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Organisation finds video offers more ways to connect than meet the eye. 

Not-for-profit health and community care organisation Silver Chain is using Polycom video technology, together with tablets and a secure platform, to overcome distance. Nurses have access to media phones, screens on carts and mobile applications on tablets.

The technology allows staff to access support and advice, whether they’re stationed in a clinic or in a patient’s home. Nurses can seek outside support remotely to make a change in care or consult other professionals.

“One example could be a wound that is not healing and the nurse requires further expertise in managing the wound with the client,” Silver Chain general manager country services, Carole Bain, says. “The in-home nurse can use the mobile application to ask for a specialist’s input, and this can all be done from the patient’s living room.”

Bain says this means quicker and sometimes more accurate care. “It also ensures the client is fully involved in their care and can understand why things [need] to be changed, [whilst also] having interaction with more than one nurse,” she explains, adding the technology has resulted in more collaboration and sharing between teams.

Silver Chain originally used the Polycom VVX phones as a pilot program in a metropolitan area and then launched them in remote locations.

Bain says Rosie Clarke, clinical nurse manager at Silver Chain, was instrumental in facilitating the widespread use and embracing of video technology amongst remote area nurses (RAN) and was able to perform competency-based training via video.

Silver Chain’s country services team then explored using Polycom technology on tablet devices and worked with the company and Telstra to find a solution that would meet the needs of the company and integrate video capability, whether the work was in an office, clinic or community.

The reduction in travel time, down time and accommodation expenses has had cost benefits for the company, Bain says.

There have also been perceived benefits for patients, predominantly around access to experts at point of contact, meaning a reduction in waiting time. “We have increased community access to some specialist services in rural areas, like diabetes education in Shark Bay and speech therapy in Brookton,” Bain says.

She adds there has also been the greater socialisation, as clients involved in telehealth have been able to use the video system to connect with distant family and friends as well. And Clarke says the technology has allowed connections with staff at all times, regardless of location.

Silver Chain has a partnership with an Aboriginal medical service in the Pilbara, where diabetes education involving the health workers there is being conducted.

Bain says, “This new technology is assisting in not just client outcomes but also up-skilling the health workers locally to be able to support their clients, and subsequently building on the community capacity and service sustainability.”

Clarke adds, “Having access to visual communication with our patients, who are often in remote parts of Australia, allows us to be able to see exactly what the issue or medical condition may be.

“With video, I can more easily diagnose exactly what the patient may be suffering from, as I can see the visual signs. For example, if a local nurse has to perform suturing, they can simply dial me in via video so I can provide advice remotely.”

She adds this has enabled nurses to make safer recommendations and also acts as a security blanket. “Sometimes when you are dealing with patients, you can feel a little rusty on techniques, or you may be unsure if the advice you are giving is correct,” Clarke says. “However, when you have someone on the screen offering tips it provides that extra bit of support so you feel more comfortable and confident.”

In one case, a RAN who was stationed where the closest medical support team was eight hours away was able to get clinical support. And not all centres have midwives but the video allows RANs and pregnant patients to access midwifery advice.

Clarke says video also provides training benefits. “With our centres being scattered across the state, it is often not practical for staff to close their centre for a day, or sometimes even days, to travel for training,” she explains. “However with video, we can offer training to many staff at once, from remote locations, without anyone needing to travel.”

Recently, the organisations’ mental health trainer conducted sessions with all of the centres tuning in. “This allowed for discussions between centres about their experiences with mental health training, which was extremely valuable for everyone involved, and it meant no one needed to travel,” Clarke said.

Video is also used to train staff when new equipment is being implemented, allowing nurses to see firsthand how to use new devices. On top of this, staff members’ mandatory skills are assessed using the technology. This allows Clarke to evaluate staff as they perform in their normal place of work.

“This method has proven to be more successful than staff attending classrooms, where often their work practices are different,” she adds. “Video allows me to see how they function in their day-to-day environment.”

Clients can be trained in this way as well, such as those with chronic diseases. “With video we are able to have training sessions with clients in their own home, with a clinician in another area,” Bain says. “This is assisting in the empowerment of clients in disease management and in making support for education more available.”

Silver Chain also has virtual meeting rooms, allowing for group training sessions with nurses across the country.

In addition to the benefits surrounding training, Clarke says the technology has social benefit for nurses. “Video also helps to remove some of the isolation our nurses may experience when working in remote locations,” she explains. “If one nurse has a bad day, for example, it can help to discuss the problem face to face with a colleague.”

Initially, some staff were hesitant to use the technology; however, Clarke says once they saw the benefits they were receptive. She adds it is easy to use and is “just like dialing a voice call so the adoption rate has been substantial”.

Bain adds this has been the same experience that they had with clients, particularly when tablets were allocated as part of telehealth monitoring.

Bain admits the technology doesn’t always work the way it is meant to. “[As with] the introduction of any technology or new way of working, there have been challenges,” she says. “Our main challenge with video is often connectivity. The technology is not usually the issue, but rather the [lack of] access to sufficient connectivity can cause problems on occasions, especially in rural and remote locations.”

Silver Chain is looking to increase connectivity in some areas but is limited by cost restraints. Bain says the team manages well with the current level of access.

“As an organisation, we see technology as an enabler to any services or programs we offer,” Bain says. “As we review our models of care, we look at how we could add technology to support improved outcomes for clients, as well as efficiency of service, allowing us to then provide an increase of services within the community.

“Essentially,” she says, “it is all about where we can have the most impact for our patients and staff.”

Benefits of video

• Improved connection
• More engagement
• Better access to training opportunities
• Improved client outcomes
• Access to services for clients that is otherwise not possible, such as remote diagnosis and remote medicine administration
• Increase in access to expertise through specialists and doctors, for both staff and patients

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