Residential Aged Care
Virtual Care Project

As part of the Australian Government’s response to the Royal Commission into Aged Care Quality and Safety, Healthy North Coast is piloting a digital health project designed to improve primary care access in residential aged care homes (RACHs) through increased use of telehealth.

Supporting access to primary care clinicians and specialist services in aged care homes through telehealth will improve health outcomes for residents, avoiding unnecessary Emergency Department presentations and hospital transfers.

Fifty participating local RACHs have received iPads, laptops or the remote diagnostic system, Visionflex Telehealth cart. Early feedback from pilot participants has shown a promising number of GPs and specialist services embracing the equipment.

We have also invested in a self-paced education program of short, ‘micro-learning’ modules, to increase awareness of the fundamentals of setting up, conducting or participating in a video-telehealth consultation. This will be available to RACH staff, GPs, allied health and specialist services from early 2024.

This is supported with capacity-building activities and guidance on enablers such as My Health Record.

Case study 1

An 89-year-old female resident experienced a fall at their RACH, resulting in a fractured neck of femur. Following her treatment, her follow-up appointments were conducted via telehealth with the Local Health District (LHD) fracture clinic.

This innovative approach has yielded significant benefits:

  • Enhanced Comfort and Convenience: By leveraging telehealth services, the resident avoided the need for a strenuous trip in an ambulance and the discomfort associated with a day-long visit to the clinic.
  • Cost Savings: Utilising telehealth eliminated the expenses associated with ambulance transportation and the need for a staff member to accompany the resident to the clinic, thereby reducing overall healthcare costs.

This case exemplifies how telehealth not only improves patient experience and convenience but also offers cost-effective solutions while ensuring continuity of care.

Case study 2

The Royal Freemasons Benevolent Foundation (RFBI) embraces telehealth as a means to offer equitable and accessible healthcare to its residents. By leveraging this technology, RFBI not only reduces wait times and hospital visits but also facilitates early intervention and ensures a seamless continuum of care.

According to Nurse Practitioner Amanda Woodlands, the Visionflex cart is more than just a telehealth tool;

“It is not just a telehealth cart that is able to perform visual and audio consultations. It has improved diagnostic tools that take the consultation to that next level.“

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Click here to learn more about the Healthy Ageing Strategy and related activities

Project details

To ensure that we are meeting the unique needs of local RACHs, we conducted a comprehensive survey in 2022 to assess digital capabilities and attitudes towards technology.

Through this survey, as well as additional consultations with RACH managers, residents, local health district partners, and ageing workshops, we were able to gain valuable insights that informed the development of a multi-tiered project model designed to meet the different digital journey stages of RACHs.

Some of the key findings from our survey include:

  • Internet coverage varies significantly across all RACHs, indicating that there is no one-size-fits-all model. 
  • Only half of the RACHs indicated that they have sufficient video consultation equipment.
  • RACHs were highly supportive of virtual care models, with over 80% indicating that they are very or quite confident in using technology.

Throughout the consultation process, RACH managers showed strong support for a proposed 3-option offering, with anecdotal feedback indicating that many are interested in the advanced remote diagnostic option. 

This virtual care project is part of an integrated model of support for RACHs, inclusive of after-hours, palliative care initiatives and access to other specialist services. This will provide ongoing assistance to create culture change, engage with other health practitioners, and collaboratively improve health outcomes. 

Healthy North Coast’s RACH Virtual Care project offers three different telehealth options, enabling RACHs to choose the most suited option to their technology journey.

This option will provide the RACH with digital equipment to undertake videoconferencing with clinicians or other services required by the residents.

RACH responsibilities:

  • Have a designated clinic consult room – site will need to provide internet connection
  • We promote appointing a telehealth champion, to support other staff
  • Engage internal or regular IT teams (where possible) to support the setup and installation of the equipment

Healthy North Coast responsibilities:

  • Provide support to internal IT teams regarding the installation of the equipment
  • Provide a digital consultant to support installation for RACHs that do not have an internal or regular IT team to assist
  • Purchase and dispatch equipment to RACHs with relevant purchase and warranty documentation
  • Coordinate initial and ongoing telehealth training
  • Provide the RACH integrated model of support

Equipment

  • Dell 27” Full HD Monitor
  • Portable camera + speaker +microphone —Logitech Connect
  • Wireless keyboard and mouse, spill-resistant design — Logitech MK235

Optional add-ons – choose one or both

  • Noise-cancelling wireless headphones – Dell Pro WL5022
  • Laptop – Dell Inspiron 3511 15.6” FHD laptop, 1 HDMI, 3 USB-A, Windows 11, i5, 512G storage, 8MB memory

This option will provide the RACH with digital equipment to undertake mobile videoconferencing. RACHs with existing mobile solutions may select this package to increase their fleet of mobile equipment.

RACH responsibilities:

  • Have Wi-Fi coverage for areas where mobile solution will be used
  • We promote appointing a telehealth champion, to support other staff
  • Engage internal or regular IT teams (where possible) to support the setup of the equipment

Healthy North Coast responsibilities:

  • Provide support to internal IT teams regarding the installation of the equipment
  • Provide a digital consultant to support installation for RACHs that do not have an internal or regular IT team to assist
  • Purchase and dispatch equipment to RACHs with relevant purchase and warranty documentation
  • Coordinate initial and ongoing telehealth training
  • Provide the RACH integrated model of support

Equipment:

  • iPad Pro 12.9” 512GB (6th Gen)
  • Noise-cancelling wireless headphones – Dell Pro WL5022

Optional add-ons – choose any

  • Apple magic keyboard
  • Apple pencil
  • Case/stand – Cygnett TekView Shell for iPad Pro 12.9”

This option will provide the RACH with remote diagnosis equipment to undertake clinical examination of residents, inclusive of heart and pulmonary sounds, ear, eye, skin and oral camera examination, and monitoring of vital signs. Subject to pending evaluation, this would be via the Visionflex Telehealth cart solution, inclusive of hardware, peripherals and software. 

RACH responsibilities:

  • Have good Wi-Fi coverage across the RACH, with minimum internet upload speed of 1 Mb/second
  • Appoint a change champion to coordinate adoption of this technology and support staff as they adjust to a new way of working
  • Participation in ongoing community of practice during pilot
  • Recruit one or all of the general practice team to participate in pilot i.e. prepared to undertake training, work remotely with telehealth diagnostics ECG, stethoscope, camera; wounds, oral and ear
  • Engage internal or regular IT teams (where possible) to support the setup of the equipment

Healthy North Coast responsibilities:

  • Supply equipment and 1-year software subscription*
  • Coordinate initial and ongoing training on use of system and equipment to change champions
  • Facilitation of community of practice to set up clinical systems and ongoing meetings to support pilot
  • Support general practices participating in the pilot
  • Provide the RACH integrated model of support

*RACHs will need to review their ability to take on ongoing investment post 12 month pilot. $820.00 yearly software fee (max 500mins/month) + Platinum support for telehealth cart including accessories, calculated at 15% per year ~$2,200.00 yearly. Total ~$3k per year.

Equipment

  • Visionflex equipment:
    • Ergotron cart with Intel i5 512GB 16GB RAM PC with Windows 10-Pro, 24” patient-facing monitor on swing arm, patient-facing camera on telescopic pole, wireless keyboard and mouse. Camera suited to eye, skin, ear, etc examination)
    • Accessories – HD examination camera suited to oral, skin, eye, ear; blood pressure cuff with integrated pump and Bluetooth, pulse oximeter Bluetooth; ECG single wire and three wire Bluetooth; digital stethoscope
    • Visionflex subscription
    • Visionflex support, implementation, training

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