A University of New England professor's vision of a "virtual hospital" system to provide medical support in regional areas has become a sudden, urgent reality as the COVID-19 crisis expands.
Professor Rod McClure spent years thinking about how basic telehealth can evolve to the stage where hospital-level care is not dependent on a physical location. When he recognised the potential for devastation from the coronavirus pandemic, he stopped planning and started acting.
Remote monitoring technology has already been ordered and shipped to Armidale, NSW, where it will be given to COVID-19 patients to track their condition while they stay at home in their own beds.
Patient data will be streamed to a central command centre at Armidale Regional Hospital, where software will automatically monitor for signs of critical decline in patients, and trigger an alert if professional intervention is necessary.
If it all comes together as Prof. McClure hopes, a surge in COVID-19 cases in the New England-North West region of NSW may be better managed against hospital capability because patients not needing intensive care can stay at home while still receiving professional attention.
Prof. McClure, the Dean of UNE's Faculty of Medicine and Health and a former director with the US Centres for Disease Control and Prevention, says that availability of remote monitoring units will define the project's impact. If several hundred units are available, that means that several hundred COVID-19 patients could be under 24-hour professional surveillance with little extra burden to the regional hospital network.
Dozens of remote monitoring units have already been ordered after UNE management backed an emergency purchase order. The units are "intensive care quality", Prof, McClure says. Among other factors, they will monitor patients' blood pressure - which provides an early warning of sepsis or organ damage – and oxygen saturation, which typically changes as pneumonia sets in.
Patients with mild symptoms who would typically not be admitted to hospital will not receive a monitor but will be able to have regular video check-ins with doctors. Those with severe symptoms will still be admitted to hospital.
Prof. McClure is still looking for additional funding support to get the concept operational. He needs to source software for the central command centre – to be located in UNE's Tablelands Clinical School – and other elements of the system to complete the package.
"If we can provide proof-of-concept during a pandemic, then we have a platform on which to expand the virtual hospital idea," he said.
"Rural healthcare was in crisis before COVID-19, and it will still be in crisis after the epidemic has passed. Building virtual hospitals in regional areas has the potential to generate significant long-term economic, social and health benefits for the regions, and therefore for Australia."
A pilot program to test the virtual hospital concept was scheduled to be rolled out by UNE later this year. The pilot aimed to support medical students to undertake a year's apprenticeship in a rural area, where they would be embedded as health practitioners in small communities while receiving full professional support via communications technologies from the Tablelands Clinical School.
"It may even be an enhanced form of training, because a student will have virtual access to all the facilities of a modern hospital and still be able to apply their learning directly to the hands-on situations they encounter within their communities," Prof. McClure said.
Like all projects in a world preoccupied with COVID-19, the future of this program is now uncertain – but in the future, Prof. McClure hopes, a successful COVID-19 remote monitoring program will have made the value of a virtual hospital incontestable.
