The Vision-For-Life project is a joint initiative of NSW Health and
Variety, the Children's Charity. The project aims to put NETS specialists
and other experts in neonatal and paediatric care 'into' special care
nurseries, children's wards and paediatric bays in Emergency Departments
by using high-quality video technology to better augment the emergency
consultation and retrieval process for sick or injured babies, infants
and children. The virtual network of dedicated Vision-For-Life cameras
has introduced the ability for NETS to not only hear about the case but
to also view the case as it happens on the ground. This increased level
of knowledge and situational awareness allows NETS consultants to guide
the team through any immediate changes in the care and has increased the
operational effectiveness of the service as well as the traditional
efficiency of the decision making process via telephone; ultimately
saving more lives. NETS works in partnership with the Local Health
Districts to identify optimal camera positions, train clinical staff and
to provide support and assistance as required. Variety has sourced kind
donations to help fund 96 cameras across 53 NSW hospitals to date.
The NETS consultants now also have access to general-purpose cameras in
the Emergency Department located in other hospitals across the State,
which has expanded the overall virtual network and the ability to provide
remote telemedicine support. The responsibility for procurement,
commissioning and maintenance of the technology ultimately falls under
the Local Health District umbrella therefore ensuring a futureproof
lifespan for the project.
NETS is an advocate for technology enhancement to improve the delivery of
healthcare services due to the achievable benefits to patient outcomes,
patient experience, staff satisfaction and the broader system outcomes
such as greater level of workforce efficiency. NETS pioneered clinical
teleconferencing in 1993 to support the transport process, which enables
clinical staff members in a local hospital to call a State-wide hotline.
The telephone network continues to facilitate the provision of immediate
expert advice from a NETS consultant in order to care for a patient and
ensure their ongoing care is managed in the best possible way. Where
transportation is deemed necessary the conference call is expanded to
include the relevant expertise at the receiving hospital thus providing
complete transparency and agreement upon the next steps. Since then other
telemedicine modalities such as the establishment of remote access to
radiology imaging in most hospitals has also helped to provide additional
knowledge and assistance to hospitals across the vast geographical area
of NSW. NETS works in partnership with eHealth NSW to strategically
introduce enhancements in accordance with the State-wide direction and
the organisation is also generously supported by charities such as
Variety and other groups and individuals who continue to make in-kind
donations to the technology portfolio.
Technology in Practice
Vision can be seen at the NETS State Headquarters by NETS Consultants and
authorised NETS team members and access for these individuals is also
permitted when working off-site or on call. Where a video camera is
installed and available, a decision is made for the local staff to press
a button to activate it. In order that the calling clinician can readily
move between the telephone, hospital information systems and the patient,
calls are made using a cordless headset provided as part of this package.
The initial objective is to assess the situation as a collaborative team
and where possible provide support to the local staff members via remote
specialist expertise and guidance. In many cases it is not possible to
triage down and following the clinical assessment a decision is then made
to determine the most appropriate, rapid and economical next step. These
options could involve dispatching an appropriate equipped team in an
Intensive Care Ambulance to safely move the patient to the nearest
available facility who offer capacity to accept the patient, or,
alternatively in critical circumstances where the patient is seriously
deteriorating transport is organised to one of the major paediatric
units; in some cases, via air transportation.
Patient and Family Feedback
"We felt that the process was very good under the circumstances, and
through this was able to have our child transferred to get the specialist
care that she needed at the time"
"We were very grateful for all the efforts of the attending staff at
"If the doctor feels the need to consult with another doctor, I would
never argue with that"
"Really very useful tool which provides more information about the
clinical condition of the child"
"Allowed NETS doctors to make an informed assessment, and in this
case, allowed a very significant change in management"
"In this instance it enabled a child to be referred to a base
hospital as well as enabling the patient to be assessed to be appropriate
for an ambulance transfer as opposed to utilising a NETS team"
"Great concept with a little more experience and opportunities should
be easy to adapt"
"By having this it helped us reassure parents we are getting the best
advice, also it was useful to train other Emergency Staff Adults and
The Vision-For-Life project has validated the concept of remote
telemedicine specialist support. The cameras ensure that a patient is
only transported when absolutely necessary, and, that transportation
occurs to the ideal facility to accept responsibility for providing the
ongoing care. This process is coordinated in collaboration with the
receiving team, which assists the Local Health Districts to manage cases
locally and to reduce their transport costs.
Further expansion of the Vision-For-Life Camera network.
Providing relevant clinicians within Local Health Districts with access
to appropriate cameras to assist with local triaging and decision
making prior to the NETS call.
Enabling camera usage via mobile devices to improve accessibility.
Installation of Vision-For-Life cameras in NETS ambulances to better
support patient care whilst in transit.