Global Exemplars of Digital Healthcare | Insights with Karen Chia

In this edition of Coviu’s Future of Digital Health Series 2024 we talk to Karen Chia, a contributor to the “Care is Care” collaborative white paper. Karen shares her insights drawn from her participation in the study which examined international digital health models and their potential applicability to digital healthcare in Australia.

The goal of the "Care is Care: Optimising virtual and digital healthcare Industry” Collaborative White Paper published at the end of 2023 was to summarise overseas best practices uncovered during the collaborative industry group’s research and reshape digital healthcare perceptions and practices in Australia and New Zealand.

Karen Chia, a virtual care expert with six years of experience in implementing virtual care strategies, shared valuable insights with Coviu into the drivers of the study and her observations and findings throughout the research project.

Karen Chia, Contributor 'Care is Care' Whitepaper

Common Barriers Encountered in Digital Healthcare Driving the Research Study

Karen expressed her initial excitement about joining the study, driven by her desire to explore how international healthcare models were tackling what she identified as three persistent barriers to the adoption of digital healthcare in Australia.

“The research foundations for the study matched common barriers that I had seen over the past few years and I was excited by the opportunity to know what other countries were doing to address it.”

The first barrier Karen noticed was the absence of sustainable funding models to realistically implement broad-scale virtual care strategies. Funding challenges often arose for clinicians during the transition from pilot programs to full-scale implementation, where the current lack of system funding hindered the scalability of virtual care practices. As a virtual care strategist, Karen was constantly meeting funding roadblocks.

Technological limitations often emerged as another critical obstacle in Karen’s work with healthcare organisations, with the ideal integration of platforms proving to be a costly endeavour. Despite some success among small private providers, Karen’s experience was that large-scale hospitals struggled to achieve seamless technology integration between their electronic medical records, virtual care platforms, biomedical devices and digital front doors.

“In an ideal world environment, you have a patient portal that’s linked to your electronic medical record that has telehealth and remote monitoring capabilities on the same interface. You can automatically upload your monitoring vitals, review your care plan and upcoming appointments, be directed to health education content, and click on a telehealth icon and that opens up a video call. You would also be confident that the health data you are providing is being adequately reviewed and that any causes of concern are relayed back to you in a timely manner. That’s what a really seamless experience would look like for a patient. But the reality is, that kind of integration and technology can be expensive,” says Karen.

Karen also identified that the fatigue commonly experienced by clinicians, exacerbated by additional administrative load and the need for technical support during the COVID-19 pandemic, presented a significant challenge. The simplicity of picking up the phone during challenging situations often outweighed the perceived benefits of virtual care.

Virtual Care is the Most Viable Solution to a Global Healthcare Capacity Crisis

Karen was also interested in the study because of a steadfast belief that virtual care is the most viable solution to the current healthcare capacity crisis. She emphasised that scalability and accessibility are the key advantages virtual care offers that directly bridge the gap in healthcare inequality caused by healthcare shortages, especially in rural and regional areas.

“Virtual care helps to solve healthcare capacity for two key reasons; scalability and accessibility. Most people understand technology offers scalability because it allows us to do more in a shorter amount of time. In a healthcare context, it means certain levels of care, such as chronic disease management, can be monitored or provided to a larger cohort of patients when pathways are digitally enabled. Accessibility is aided by virtual care's ability to  bridge the distance barrier and provide patients with more timely access to care providers, such as specialists, without the significant stresses associated with needing extensive travel to seek care.”

Further, Karen explained that virtual care enables alternative care pathways that can alleviate pressures on our emergency departments and within our hospital systems. Virtual EDs, hospital in the home, and virtually enabled community care models that allow patients to leave the hospital earlier have demonstrated success in Australia and overseas.

“So the point is,” said Karen “Virtual care has a wide range of benefits and I’m passionate about whatever needs to be done to see it taken up; not just previously as a solution to COVID, but as a new standard of care going forward.”

Clear Consumer Preferences for Virtual Care

Karen said it’s not just her and her colleagues backing virtual care. She said studies show the consumer demands it with under 50-year-olds having a strong preference for virtual care. Given this, Karen believes it has become too late for clinicians to ignore the modality. The desire for more options, convenience and improved care standards within the community highlights a shift in expectations, mirroring experiences in other industries such as retail and banking.

“But this isn’t a new attitude. In a study I was involved in a few years ago we interviewed about 2000 parents about their preference for virtual care. The majority agreed they would embrace virtual care for their children in outpatient care.”

Innovation Culture is the Foundation for Widespread Digital Care Transformation

Karen highlighted that the study revealed five other considerations key to widespread transformation. The first finding was that organisations needed to have an embedded culture of innovation. Karen explained that this type of culture is in its infancy and growing in digital healthcare, but it does exist in healthcare generally.

“The most powerful lesson we took from this study is about the mindset of the innovators we met and that is – innovation starts with just starting – underpinned by a strong connection with clinical research processes. Our global colleagues explained this process through three key points. Firstly, what they called ‘end-to-end innovation process’ involved combining research and prototyping with the health practice. This eliminated the inertia often caused by the pursuit of perfection, which can otherwise prevent prototypes from deploying to the real world in a timely manner. The second is that they were also supported by collaboration and capacity enablers meaning they had the ability and collaborate with industry and academic partners. And lastly, they were less hindered by their regulatory environment by having governance and funding frameworks in place that supported innovation.”

Multidisciplinary Teams Are Needed to Make Virtual Care Work

The Care is Care collaborative industry group concluded that the model of the future is where healthcare organisations have dedicated digital service delivery teams that operate alongside clinically trained professionals. The paper explored the multidisciplinary team model of the future, envisioning a blend of clinical and non-clinical roles. The introduction of dedicated digital service delivery teams, including data analysts and logistics specialists, showcased a proactive approach to address evolving healthcare needs.

“I really liked this concept,” said Karen, “Because it changes your care team to include the most suitable and trained professionals to deliver the care in the modality most appropriate or preferred by the patient. It means clinicians can work at the top of their scope and focus on what they do best, which is healthcare”.

Patient-Centric Approaches

The conversation shifted towards what stood out for Karen in her observations of overseas models. She said she was really impressed with the Danish digital health strategy which emphasised individual responsibility for maintaining wellness and challenged the traditional patient-centric approach.

“In Denmark, they don’t call patients ‘patients’. They call them ‘citizens’. This implies that you’re not a patient of the health system, you’re a citizen of the health system. There is a responsibility to maintain your wellness and empower yourself when you’re receiving care. So I thought that was a huge shift in mentality, particularly applicable to Australia, where we’re still receivers not owners of our care.’

Australia is a Leader in Digital Healthcare

Despite some challenges and overseas models to draw inspiration from, Karen emphasised that Australia is making strides in virtual care adoption and in many ways is still a leader. Exemplar models of care, such as Victoria’s Virtual ED, NSW’s Virtual Rural Generalist Service, SA Health’s My Home Hospital and the Sydney Children’s Hospital Virtual Kids initiative, highlight positive domestic efforts within the healthcare landscape.

“There are significant efforts across Australia with health services rolling out impressive virtually enabled models that are making an incredible impact to patients and the health system at large.”

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