Healthcare provider St. Vincent’s is advancing virtual and at-home care, through its recently established Virtual and Home division, and is extending the model to meet growing need at the local and state level.
From online cognitive behavioural therapy (CBT), to remote blood glucose monitoring, the organisation has already developed a wide range of virtual health use cases, treating tens of thousands of patients virtually.
However, its expansion plans for 2025 will cover even more breadth of the health continuum, putting it on track to deliver 30 per cent of all its outpatient consultations by telehealth.
“We are looking to expand our partnership with St Vincent’s Virtual and Home to scale up our existing models and further enhance outcomes and experiences for our community,” said Anna McFadgen, Chief Executive of St. Vincent’s Hospital Sydney.
“We now have sufficient data to support the efficacy of these services and know they serve the added functions of meeting patient needs and preferences. That could be an accessibility need, for people in rural, regional and remote areas; or a psychosocial need, for people who prefer the online medium.”
So what does the St Vincent’s Virtual and Home division currently offer, and what does it have in store for 2025?
Mental health treatment
Dean Jones, National Director of St Vincent’s Virtual and Home, says its digital mental health platform ‘This Way Up’, is an accessible and effective way to deliver evidence-based online cognitive behavioural therapy (CBT). The platform, developed by St. Vincent’s, currently offers nineteen programs.
“We’ve already seen 270,000 Australians use the platform, and it’s been really effective at treating anxiety, depression, insomnia and a range of other conditions,” he said.
“We partner with around 36,000 healthcare workers, including one third of all Australian GPs who can prescribe, or refer This Way Up programs for patients. It’s also been licenced internationally, in particular to New Zealand and Montreal in Canada.”
GP’s who prescribe the programs for their patients can track their progress via a clinician specific dashboard.
“This is quite a unique feature – and it’s a really important one in terms of supporting the patient throughout their care cycle,” Mr Jones said.
While the programs are not suited to all mental health conditions, Mr Jones says the platform can support many patients presenting with depression and anxiety.
“We of course take into account the severity of the condition, the patient’s history etc. But on the whole it’s a great option for a range of mental health presentations, and will help us support more people into the future, when healthcare resources are increasingly stretched.”
Diabetes management
St Vincent’s Diabetes Regional Education, Access and Management (DREAM) initiative has also seen widespread impact in people with diabetes and is earmarked for expansion in the coming years.
A key focus of the initiative has been developing partnerships with clinicians and consumers in rural and regional areas to build capability in managing diabetes and enhance equity of access to care.
“We already offer remote monitoring for blood glucose levels, which is an extension of some other work we’ve done around insulin dose adjustment clinics.
“Looking ahead there is quite a bit of opportunity in the diabetes space that we’re looking to scale” Mr Jones said.
Rehabilitation at home
St Vincent’s Rehab at Home program is now providing care across Australia’s eastern seaboard, supporting people following knee and hip surgeries.
“Rehab at Home can be fully virtual – sometimes out of necessity,” Ms McFagden said. “For example, people in Toowoomba and regional Queensland previously experienced difficulty in accessing at-home rehabilitation after joint surgery, but this service can now be offered through virtual care and video telehealth with us. This is an important health equity step to ensure access to care for all people, regardless of where they live.
“Aside from video consultations, we provide patients with the ability to communicate with their care team via secure chat messaging, and remotely monitor them for signs of concern or deterioration in post-operative progress.”
Residential aged care
Alongside expansion, a strategic priority for Ms McFadgen is improving the interface between public hospitals and aged care.
“Most older Australians have multiple medical conditions, so they often end up in hospital, where their care could be more appropriately provided in their residential aged care home.
“An acute hospital stay often isn’t a good outcome for the patient or their families, which is why we are exploring different models with our aged care division. We’re developing geriatric flying squads, where clinicians are sent out to aged care facilities, for example.”
Palliative care
St Vincent’s has a range of Palliative Care at Home services in Brisbane, Sydney and Melbourne.
Multi-disciplinary teams can provide in-home assessment and management of symptoms, support with psychological well-being and Advance Care Planning.
Through Palliative Care at Home, most patients are able to reduce or prevent time in hospital and spend more time at home, which is usually their preference.
Discharge support
In Victoria, St Vincent’s runs the HealthMonitor Programe – a fully virtual short-term, care coordination service for patients after discharge from its public hospital in Melbourne.
“We provide more than 6,000 client contacts a year through that service. The service is provided to people over 60 who have left the main hospital or emergency department,” Mr Jones said.
“Essentially, they receive a follow up SMS within 24-48 hours e of discharge to check they are managing well and everything is going as expected.
“If the client then expresses they would like a follow up call, we have clinicians who can provide clinical advice, escalation pathways and care coordination, navigating their care remotely.”
Scaling things up
With a large number of use cases already under its belt, the St Vincent’s Virtual and Home Team are now focussed on developing technical capability to support broader uptake and expansion.
“We are investing time on a new digital care platform. We already have a range of applications which support our existing programs, but for us to do these things at scale, we need a platform that can support two way communication and remotely monitor patients, through wearable tech or home diagnostics, for example, and then link those results to the platform,” Mr Jones said.
The effort is part of a broader one to support patients across the full care continuum, Ms McFadgen added.
“We’re really looking to establish lifelong relationships with our patients. St Vincent’s is a microcosm of the Australian health system, offering everything from maternity services, through to community, and public and private hospitals. Then we’ve got residential aged care, home care, through to palliative care – so we help throughout all stages of life. Being able to do this at scale will mean we can reach more patients and serve as that interface over their lifetime.”
Scaling out-of-hospital and virtual models will also help St Vincent’s navigate the resource constraints affecting the sector.
“It’s not sustainable to continue investing in bricks and mortar in the way that we have. We’ve really got to look at opportunities to provide more care to more people. And through virtual and out of hospital care, we see the opportunity to do that,” Ms McFadgen said.
“For our public hospitals, we have a key role in managing access and demand, and creating capacity for emergency presentations and elective surgeries. Across our Public hospitals we e substitute a little over 12 per cent of our overall bed days in the home currently – and our goal is to grow on that.
Further insight
Talking more about Virtual at Home, Anna McFadgen and Dean Jones will co-present at the upcoming Telehealth and Virtual Care Conference, as part of Connect Virtual Care.
One ticket to Connect Virtual Care gives you access to three conferences: Medication Safety & Efficiency, National Telehealth and Virtual Care, and Hospital in the Home.
This year’s event will be held 2-3 April 2025 at the Hilton Sydney.
Learn more and register your tickets here.