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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Establishing a ‘Virtual’ model of emergency care in Melbourne’s southeast

Muhuntha Sri-Ganeshan https://orcid.org/0000-0001-5541-8920 A B * , Andrew Underhill B , Claire Charteris C , Fergus McGee D and Peter A. Cameron on behalf of the Southeast Region Virtual Emergency Department (SERVED) Research Group A B
+ Author Affiliations
- Author Affiliations

A School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic. 3004, Australia.

B Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Vic., Australia.

C Community, Integrated and Ambulatory Care, Peninsula Health, Melbourne, Vic., Australia.

D Emergency Department, Monash Health, Melbourne, Vic., Australia.

* Correspondence to: m.sriganeshan@alfred.org.au

Australian Health Review 47(6) 684-688 https://doi.org/10.1071/AH23070
Submitted: 8 March 2023  Accepted: 19 October 2023  Published: 9 November 2023

© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Digital technologies, specifically those required to facilitate telehealth via an audiovisual medium, are now at a standard that allows them to reliably assess patients with acute complaints within their homes. The coronavirus disease 2019 (COVID-19) pandemic forced innovation and led to an increased acceptance of telehealth from both clinicians and patients and presented an opportunity to incorporate telehealth into emergency medicine practice. With inpatient capacity strain exacerbated by the pandemic, three hospital networks within Melbourne’s geographical southeast collaborated with Ambulance Victoria (AV) to set up a virtual emergency department (VED) service in January 2022. This service aimed to allow certain patients to receive care in the more convenient setting of their homes. Referrals were made directly by AV personnel at the home while they were attending to these patients. Consultation with a VED clinician was initiated through a secure audiovisual platform, ‘Healthdirect’. Following this consultation, care could be facilitated at home through the VED clinician providing advice regarding treatment that paramedics could administer or through linkage into one of the various outreach services provided by the organisations. The VED represents part of the initial integration of telehealth into our organisations. We hope our initial framework might be built upon through greater integration with community services and incorporating more digital technologies. The ongoing graded expansion of telehealth services within our organisations will likely see more and more patients managed in their own homes.

Keywords: digital technologies, emergency department, Emergency Medical Services, emergency medicine, paramedic, telemedicine, telehealth, virtual emergency department.

References

Holliman CJ, Mulligan TM, Suter RE, et al. The efficacy and value of emergency medicine: A supportive literature review. Int J Emerg Med 2011; 4: 44.
| Crossref | Google Scholar | PubMed |

Adams K. How American attitudes on telehealth have changed since the start of the pandemic. Available at https://www.beckershospitalreview.com/telehealth/how-american-attitudes-on-telehealth-have-changed-since-the-start-of-the-pandemic.html [cited 17 July 2023].

Richardson DB. Access block in Australian emergency departments 2017–2020. Emerg Med Australas 2021; 33: 529-33.
| Crossref | Google Scholar | PubMed |

Jaffe TA, Hayden E, Uscher-Pines L, et al. Telehealth use in emergency care during coronavirus disease 2019: a systematic review. J Am Coll Emerg Physicians Open 2021; 2: e12443.
| Crossref | Google Scholar | PubMed |

Sher L, Semciw A, Jessup RL, et al. Structured evaluation of a virtual emergency department triage model of care: A study protocol. Emerg Med Australas 2022; 34: 907-12.
| Crossref | Google Scholar | PubMed |

Australian Commission on Safety and Quality in Health Care. Review of the key attributes of high-performing person-centred healthcare organisations. Sydney: ACSQHC; 2018.

Australian Bureau of Statistics. Greater Melbourne, Census All persons QuickStats 2021. 2021. Available at https://www.abs.gov.au/census/find-census-data/quickstats/2021/2GMEL [cited 26 September 2022].

Emergency care. Victorian Agency for Health Information. 2023. Available at https://vahi.vic.gov.au/reports/victorian-health-services-performance/emergency-care [cited 26 September 2022].

My Emergency Doctor. Mission possible. 2022. Available at https://www.myemergencydr.com/ [cited 21 June 2022].

10  Sri-Ganeshan M, Mitra B, Soldatos G, et al. Disposition of patients utilising the Virtual Emergency Department service in Southeast Region of Melbourne (SERVED-1). Emerg Med Australas 2023; 35: 553-9.
| Crossref | Google Scholar | PubMed |

11  Sri-Ganeshan M, Cameron PA, O’Reilly GM, Mitra B, Smit DV. Evaluating the utility of telehealth in emergency medicine. Emerg Med Australas 2022; 34: 1021-4.
| Crossref | Google Scholar | PubMed |