VOICeD

Patient centred care is the gold standard which we’re all striving for. From providing services in ways that suit consumers, collaborating across specialties and streamlining processes, it is a rich tapestry that goes in to achieving that aim.

VOICeD, or the Virtual Outpatient Integration for Chronic Disease, is a game changing service bringing multiple clinicians together via telehealth with the patient for a single consultation. It reduces the number of times a patient interacts with a health service, but exponentially improves the quality of the care provided.

It saves people like Thea multiple lengthy drives down a winding mountain road or people like Tony with accessibility requirements the time spent worried about logistical considerations.

From the bush to beach or even just down the road, a service like VOICeD is making sure care doesn’t take away from Thea and Tony living their lives.

And better yet, this is only just the beginning.

Thea's Story | Virtual Outpatient Integration for Chronic Disease

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Thea's Story | Virtual Outpatient Integration for Chronic Disease - video transcript

Thea Buthmann
Hi, my name is Thea Buthmann, I come from Kurranda North Queensland, my family from Yuru country Takaklak and Kuka-Yalamji people. Were actually on Djabuganjdji country at the moment, but we love it this time. Yes, I was diagnosed when I was 40 that I was a diabetic, took me a very, very long time to accept that I was a diabetic. I was, I was in denial for many years. And then now I'm 63. I'm actually in stage 4 renal failure. I actually have peritoneal dialysis at the moment, and I do it at home.

Dr Shyam Dheda
My name is Gaurav puri. I'm an Endocrinologist and here we are in Cairns hospital. You can see the background behind can't be anywhere more beautiful than this. VOICeD stands for Virtual Outpatient Integration for Chronic Disease. The VOICeD is nothing but an MDT combined with telehealth and we took it to the patient's closer to their homes. Telehealth is widely used in Queensland, the infrastructure provided by the Queensland Health, even in the outer Island remote communities was fabulous. And I thought, well, if you've got the telehealth facility available here, why can't we combine the three specialties or clinicians sitting on the other end and providing a comprehensive review for the patient, then still, you're killing 12 appointments with maybe three or four. Most importantly, taking into account what patients have to go through.

Thea Buthmann
I've had cardiac appointments, I've had renal appointments, I've had diabetes appointments, I have it every month, or if I if I'm ok every two months. So it's a 45 kilometer drive from here to Cairns, and if it's raining, it's terrible. Very dangerous in driving down there. But I always go for my appointments. Yes, it's important. And I think that's a better way of actually doing your appointments, telehealth, it's a lot easier for me to be able to just go on the telephone on the on the TV, have my consultations and then everybody is aware, everybody is on the same page. Everybody knows exactly what's happening. And I liked it.

Dr Shyam Dheda
So the VOICeD model, we should call it is a is a collaborative model which effectively uses telehealth and collaborative medicine. To minimize the number of times a patient needs to interact with a health service. But at the same time, tripling or quadrupling the quality of that consultation.

Dr Gregory Starmer
We live in an era now where we're seeing an increasingly complex group of patients people are living longer. And therefore they're living with more medical problems for longer. So a model such as such as this, it really compresses the the healthcare requirements for that patient. But also from our point of view. It's fantastic for collaboration across different specialties. It reduces the need for, you know, the usual traditional mechanisms of communication, such as letters or even phone calls after the patient has left.

Thea Buthmann
They're all treating me. So it's a bit silly with me going to one and I'll go to another that I got to another and really do they all know what's happening. But with them all together, it's so much better, because then they're all aware and they all make decisions together. But I make decisions for myself, I don't allow them to make all the decisions for me.

Dr Gregory Starmer
I'm a Cardiologist, but I have learnt diabetic medicine and I have learned renal medicine and there is a significant overlap. And as we have split further and further into sub specialty medicine, we do less and less of the crossover. And this type of model eliminates that it really brings us back together which is great for the patient care.

