Does telehealth/virtual care impact patient care?

COVID-19 led to unprecedented changes in the way that we deliver healthcare at the Royal Brisbane and Women's Hospital (RBWH). In many cases, services rapidly transitioned from face-to-face appointments to using telehealth. This research grant will investigate what worked, what didn't work and how we can best embed telehealth/ virtual care into services such as the Heart Support and Pulmonary Rehabilitation Services in a way that is patient focused, delivers evidence-based care, and is able to scale up and scale down as need arises. The Heart Support Service (HSS) and Pulmonary Rehabilitation services at RBWH assist patients through symptom control, behaviour change, exercise rehabilitation and medication optimisation. Evidence suggests aspects of care that can be delivered virtually can be cost effective, improve adherence to therapies and induce similar outcomes to usual care. Despite this evidence, uptake of virtual care in heart failure and pulmonary rehabilitation programs across Australia has been poor. The COVID-19 pandemic created an urgent challenge to meet the needs of these high-risk patients at a time when hospital avoidance was critical to mitigate risk and to free-up hospital capacity. There was rapid substitution of video and telephone support for face-to face occasions of service, but the equity, acceptability and effectiveness of this change is unknown. The "natural experiment" posed by COVID-19 provides a unique opportunity to measure the impact of a rapid change on the patient experience, clinical roles and organisational capacity. The findings will inform ways to ensure the sustainable uptake of virtual care and blended models in chronic disease management at RBWH.