How Sydney LHD built an integrated, sustainable virtual care model to meet the needs of 85,000 patients

About Sydney Local Health District

Sydney LHD is one of the leading metropolitan Local Health Districts in New South Wales, located in the centre and inner west of Sydney. With approximately 12,000 staff, Sydney LHD is responsible for the health and wellbeing of more than 740,000 people living within the District’s boundaries, as well as people from rural and remote parts of NSW and Australia. Sydney Local Health District also cares for more than a million people who come into the District boundaries each day to work, study and visit 

Sydney LHD oversees five facilities including the Royal Prince Alfred Hospital, Concord and Canterbury Hospitals, a range of in-hospital and community-based support services and the new virtual hospital. 

Addressing integration challenges and poor patient experiences in virtual care models

There is an expectation that virtual care and virtual hospital models will contribute to alleviating the increasing demand on Emergency Departments and acute hospitals, improve the patient experience and provide a scalable approach to mitigate workforce shortages across the health system. 

Despite their potential benefits, including cost savings, convenience, and accessibility, numerous virtual care pilot programs have failed to be sustained or scaled due to data integration challenges and poor patient experience with remote monitoring tools. The COVID-19 pandemic was the catalyst for many health systems to accelerate the implementation of new models of care, but in the haste of these pressures, the integration of these services into the broader healthcare strategy and system was overlooked. 

Sydney LHD recognised the importance of not only implementing rapid changes but also ensuring their alignment with long-term strategic goals, the evolving needs of patients, and the healthcare system as a whole. 

Sydney Local Health District Virtual Hospital (Sydney Virtual) was established in February 2020 as a new and innovative way to deliver hospital level care in the community and provide a sustainable solution to the increasing demand on health care in Sydney. 

An adaptive virtual care model with interoperability at its core

Sydney LHD implemented Alcidion’s Miya Precision, a FHIR-events platform that enables healthcare organisations to address an extensive range of clinical challenges and build an enterprise-level foundation to address continuously evolving models of care.

Initially, Sydney Virtual provided a 24/7 in-home remote patient monitoring service to patients who had tested positive to COVID-19 and were assessed as clinically appropriate for virtual care.

These patients were equipped with a wearable care kit, that transmitted temperature and oxygen saturation datavia Bluetooth to Alcidion’s patient-facing application, Miya Care. Having gone through an iterative human-centred design process, Miya Care facilitates seamless collaboration and communication between patients and clinicians with an intuitive interface. The mobile application guides patients in their care journey and captures information which is surfaced back to clinicians on the Miya Precision web-based, clinical dashboards. When clinicians receive the patient’s data, it is then entered directly into the EPR, ensuring the continuity and completeness of the patient’s health record.

RPA Virtual Hospital has provided virtual care to approximately 85,000 patients since 2020

Sydney LHD commenced planning for a new virtual hospital in late 2019, with initial emphasis on developing the necessary infrastructure and governance for virtual care delivery and consulting extensively to inform the model of care.

Sydney Virtual was the first in New South Wales to introduce remote monitoring of COVID-19 in the community and has provided essential care for:

• 20,075 COVID-19 positive patients at home
• 17,685 COVID-19 positive patients in mandatory hotel isolation

Over 3,000 COVID-19 positive patients receiving care at home provided feedback on their virtual care experience:

• 90% rated their care as very good or good
• 92% said they felt confident knowing their symptoms were being monitored virtually
• 87% said the technologies used by rpavirtual improved their access to care
• 98% said the health devices were easy to use

With that foundation, Sydney LHD has continued to introduce innovative and scalable models of care for abroad range of patient cohorts both in hospital settings and in the community, beyond COVID positive cases.

As of May 2024, Sydney Virtual has provided care to more than 85,000 patients across a number of patient cohorts.

“The Miya Precision platform has been able to make it easier for the nursing staff to keep track of the patients and reducing some of that time to schedule the calls, as they’re already prescheduled, and also just having that oversight of the patients has made it a lot easier to coordinate those medical reviews.” – Nurse Unit Manager, RPA Virtual Hospital

The future

Beyond the COVID-19 use case, Sydney Virtual has demonstrated its ability to scale up virtual care without the challenges associated with traditional hospital infrastructure. With only 500 square metres of physical space, carefully designed and constructed to maximise utilisation of space and clinician comfort, the in-home monitoring initiatives adapt to deliver a range of other virtually- enabled care including: 

• Virtual Rehabilitation
• Remote Monitoring for Acute Diverticulitis
• Virtual Low Back Pain Care
• Long COVID Program
• Virtual Urgent Care and Emergency Department
• Virtual Trauma Care
• Wound Care Command Centre
• 24/7 Palliative Care Patient Advice Line
• Virtual Drain Management
• Medication Monitoring