Virtual emergency departments to nursing homes

A virtual Emergency Department program is being developed to specifically allow patients in residential aged care facilities (RACFs) to be diagnosed, treated and monitored in situ without the cost and distress of having to be transported to hospital.

The model, which is an extension of the Virtual Emergency Department that was started during COVID, is expected to reduce transfers from RACGs to hospital by 50% taking the pressure off EDs and ambulance services.

La Trobe University has collaborated with the Northern Health Virtual Emergency Department and Cisco to study how Augmented Reality (AR) can modernise emergency care models and reduce pressure on Emergency Departments. Our prototype system harnesses Augmented Reality (AR) to connect patients and medical professionals remotely.

The technology allows a nurse or paramedic to perform hands-free head-to-toe examinations. The person using the AR device can discuss the patient’s condition with multiple doctors who can see the patient, observe their vital signs in real time and maintain a collaborative 5G connection from any location, at any time.

Northern Health’s Virtual Emergency Department (Virtual ED) was designed during COVID-19 to reduce the burden on the state’s EDs – by providing real-time, online video consultations to patients.

On a survey of 2500 patients – with criteria such as the Virtual ED being acceptable to patients, being a positive experience and no burden compared to in person consults – the Virtual ED was seen as a positive experience.

According to Dr Loren Sher, director of the Pediatric Emergency Department with Northern Health and the Director of the new Victorian Virtual ED, the Virtual ED has been an enormous success.

“In many instances, we are able manage a patient’s condition at home. And for patients that need to attend the ED are advised when its best to attend for their condition and will be given advice on how to manage their condition at home until they are seen in ED. This way, patients will spend least amount of time in the waiting room and the Emergency Department,” Dr Sher said.

Dr Jeff Jones, Manager of La Trobe University’s Digital Innovation Hub and Director, Cisco Innovation Central Melbourne, is developing a pilot study of the AI-driven Virtual ED program in a number of Residential Aged Care Facilities (RACFs) starting this year, once funding for the pilot study has been found.

“Because RACFs are variable in terms of their medical and nursing support, compared to EDs, the Virtual ED model needs to be adapted for this sector,” Dr Jones said.

“Importantly staff and patients in RACFs would prefer to offer treatment, and be treated, in situ rather than be moved to an ED, so this is a sector that can really benefit from this program.”

During the COVID lockdowns in Melbourne, Northern Health saw a 39% drop in monthly transfers from RACFs to EDs – despite the large number of COVID outbreaks in RACFs.

“Once we have tailor the model for RACFs we can expect this reduction in transfers to reach 50%,” Dr Jones said.

Professor James Boyd, Chair of La Trobe University’s Department of Digital Health, said that the success of the Virtual ED during COVID will transfer over to the aged care sector.

“The program also leverages the in-built knowledge of the older person’s comorbidities and polypharmacy by their carers and nurses, which can be immediately discussed with the clinicians in the Virtual ED,” Professor Boyd said.

The initial development and testing of the digital infrastructure for the model, called SERVE, will take place at the La Trobe University Digital Innovation Hub.

The technology will then be installed alongside RACFs in Victoria. It will incorporate a hands-free head-mounted device which will allow the carer/nurse to communicate with the Virtual ED consultant remotely. It also allows the transmission of live, high-quality video and audio with sensors to capture a full set of medical information.

The University is in discussions with industry and philanthropy groups to source funding for the pilot study to start this year.

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Media: Courtney Carthy – +61 487 448 734