Innovations in virtual nursing deliver healthcare at a distance through technology, offering the potential to alleviate stress for both practitioners and patients.
Nurses are at the forefront of a digital evolution that could relieve pressures on an overburdened health system, as well as provide Australians with better access to treatment. The expansion of virtual care by means of advances such as telehealth and self-monitoring apps and devices is a key component of the Australian government’s Digital Health Blueprint 2023-2033.
Virtual nursing and midwifery, also known as telenursing and telematernity, can help patients in many ways. They can provide remote and rural populations with timely access to healthcare, reduce the costs of traveling to and from medical appointments, provide ongoing support of patients with chronic conditions, and make it easier for culturally and linguistically diverse patients to receive treatment with the support of their families or communities.
Virtual care is not a one-size-fits-all solution, however, and it must go hand in hand with in-person care to maintain the integrity of evidence-based practice.
Virtual care in nursing
The term virtual care is often used interchangeably with the terms telehealth, digital health, and telemedicine. The Australian Commission on Safety and Quality in Health Care defines virtual care as “healthcare activity supported at a distance by information and communication technology services.” That includes care provided by phone and video as well as remote patient monitoring and mobile apps. When it comes to nursing, the US Agency for Healthcare Research and Quality has noted that virtual practice is most effective when integrated into a coordinated model that better connects patients with their healthcare team rather than the ad hoc approach to telehealth that arose out of necessity during the COVID-19 pandemic.
Nurses are already using virtual care in a range of settings, including virtual triaging. Callers to the national health direct helpline speak to registered nurses, who ask clinical questions, assess the urgency of a situation, and offer advice or direct patients to appropriate care in their area. Australia’s virtual health service, which began in 2007, reported 85 million interactions with the community in 2023.
Hospitals around the country are also increasingly embracing technology to provide virtual care — from following up with patients after discharge to offering hospital-in-the-home services whereby in-person nursing care is complemented by telehealth consultations and digital monitoring.
As experts at Wolters Kluwer Health have noted, virtual nursing brings experienced-nurse knowledge, expertise, and support to less-experienced nurses at the push of a button. Virtual nursing can help nurses make bedside decisions, perform a procedure that the nurse at the bedside hasn’t ever done or hasn’t done recently, and be the support system for new nurses in the first few years after graduation.
Virtual growth
Although the uptake of virtual healthcare has been slower in Australia than in other parts of the developed world, there has been significant investment in recent years.
The New South Wales government opened Australia’s first virtual hospital, RPA Virtual Hospital, in early 2020 with a handful of nurses caring for patients with cystic fibrosis and those needing palliative care. RPA Virtual Hospital now operates around the clock, providing care for more than 2,000 patients via 16 virtual care centres, including the nurse-led Wound Care Command Centre.
In acute cases, clinicians affiliated with the South Australian Virtual Care Service provide individualized assessment via video link by working with paramedics, nurses, and doctors on the ground to determine the best care for each patient. Since the service began in 2021, almost two-thirds of the service’s patients have been able to avoid emergency departments in favor of more-patient-centred care through either regional hospitals, aged-care facilities, or follow-up treatments at home.
In Western Australia, the Emergency Telehealth Service maintains more than 90 small hospitals and nursing posts around the state, with access to specialist emergency clinicians. The service has conducted more than 250,000 patient consultations since its inception in 2012.
Support for virtual care
The need to keep healthcare workers and patients safe during COVID-19 saw a surge in virtual care across Australia, with almost 18 million patients receiving telehealth services from March 2020 to July 2022, according to the Australian Digital Health Agency. The willingness of Australians to have telehealth consultations also rose, with 85% of those who had used telehealth in 2021–22 saying they would do so again, according to the Australian Bureau of Statistics. In its report entitled Turning the tide: Consumers and clinicians increasingly move towards virtual health care, PwC found the percentage of Australians who were likely or very likely to use virtual care had risen from 44% in a 2021 survey to 50% in 2022, with respondents listing the following perceived benefits:
- Saves time and money
- Offers convenient access from home
- Provides timely access to care
Various studies have found nurses and midwives, too, see many benefits to virtual care, including helping patients in high-risk populations, assisting patients in the management of chronic conditions; easing the burden on time-poor staff, facilitating meaningful contact, and reducing hospitalizations and readmissions.
Concerns about virtual care
Virtual care is not without its issues. As outlined in the Australian government’s National Digital Health Strategy 2023-2028, issues include digital health literacy, access, and affordability. People who most need care, such as those in remote Aboriginal communities, are sometimes unable to get help because they cannot afford a smartphone or they have limited internet access. Similarly, many healthcare workers lack the digital training needed to deliver virtual care properly.
Virtual nursing also removes the personal connection made with face-to-face care, which raises challenges to building trust and putting new patients at ease. The issue can become even more problematic when nurses are trying to deliver culturally safe care remotely or to communicate sensitive health information with the assistance of an interpreter.
There is also concern that virtual care can lead to more and more inaccurate diagnoses or treatments because nurses and other healthcare workers are unable to perform certain physical assessments. Almost 50% of clinicians in the PwC study said they worried about clinical misdiagnoses due to missing information.
The road ahead
Despite concerns, the benefits of virtual care are becoming increasingly clear to consumers and healthcare providers. What is just as clear is that virtual care cannot be delivered in isolation. Governments and healthcare providers have to look at innovative models of care that equip clinicians with the tools, training, and support needed to ensure the best possible virtual care — without sacrificing in-person care. That examination of models will in turn provide Australians with real choices in the ways they manage their health and well-being and will enable nurses to deliver truly patient-centred care.
Find out more about how Lippincott® Solutions Australia can support nurses across healthcare settings.
