Virtual emergency rooms to ease hospital crisis

Virtual emergency rooms could soon be rolled out across Victoria to divert thousands of patients a day from the state’s under siege hospitals.

A virtual emergency department trial at Northern Hospital is helping to ease pressure on the overflowing hospital.

Virtual emergency departments may be rolled out across Victoria to divert thousands of patients a day from overflowing hospitals.

An ongoing virtual triage trial at Northern Hospital is saving hundreds of ambulances a week from having to ramp in long queues at EDs and raising hopes it could help ease the strain on Victoria’s besieged hospital system if expanded.

For the past month an average of 230 patients a day have been triaged through the Northern Hospitals’ virtual ED, rather than attending its Epping ED, which is already under pressure from an average of 320 daily presentations.

Paramedics across the state have also been given access to the pilot service.

On average 120 a day are now calling the Virtual ED to assess their patients before loading them into ambulances – saving most the need to actually attend hospitals and the prospect of hours waiting on trolleys.

Northern Hospital nurse Hayley consults at the virtual emergency room. Picture: Rebecca Michael

Victorian Virtual ED director Dr Loren Sher said initial data from the trial was “amazing”, with three in four patients who would otherwise have attended overcrowded EDs able to be treated outside the hospital system.

“We are diverting at least 100 ambulances a day. This is saving hundreds of hours of ramping and transport,” she said.

“It’s not just it’s playing out in emergency departments, it’s also ambulances that are under the pump, primary healthcare is under the pump, so we’re trying to see how we can take a model that’s working really effectively locally and expand that as widely as possible.”

Launched in 2020 as a way to remotely triage Covid patients, the Northern Hospital trial is now being backed by the state government as a way to ease the crush facing EDs across the state.

As Victoria’s busiest ED, the Epping hospital was already seeing 340-350 emergency presentations a day before the pandemic.

By diverting hundreds of people presenting with symptoms such as cough, shortness of breath, fever, chest pain, nausea, vomiting and pain to the Virtual ED the hospital has been able to prevent hundreds more a day overrunning the ED since Covid restrictions eased.

People queue outside the emergency department at Sunshine hospital. Picture: Supplied

Paramedic Stephanie Vassett on a virtual call to nurse Hayley. Picture: Rebecca Michael

Virtual ED clinicians are instead able to refer patients to other health professionals including pharmacies, pathology, GPs, and hospitals in the home, or directly admit them to hospital wards without the need to go through the physical ED.

After triaging up to 293 patients on a single day, Health Minister Martin Foley said the Northern Hospital success was underlined why the government was investing $21 million to implement virtual triage services around the state.

“This innovation is helping hundreds of patients a day – giving people safe care in the comfort of their own home and saving valuable hospital and ambulance resources,” Mr Foley said.

“Saving an extra 230 people per day from needing to go to the ED makes a huge difference for all the frontline workers who are under significant pressure through the global pandemic, deferred care and rising influenza cases.”

Whereas 95 per cent of ambulance callouts to aged care homes see residents transported to hospitals where they remain for days or weeks, those rates have been cut in half under the virtual triage service to free up acute beds and provide in-home treatment.

“We’re having a considerable impact not just on preventing transfer, but having people recognise that it’s better for the patient,” Dr Sher said.

“Having a patient more comfortable in their normal environment and bringing care to their setting is far more palatable than bringing them into a really busy, confusing emergency department with sensory overload and having them sit on a hospital trolley for many hours.”