After Hours Telehealth Pilot Provides Relief for Maryborough’s GP Workforce

Since 2019, Western Victoria PHN (WVPHN) has delivered the After Hours Telehealth Pilot program to nine Health Services Urgent Care Centres (UCCs) with My Emergency Doctor.

The pilot at Maryborough District Health Service’s’ (MDHS) UCC commenced in August 2019 and will end in December 2020. The telehealth service was used by UCC staff in the after hours period via the My Emergency Doctor App on a smart phone or tablet, which provided access to a team of Emergency Specialist Doctor who can remotely assess, diagnose and arrange treatment for patients. My Emergency Doctor’s medical workforce consists entirely of Fellows of the Australasian College for Emergency Medicine (FACEMs).

A case study of the service at MDHS by My Emergency Doctor has found that the pilot addressed the key issues that it was designed to resolve.

Well before the COVID-19 pandemic forced a revolution in how primary health care was given with the widespread introduction of telehealth services, WVPHN understood telehealth’s value as an advocate of the technology.

Photo: The After Hours Telehealth Pilot was launched at MDHS in October 2019. (L-R) Amor Kisling, Wendy Giddings, Dr Leanne Beagley, Dawn Floyd and Laura Martin

Evaluations of previously funded after hours initiatives identified a need across the region to consider alternate models for the provision of after hours care that complement services provided by GPs and address recruitment and workforce retention challenges that commonly impact UCCs.  The use of telehealth was identified as a potential option to address these workforce shortages by reducing the significant afterhours burden placed on some GPs.

In a recent interview, MDHS Chief Executive Officer Nickola Allan revealed that the pilot did indeed provide this workforce relief, with local GPs reassured that they will only receive a call to attend the UCC for serious cases that absolutely require their attendance.

“The ability to dial a FACEM is an enormous positive for the work life balance of our GPs and giving them the comfort that they’re not going to be called for things unnecessarily,” said Ms Allan. “Particularly when you’re thinking about our staff in urgent care at night ringing a FACEM who they aren’t necessarily familiar with, to know that they are a skilled clinician is incredibly reassuring.”

MDHS UCC was one of the nine participating health services in the WVPHN After Hours Telehealth Pilot. UCCs are located in small rural communities where higher levels of trauma care are not available. UCCs provide initial resuscitation and have a limited stabilisation capacity prior to early transfer to a Regional Trauma Service or Major Trauma Service.

“When Western Victoria PHN put out an expression of interest for organisations to be involved in the My Emergency Doctor program, we thought ‘yes, let’s get involved to support our GPs’ because we are very cognizant of the enormous work that they’ve put in to support the organisation,” said Ms Allan, “and if we could reduce their ‘on-call’ burden, then we would absolutely do that.”

Celebrating telehealth

My Emergency Doctor’s recent case study into MDHS’ involvement in the pilot program found that in the nine-month period between October 2019 and June 2020:

  • MDHS has utilised the service of My Emergency Doctor 245 times
  • Of those 245 patients:
    • 5% were admitted for ongoing care and management
    • 4% were discharged home after assessment and management
    • 2% were transferred to a higher level of care at another health service

“The team in urgent care are able to celebrate the positive of having access to someone who’s an ED (emergency department) physician who can provide you with the appropriate support and management plans for patients that present,” said Ms Allan. “We were really trying to think of ways where we could celebrate and endorse telehealth across the health service and this has been a really good program.”

“I know that this (My Emergency Doctor) will be part of Urgent Care moving forward. We won’t stop using it. This is something that will be embedded as part of our practice.”

WVPHN is now working in partnership with Deakin University to undertake an evaluation of the After Hours Telehealth Pilot to determine whether the telehealth model is a financially viable solution to manage after hours service priority issues and whether the model is sustainable.

Recently, Rowena Clift, WVPHN Chief Executive Officer, welcomed the announcement from Commonwealth Minister for Health Greg Hunt that telehealth consultations will continue to be covered by the Medicare Benefits Scheme.