Context
Virtual care is bringing new challenges and opportunities. As technology continues to evolve, the current and future health workforce needs support to provide virtual care confidently and effectively. However, there are workforce challenges associated with implementing virtual care. Some clinicians are concerned that virtual interactions may reduce their sense of connection with their patients and colleagues and limit their ability to provide effective care. There are different perceptions and capability to use and adopt technology within and between health sectors.
Commitment: Build confidence in virtual care and empower the workforce
Actions
- Support development of the evidence base on virtual care experience and outcomes through inclusion in the existing quality improvement measures (links to Pillar 4).
- Provide clear guidance and support for the workforce on delivering virtual care
- Engage the workforce as expert users when designing and reviewing their virtual care models.
Responsibility: Public Health Agencies
Commitment: Provide training and supports for all staff delivering virtual care
Actions
- Include virtual care capabilities in training and supports for staff including:
- digital capabilities such as the use of digital platforms
- adaptation to delivery required for virtual care
- identification of the deteriorating patient
- safe and efficacious use of remote physiological monitoring.
Responsibility: Public Health Agencies
- Update discipline-specific guidelines to include virtual care and formalise staff training through suitable qualifications and accreditation processes.
Responsibility: Department of Health and Professional Bodies
- Provide a well-equipped work environment for delivering virtual care, including secure and reliable IT systems and solutions (links to Pillar 3).
Responsibility: Public Health Agencies and Department of Health
Commitment: Foster a digitally adaptive workforce
Actions
- Recruit and retain a digitally skilled health workforce, especially in rural and regional areas.
- Set consistent and appropriate work parameters and expectations in virtual care settings.
- Offer efficient and flexible ways of working and engaging in professional development.
Responsibility: Public Health Agencies and Department of Health
Case Study: Monash integrated antenatal care program
In response to the COVID-19 pandemic, Monash Health developed and implemented a new antenatal care schedule integrating telehealth across all models of pregnancy care.
Telehealth consultations are provided based on assessed risk level and supplemented with support to undertake remote blood pressure checks and fetal growth assessments.
Women can check their blood pressure at home using automated blood pressure monitors, with local health providers, or at the time of hospital ultrasound assessments. Women take weekly measurements from 24 weeks’ gestation for remote monitoring of fetal growth. Ultrasound assessment of foetal growth is undertaken in hospital according to national clinical care recommendations.
Women are screened regularly for gestational diabetes. If positive, they receive education to support self-monitoring of blood glucose levels. Diabetes nurse educators and endocrinologists predominately deliver care using telehealth.Integrated antenatal care program successfully reduced face-to-face consultations by 50 per cent without affecting the detection and management of common pregnancy complications, including pre-eclampsia, fetal growth restriction and gestational diabetes. There was also a significant reduction in pre-term births for high-risk groups in the integrated antennal care program compared with conventional care.
This program has provided an opportunity to explore alternative approaches in antenatal care. This is informing the future of antenatal care at Monash Health. It provides for more personalised care pathways for pregnant women, as well as a more agile and resilient health service. With the increasing digitalisation of healthcare and the community at large, maternity care is an ideal environment to assess future opportunities to enhance and personalise care and improve access to care for every woman in every pregnancy.
Reviewed 25 September 2023