Discussion
- eCDS is four times cheaper than employing just one specialist locally while still providing access to expertise within the community.
- High engagement with 0% DNA rate
- 93% of families accessing eCDS identify as Aboriginal and Torres Strait Islander
- 83 % of local clinicians identified that eCDS improved professional growth and skills, was rewarding and increased their confidence in supporting children and families with assessment and development
- 72% of children seen through eCDS did not require a specialist level review
- 100% of the clients seen through eCDS were long waits breaches for specialist services across HHSs
- Using a Family Outcome Scale (FOS) eCDS was identified by families as being mostly and extremely helpful as an early intervention service, supporting families to communicate their child’s needs and helping their child learn and develop
Lessons learnt
eCDS was developed with the goal of providing equitable access to specialist child development diagnostics using an interdisciplinary, virtual model of care. There have been many positive outcomes and lessons learnt for ongoing care in outpatient paediatric care across the state, including:
- For most families a virtual service delivery is helpful
- Virtual CDS delivery can be equitably delivered throughout the state regardless of geography
- eCDS has shown significant efficiencies clinically (less demands on specialist services), systemically (reduced outpatient long waitlist), financially (cheaper than transporting families to other HHSs for care, cheaper than employing specialist)
- Virtual CDS delivery can be an effective model to address long waits breaches throughout the state
- eCDS inter-professional model can be a useful model to support staff retention and address staffing gaps in HHSs where recruitment of specialist staff is historically difficult.
- eCDS is a flexible and responsive model that can be used in a number of ways. The model was utilised through the Covid-19 period within the metro region (CHQ) with similar positive outcomes and efficiencies.
Sustainability of the model is an area of development. eCDS is an innovation project that was initiated through the Clinical Excellence Queensland's Child and Youth Clinical Network. Due to the statewide focus and the integrated nature of the model across HHSs there are a number of system and financial barriers that need to be clarified before eCDS delivered virtual services can be provided throughout the state in a sustainable way.
References
Bringing specialist child development service to Queensland’s rural and remote families, Excellence Matters, 2020.
Wood, Stathis, Smith and Krause. (2012). E-CYMHS: and expansion of a child and youth telepsychiatry model in Queensland. Australasian Psychiatry. 0 (0), 1-5.
Smith, Stathis, Randell, Best, Ryan, Bergwever, Keegan, Fraser, Scuffham and Wootton. (2007). A Cost-minimisation Analysis of a Telepaediatric Mental Health. Journal of Telemedicine and Telecare. 13: 3.
Further Reading
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