palliative care patients receives virtual care.

Quality checking supporting technologies

One healthcare model currently being championed by rpavirtual is ‘wellness over illness’ — a paradigm in which the emphasis is placed on prevention, not cure, of acute and chronic health conditions.

“We have launched a new program for vascular lower leg ulcers that have healed,” Shaw said.

“We know from reviewing the data that people who experience these ulcers have a high risk of readmission and, as such, have introduced a maintenance program that prompts them to wear and change compression stockings, follow up with their GP and their specialist.”

rpavirtual has an approved vendor shortlist which helps them procure technologies used to deliver programs like this — an approach Dr Allen said is critical.

“The market is awash with wellness tech and it is vital that both clinicians and patients can identify a quality product that has a solid evidence base behind it,” she said.

“Take healthcare apps. Just a quick search on Google Play will tell you there are tens of thousands of them available online — but many have never been properly tested, meaning patients nor clinicians have any idea which ones are clinically efficacious,” she said.

“If we want to make virtual care more mainstream then we need a better system, whereby apps are ‘quality kite-marked’ by an independent assessor and can be prescribed to patients reliably.”

Better funding models

Comprehensive funding models will be another key driver for scaling virtual care — ensuring, like rpavirtual, it is consistently hospital-grade.

“During COVID we saw a rapid shift to virtual consultations or diagnostic services. At the same time, we saw an increased focus on prevention and early intervention, reinvigorating conversations about outcome-based care models,” Dr Allen said.

“We now need to focus on developing virtual treatment options that have the same quality standards and reimbursement arrangements in place as hospital-based care.

“If we could work out a way to drive both of these models — outcome-based care using virtual delivery — that would be the best path forward.”

A magic pill?

While virtual hospitals may be winning popularity nationwide, with clinics like rpavirtual blazing the trail, their wider-spread rollout should be done with careful consideration, Dr Allen concluded.

“As rpavirtual has demonstrated, there are many factors that will influence quality of care and patient communication in a virtual-care setting. It’s important we tailor these clinics — and procure their supporting technologies — very thoughtfully,” she concluded.

Main image caption: An RPA Virtual Care Centre Nurse working in a Care Pod.