The COVID-19 pandemic has shifted perceptions of the health system. With virtual healthcare, some acute conditions can be treated at home.
This article by Martin Bowles, former Northern Rivers Area Health Service CEO and former Secretary of the Commonwealth Department of Health first appeared in John Menadue’s Pearls and Irritations in September 2021.
I have long believed we need to see a shift from our fixation on beds in hospitals. We have seen successive governments focus on beds as a proxy for the healthcare system.
We have also had a very structured view on how we pay for healthcare. We have a transactional approach to care. While this is fine for my broken leg or a simple viral infection (not COVID-19, of course) it is not appropriate for someoneThe COVID-19 pandemic has shifted perceptions of the health system. With virtual healthcare, some acute conditions can be treated at home.
with a long term chronic condition. Where we need multidisciplinary care, we need a different payment structure to support that care.
When I was secretary of health we tried to look at a medical home model which would incentivise clinicians to take a more holistic view of patients with chronic conditions to better meet their needs. While this was trialled it has not gained traction.
Fast forward a few years and 18 months into the COVID-19 pandemic, I think we are finally seeing the emergence of some very interesting models of care delivery. At Calvary Healthcare, where I now work, we are looking at this opportunity to see if we can make these models work.
Responding to a tender from the South Australian government we developed a virtual care centre concept. At the base of this sits a digital platform with remote monitoring capability. We are still in the first year of this and we are seeing some great signs for the future. There are a number of acute conditions that can be dealt with at home with a medical led digital platform with remote monitoring. The list of illnesses we will be able to deal with will grow as the program matures.
Patients are loving it, as they can have their acute treatments at home in the secure knowledge that they are being monitored and supported by a clinical team led by a doctor and that there is a mechanism for someone to “visit” them regularly, both physically and virtually. While the traditional hospital in the home deals effectively with non-acute patients this virtual medical model allows us to treat more acute patients at home. And patient experience and satisfaction has been fantastic.
COVID-19 has changed the perceptions of society more broadly, but for patients of our healthcare system, they are increasingly looking at not going to hospital if they can avoid it. Virtual care is the answer and the future of healthcare. Clearly not for all reasons but for appropriate reasons and particularly for chronic disease sufferers.
If we strive to achieve the quadruple aim here: improved patient experience and outcomes, an efficient sustainable system and improved provider experience we are definitely on the right path I believe.
At Calvary we run public and private hospitals, residential aged care homes and community at home care. With the introduction of this virtual platform it gives us a unique opportunity to provide an integrated service to the patients, residents and clients we care for.
With the advent of the Delta strain of SARS-Cov-2 we have seen extended lockdowns and significant numbers of people affected by the virus. As we move to higher vaccination rates and start to “open up” we will likely see more people affected but hopefully not requiring hospitalisation. That said we will still need to care for and support these people, most likely in their homes.
What better way than to use our capability in virtual care? A month ago we were approached by Western Sydney Local Health District to see if our capability could be used to look after COVID-19-positive patients at home. And of course the answer is a big yes.
What we are seeing at the moment is that approximately 90 percent of COVID-19 positive patients can and are being cared for and supported at home. These people can be managed virtually. Another interesting behaviour we are seeing is that some of these patients don’t really want to have someone call them daily to check in on them. They would prefer to respond digitally. As long as we can build the guidelines and escalation protocols, all this is entirely doable and safe.
So I think we have a unique opportunity at the moment to capitalise on looking at new and innovative ways to deliver healthcare where we can get to the right patient at the right time in the right setting for their circumstances.
We are demonstrating that these models work. We now need to be courageous and forge ahead to revolutionise healthcare. We have amazing clinicians and care workers and now technology solutions that will support them to meet the demands of patients and the community at large.