Transformation and Digital, Gold Coast Health, Gold Coast University Hospital, Block D, Level 6, 1 Hospital Boulevard, Southport, Qld 4215, Australia. Email:
Aust Health Rev. 2021 Jun;45(3):311-316. doi: 10.1071/AH20190.
Objective This study examined Gold Coast staff and patient experiences with the rapid expansion of a virtual model of chronic disease management during the COVID-19 pandemic. Methods The study undertook a survey of enrolled patients (n=24) and focus groups with clinical and administrative staff (n=44) delivering chronic disease programs at Gold Coast Health in Queensland. The study also examined routinely collected activity data for the chronic disease programs before COVID (January-February 2020) and for the first 3 months of the COVID-19 response (March-May 2020). Results Chronic disease programs continued to provide similar numbers of appointments over the COVID-19 response period, but there was a marked increase in the proportion of appointments that were delivered virtually, either by telephone or video conference. Most patients were satisfied with their virtual care experiences and felt that their health care needs were met. Conclusions The COVID-19 response provided an opportunity to learn and further develop models of virtual care. Staff and patients were generally supportive of continuing to include virtual appointments in the future. Ongoing concerns were predominantly around the support available to patients and staff to ensure they are trained and equipped to manage the technology and new mode of communicating. What is known about the topic? Emerging evidence suggests that virtual models of health care delivery, such as telephone and video consultations and remote patient monitoring, can be safe and cost-effective alternatives to traditional face-to-face chronic disease management programs. Virtual care is associated with equal or improved clinical outcomes, as well as efficiency improvements, such as reduced failure to attend rates. What does this paper add? The increasing burden of chronic disease across Australia, as well as the need to minimise the risk of vulnerable patient groups attending in-hospital appointments where it is safe and appropriate to do so, means that expanding the delivery of virtual chronic disease management will become increasingly necessary. The results of this study provide an opportunity to learn from a rapid rollout of virtual care for these staff and patient groups and will help inform advances in this area. What are the implications for practitioners? Existing evidence, demographic pressures and the COVID-19 pandemic response all point to virtual care as a viable and safe alternative to traditional models of chronic disease management. The lessons presented here provide more detailed guidance on the support that staff and patients require to ensure virtual care is a seamless and safe alternative or adjunct to traditional chronic disease management programs.
目的 本研究调查了黄金海岸工作人员和患者在 COVID-19 大流行期间对慢性病管理虚拟模式快速扩张的体验。
方法 该研究对昆士兰州黄金海岸卫生保健中心提供慢性病项目的注册患者（n=24）和临床及行政工作人员（n=44）进行了调查，并进行了焦点小组讨论。该研究还检查了 COVID 之前（2020 年 1 月至 2 月）和 COVID-19 应对的前 3 个月（2020 年 3 月至 5 月）期间慢性病项目的常规收集活动数据。
结果 在 COVID-19 应对期间，慢性病项目继续提供数量相似的预约，但通过电话或视频会议提供的虚拟预约比例显著增加。大多数患者对他们的虚拟护理体验感到满意，并认为他们的医疗需求得到了满足。
结论 COVID-19 应对提供了一个学习和进一步发展虚拟护理模式的机会。工作人员和患者普遍支持在未来继续包括虚拟预约。持续存在的主要问题是为患者和工作人员提供支持，以确保他们接受培训并具备管理技术和新沟通模式的能力。
已知主题？ 新兴证据表明，诸如电话和视频咨询以及远程患者监测等虚拟医疗服务模式可以替代传统的面对面慢性病管理计划，而且安全且具有成本效益。虚拟护理与同等或改善的临床结果相关，以及效率的提高，例如降低未到诊率。
本文增加了什么？ 随着澳大利亚慢性病负担的增加，以及在安全且合适的情况下，尽量减少弱势群体在医院就诊的风险，扩大虚拟慢性病管理的范围将变得越来越必要。这项研究的结果为这些工作人员和患者群体快速推出虚拟护理提供了学习机会，并将有助于为该领域的发展提供信息。
对从业者有何影响？ 现有证据、人口统计压力和 COVID-19 大流行应对都表明虚拟护理是传统慢性病管理模式的一种可行且安全的替代方案。本文提供的经验教训为确保虚拟护理是传统慢性病管理项目的无缝且安全替代方案或辅助方案，为工作人员和患者提供了更详细的指导。
