Beyond video consultations – leading our virtual care

5 Dec 2022

The appointment is an indication of the future direction for the health care organisation, which is one of Australia’s larger Catholic not-for-profit health care organisations, beyond traditional hospital-based care and into the home and community.

But this is only half the story, Nicole’s appointment to the role after more than 30 years with the organisation and a career that started as a nurse and has included hospital projects and transformative digital innovations for disability housing, is the other.

Virtual care is about new and enhanced models of care

For most, the phrase virtual care brings to mind virtual reality goggles, video appointments and for the more ambitious Star Wars-style holograms of doctors providing care.

Nicole quickly dispels this and explains it is more about developing new and enhanced models of care that use technology to provide patient-centric care.

“I’m not focused on the technology, virtual care is about designing new models of care or improving existing models of care and then using technology to enable those models of care,” she said.

Nicole is currently working with hospital, services and strategy committees to identify specific opportunities for virtual care.

“There are a lot of opportunities to move care into the home. Palliative care is a good example as so many of us would prefer to die peacefully at home so we need to ask ourselves how we deliver good palliative care in the home via a hybrid approach of face to face and virtual care, achieve safe outcomes and provide good patient experience,” she said.

“There’s is a lot of focus currently on virtual emergency departments (EDs) in several states. We all know just how busy EDs are, so can we find opportunities where people don’t always need to go into and ED and instead offered a virtual front door where you can contact someone before you come in and determine whether that’s the best place to go or how else you can get support."

“Another really strong example is using wearables at home to monitor patients with chronic diseases such as diabetes, to avoid extended lengths of stay in hospital after procedures or unnecessary readmission.”

Putting the patient first

St John of God Health Care’s strategy clearly and definitively puts patients and clients at the centre of everything the organisation does.

Nicole said the virtual care strategy is key to this.

“A big piece of our virtual care approach is looking at how we engage with our patients and clients across their journey,” she said.

“There is the need to look at what technology we have in place that lets us engage better. At the moment, we have a lot of different tool and apps that engage with patients. I want to look at how we create that seamless, secure view for patients where they can go in without having to download three apps across a whole episode of care and avoid repeating the information they enter.

“As such, the most immediate task is to put in place governance structures for virtual care so that the organisation acts as a whole and we make good, evidenced based decisions about where we invest money for the benefit of our patients and clients.”

Changing expectations

The drive to virtual care is something that St John of God Health Care is not doing by itself, the change is coming across the health care industry led in part by funding pressures and tighter margins but also consumer expectations.

“COVID was the catalyst,” she said.

“It created a need which we had to respond to and now post-COVID, people know we can provide care remotely so they expect it.

“Consumers are already demanding this, and better ways of interacting with health care providers and if we don’t do it, other people will.”

Responding to this changing expectation is also providing more control to patients and clients.

“Consumers want to have much more control of their health and we are really at the starting point in providing this. It will become a bigger focus in the future,” Nicole said.

“The involvement with patients, isn’t just at the point of delivery, we need to ask them what they want and co-designing our models of care with them across the full journey.

“I’ve experienced this first hand, when my partner went in for a minor procedure and ended up with a poor outcome which required readmission three times. I realised that there was a lot of things we could do around picking up early deterioration for better patient outcomes.”

From hospital floor to leading strategy

Nicole’s focus on patients and clients, even in the digital sphere, is no surprise considering her career started on the hospital floor as a registered nurse in theatres and emergency departments.

She spent about eight years at St John of God Subiaco Hospital working clinically before putting her hand up for an opportunity to help implement a new theatre system.

That chance decision led her to more projects and digital and information technology opportunities, and she soon left the hospital floor to work as a project manager, then program manager and a customer relationship manager in IT.

She supported the IT program to ensure St John of God Midland Public and Private Hospitals opened on time and on budget, a role she repeated again at St John of God Berwick Hospital with similar outcomes.

She then spent the past five years working in community services implemented technology strategies including electronic medical record systems in community mental health, and the innovative smart homes project to improve the quality of life for St John of God Accord clients with intellectual disability. She recently led the co-design and commissioning of the Midland Head to Health Centre.

“I have  nursing knowledge, and understanding of how our hospitals and service run, and I have skills in delivery technology programs but my prime driver continues to be health outcomes more than the technology,” Nicole said.

“I never thought I would stay with one organisation for more than 30 years but St John of God Health Care has always provided me with great opportunities and I moved into roles that aligned with my career direction.

“Working with St John of God Health Care really gives me that sense of purpose.”

“I had no expectations when I first put my hand up for a technology role as a nurse, and it has led me on what has turned out to be an amazing career. I don’t regret it.”