Aged Care Insite Issue 100 | April-May 2017 | Seite 39

technology
The Victorian Stroke Telemedicine project is operational across
16 hospitals in Victoria. How do patients move through the
service? What role do all the staff involved play?
When an acute stroke victim is brought to a regional hospital
emergency department, the staff there call a 1300 number and
that gives them direct access to an internet roster of neurologists
who take the call. We’re available 24/7. We take some clinical
details and then we are able to open up our computers, be that at
home or at work or wherever we are because we are very mobile
with laptops. We’re then able to do an audio-visual telemedicine
consult. We’re able to look at the brain imaging, and we’re also
then able to generate a clinical note that can be promptly sent
back to the hospital to be put in the patient’s medical records.
The emergency staff at the hospital are key to this, because
they’re the ones who contact us. We talk to them as well as talking
to patients and families, so that everyone is aware of the diagnosis,
everyone is aware of the treatment plan that’s about to take place.
That interaction has been very positive for us and very positive for
the hospitals that are involved in VST.
What does the equipment that staff are working with look like?
It’s a large telemedicine cart. It stands at about shoulder height. It
has a camera and a very sophisticated screen – it’s a touch screen.
But from the hospital perspective there’s only one important part
of that equipment and that’s the big green button on the side; all
they have to do is push that button, the cart is activated, and we
pop up on the screen and we’re able to do our consult.
It’s a very plug-and-play approach. It’s simple, it’s reliable, it’s
robust. The M.I.Tech technology has really worked very well for us.
There has been a bit of talk over the past two years or so about
telehealth’s unrealised potential in some areas, and services
that haven’t met expectations. Why do you think this program
stands out and is still used in 16 hospitals?
We put a lot of time into the change management associated with
introduction of stroke telemedicine. I can’t emphasise this enough.
We go into hospitals and we not uncommonly find that they have a
bit of telemedicine equipment, but it’s parked in the broom cupboard
with a dust cover over it because no one has actually taken the
time to ensure that the process of the telemedicine care is actually
embedded in routine medical practice.
Telemedicine should become second nature in clinical care,
not a second thought. It’s very important to spend the time
to educate people as to why we’re using telemedicine, what
the protocols are, and really to get it fully embedded into the
clinical-care systems in each hospital. We do a lot of education
around that. We spend up to six months before we actually even
commence the program.
How do patient outcomes under the VST service compare to
those seen in hospitals that don’t have a telemedicine service?
An important part of our change management in each hospital
is to measure this. We measure the current status before we
commence the telemedicine program and then after. We
found dramatic improvements in treatment times, in the
number of patients being treated. Indeed, we found that the
care now delivered even in small, regional hospitals in Victoria
is comparable to that which you would receive in a large
metropolitan hospital.
We can now say that every postcode in Victoria is covered. No
matter the Victorian postcode in which you reside, you’ll get the same
acute stroke care you would if you lived in metropolitan Melbourne.
Where to next for the program?
We’ve been very successful in Victoria. We’re looking to now
expand our program across Australia, as the Australian Telestroke
Network, the ATN. We have a lot of support from colleagues
interstate. We have colleagues interstate and overseas, in
Christchurch. We’ve gone international. Those colleagues are very
supportive. They are already on our VST roster and we want to get
this set up in other states so that we move to a truly national, if not
international, ATN roster. ■
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