Thea Buthmann
Before I got sick when I got weak and I got tired, I was very active. I did a lot of stuff in my life. I used to work as a head coordinator, where we actually deal with aged clients right across the Tablelands. And we had 500 clients, I loved that job. My grandchildren. I've got six grandchildren love them all dearly. They run me ragged at times, but it's lovely having them around you

Dr Gaurav Puri
For once we take into account that their patients do have a life outside hospital. Now we've got a patient who is from Mossman, which is let's around an hour and a bit drive from Cairns. And the patient was booked to be seen through VOICeD clinic, and due to family circumstances, the patient had to fly to Western Australia. Well, we're not going to cancel her appointment. Because this is a web based portal. The three Specialists clinicians will be sitting in Cairns, the patient will be sitting in Western Australia, and the GP will be dialing in from Mossman Hospital. Now, just to say with the holidays, or life or family or circumstances change, you're not missing out on your appointment you're not feeling as if it's an onus on you to make it to your appointment.

Dr Shyam Dheda
The destination is important, but the journey is probably more important for many people and I think VOICeD improves that experience.

Tony's Story | Virtual Outpatient Integration for Chronic Disease

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Tony's Story | Virtual Outpatient Integration for Chronic Disease - video transcript

Dr Gaurav Puri
Tony, another patient, who genuinely and very highly appreciated how voiced was so helpful in providing care at his house when he was able to talk to and see the three clinicians a specialist involved, Tony was the one who came back with an evaluation, or the feedback that this is probably the best consultation I had ever had.

Tony Byrne
My name's Tony Byrne, and we're in Cairns. I'm only 10 minutes from the hospital. I'm at the hospital quite a bit actually with different appointments with cardiology, kidneys, urology, and to have an all in one I thought we'll try this and see if it works. And for me to go to the hospital, I need to first of all, book my transport, it needs to be at least half an hour before the appointment, get into the hospital, then my appointment and then allowing three quarters of an hour for my appointment. So all up I need to an hour and a quarter, hour and a half for each appointment. When you put that down, sometimes I might have two three appointments I've had in the one week, voice made a hell of a difference. A very big difference. Doing it all online,

Dr Gaurav Puri
The family issues the childcare, time taken from their workplaces, sick leave, elderly parents or people who live in for example, nursing homes not too far away from the hospital who do require to come to the hospitals could be someone who lived for just two straight from the hospital, VOICeD is a mode of care delivery to patients from rural, urban, regional and remote places.

Tony Byrne
All feeling good, I'm feeling fine today. I had my cardiologist, my dietician, and my kidney doctor all online together at the one time, we spoke for nearly an hour and sorted quite a bit. And they followed up from there. What we spoke about, they relayed everything to my doctor as well my GP for follow up with him as well. And and I found the experience excellent.

Dr Shyam Dheda
Collaborative medicine is not a new concept. Neither is telehealth. Neither is outreach, but trying to assimilate all of those things, speaks to the values of equity in medicine and accessibility. I think more specialities will take it on. That's what I suspect will happen.

Dr Gregory Starmer
But I completely agree. I mean, we know from the literature, all of the barriers that people from, from anywhere really, but particularly rural and remote people, particularly our indigenous population face. And it starts with something as simple as well, who am I going to get to look after the kids. And now I've got to come to not one, but three different appointments. And then they're going to talk to each other. And then I'm going to have to hear back from one two, or maybe even all three. So that's six. So the benefits of this are I think, almost unquantifiable.

Tony Byrne
It's a wonder somebody has not thought of it before. And the more they can push this the more they can get people to do this a lot easier for everybody I think.

Podcast

Listen to our podcast on Virtual Outpatient Integration for Chronic Disease which provides gold standard patient centred care.

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Virtual Outpatient Integration for Chronic Disease

Visit the VOICeD improvement exchange webpage to learn more about the improvements being implemented.

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Co-creating virtual care

Visit the Virtual Outpatient Integration for Chronic Disease QUT webpage to learn how the service was established.

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Telehealth

Learn more about Queensland’s telehealth program which enables patients to receive quality care closer to home via telecommunication technology.

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