Vision for Life

Vision-For-Life

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:

Armidale  
Auburn
Balmain
Bathurst
Belmont
Blacktown
Blue Mountains
Bowral
Byron
Camden
Campbelltown
Canterbury
Coffs Harbour
Concord
Dubbo
Glen Innes
Gosford
Gower Wilson
Grafton
Hawkesbury
Hornsby
Inverell
Kempsey
Lismore
Lithgow
Liverpool
Maclean
Maitland
Manly
Manning River (Taree)
Milton-Ulladulla
Mona Vale
Moree
Mount Druitt
Mudgee Hospital
Murwillumbah
Muswellbrook
Nepean Hospital
Nimbin
Orange
Port Macquarie
Royal North Shore
Royal Prince Alfred
Ryde
Shellharbour
Shoalhaven
Singleton
St George
Sutherland
Sydney Hospital
Tweed Hospital
Wollongong
Wyong

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.

Background

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 both hospitals"
"If the doctor feels the need to consult with another doctor, I would never argue with that"

Staff Feedback

"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 Paediatricians"

Outcomes

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.


Next Steps

  • 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.

Resources

  •     Introduction to Vision-For-Life