Vision: Virtual Care Strategy

This strategy is underpinned by a five-year vision and core principles (Appendix 1) for virtual care.

Our vision is that virtual care is used wherever appropriate and preferred by the patient, to provide care closer to home.

Virtual care is embedded in mainstream care provision. It enhances access and equity of care across the care continuum and improves Victorians’ experience and health outcomes.

We will achieve this vision through:

1. open and active collaboration between the department and health services
2. responding to diverse needs, levels of access to technology and consumers’ backgrounds
3. consistent, coordinated and integrated care
4. care that supports diverse communities and is culturally safe, including creating an environment that enables self-determination for Aboriginal people
5. ensuring health providers are confident in using virtual health technology, and receive ongoing skill development and support
6. effective local-level innovation that is scaled to enable equitable access
7. improving demand management and system sustainability

Defining virtual care

• Virtual care is a broad term. It includes telehealth (telephone and video-enabled) and remote monitoring. It supports self- management, and it can be provided in different settings and geographical It is used to connect and provide care and connects consumers, families and carers with clinicians and other people caring for them. It supports multidisciplinary care and specialist consultations between clinicians, professional development and peer support (see Figure 1).
• Virtual care can be provided in a number of ways. It can be in real time such as a telehealth consultation, or as asynchronous care where a patient records health parameters to be reviewed as part of care. Virtual care means practitioners can check physiological parameters and experience of different patients remotely, and escalate to virtual assessment of face to face review where indicated.
• Virtual care can be delivered across a variety of settings and care journeys across the care continuum. Patients may have part of their care journey provided virtually alongside more traditional face to face services.

Figure 1: Virtual healthcare technologies

Source: Health Education England 2019, The Topol review: preparing the healthcare workforce to deliver the digital future.

Policy context

This strategy will help the department achieve its vision of Victorians being the healthiest people in the world. It supports delivery of the department’s strategic directions, including to keep improving care and providing care closer to home.

The strategy also supports implementation of Royal Commission into Victoria’s Mental Health System final report recommendations, including that the Victorian Government ensure that:

• local and area adult and older adult mental health and wellbeing services deliver multidisciplinary, holistic and integrated treatment, care and support through a range of delivery modes, including telehealth (Recommendation 5.2b)
• each adult and older adult area mental health and wellbeing service delivers a centrally coordinated 24-hour telephone/telehealth crisis response service accessible to service providers and members of the community (Recommendation 8.1)
• mental health clinical assistance is available to ambulance and police through a range of mechanisms including 24-hour telehealth consultation systems for officers responding to mental health crises (Recommendation 10.3).
• by the end of 2022, trial two new digital service delivery initiatives in rural and regional areas that meet the needs of local communities (39.1b)

The strategy complements:

• Victoria's digital health roadmap, which sets out five programs of work to improve the safety and quality of healthcare.
• the Victorian Virtual Care Operational Framework, which articulates consistent and defined standards to meet the operational and safety requirements of virtual care models.

Benefits

Virtual care offers many benefits to consumers, their families and carers, the health workforce, healthcare providers and the broader health system, including:

• Extends care to previously unreachable areas.
• Enables multidisciplinary care across primary, community and acute care.
• Provides faster and more equitable access.
• Flexibility for consumers in how and where they receive care.
• Reduces consumer travel and related costs.
• Facilitates culturally safe environments that include family/carers.
• Reduces risk of exposure to infectious disease.
• Reduces patient transport needs.
• Facilitates increased workforce mobility and more opportunities for professional development.

Models such as virtual emergency departments and virtual post-surgical rehabilitation at home can also alleviate hospital demand (see Figure 2).

Figure 2: Virtual care across the care continuum

Challenges

Challenges to strengthening and expanding virtual care include:

1. system stewardship of virtual care across Victoria to help overcome fragmentation and ensure quality, safety, equity and value
2. risk of poor consumer experience if the system becomes harder to navigate due to many virtual care entry points, with inconsistent approaches
3. the impact of the digital divide due to lack of access to internet and technology such as smart devices, poor digital literacy, confidence in using technology, disability and age
4. need to strengthen health workforce capabilities and confidence in providing virtual care, while balancing the potential impact on workloads and workforce wellbeing
5. the requirement for access to reliable, simple platforms and technical support
6. availability of integrated, secure statewide connected and accessible patient record systems
7. systems that support cross-service collaboration, including the capacity for GPs and other primary care and community services to access virtual care programs
8. funding that enables development and implementation of virtual care models, and funding of novel service offerings.