Victorian authorities have announced the expansion of a virtual emergency department program in a bid to free up ambulances and hospitals which are under increasing strain.
Premier Daniel Andrews announced a program running at Victoria's busiest ED will be doubled to treat at least 600 patients a day in response to the challenging flu season and the Omicron BA.5 variant.
The Victorian Virtual Emergency Department was set up at the Northern Hospital in October 2020 and allows patients to have a consultation with a doctor or nurse without having to be taken to hospital by ambulance.
It has already treated more than 28,000 patients and Mr Andrews said 71 per cent avoided going to hospital after receiving advice and instructions via video conference.
"That means there are less trips, less transport, more ambulances freed up to attend to the next triple zero emergency or next lights and sirens emergency," he said.
"No- one wants to spend time in an emergency department.
"If you can get the care you need … that doesn't see you having to leave your home and sees all of our resources used as best we can possible use them, that's a great thing for the system."
A recent ABC investigation revealed some patients have been forced to wait in overcrowded emergency departments for more than 12 hours before giving up on seeing a doctor.
Rising COVID-19 hospitalisations and staff shortages have led to some Victorian hospitals cutting back on elective surgery, while surging demand and staff illnesses has caused Ambulance Victoria to call seven code reds in as many months.
About 2,000 hospital workers are unable to work due to illness each day, and in the first week of July alone, there was a cumulative absence of more than 10,000 staff across the health system.
The Northern Hospital's clinical director of the program, Dr Loren Sher, said it went further than telehealth appointments available at GP clinics.
"When a patient comes through, they'll get triaged by the triage nurse and then directed through to a 'medical waiting room' if appropriate where they can have a video consultation with one of the doctors in the service," Dr Sher said.
"We can see the problem that they're having and it's pretty easy off the back to see whether they need escalated care or whether we'll keep them at home."
Dr Sher said the virtual ED was not for life-threatening emergencies but triage staff would call an ambulance if they thought the patient needed immediate treatment.
She said the program had allowed 80 per cent of COVID patients to continue isolating at home and not go into hospital.
"Patients that are potentially getting worse or sick, perhaps are deteriorating, and are unsure whether they should attend an emergency department, they can contact us and we can provide a consultation," she said.
She said the Northern Hospital was looking to involve GP clinics to give patients early access to anti-viral treatments, which she hoped would also drive down hospital admissions.
Staff 'doing the best they can with limited resources'
Health Minister Mary-Anne Thomas said 65 per cent of aged care residents using the service had avoided being transported to hospital.
"Health care workers can tell you that often the worst place for an aged care resident to end up is in ED," she said.
"If we can provide the medical advice and support that that resident needs in their home, then not only are we delivering better care for that person, we're also ensuring that we're driving down those preventable hospital admissions and we are taking pressure off our emergency department systems."
Roderick McRae, president of the Victorian branch of the Australian Medical Association (AMA), said the expansion was welcome, but did not represent "the entire solution" to issues in the health system.
"This is not the panacea, it's not going to solve all problems, but it's certainly a step in the right direction of improving the whole-of-hospital care a patient will experience once they attend a public hospital," he said.
"Anything that reduces the presentation of patients to the emergency department is welcome because the staff are fatigued ... they haven't had a break themselves.
"They're doing the best that they can with limited resources."
More, better-rested paramedics on the road
Ambulance Victoria's Care Pathway Improvement lead, Amanda Thornton, has been working on the program since its inception.
She said it took 40-60 minutes for the average case to go through the virtual ED.
Ms Thornton also welcomed the announcement of new flexible rostering for the state's paramedics including a staggering of their 14-hour night shifts.
"Our workforce will be less fatigued, reduce sick leave and we'll be able to come to work feeling much more engaged," she said.
The health minister said the new rostering pattern for advanced life support paramedic crews would see more paramedics available at peak times.
Ms Thomas also announced more efficient real-time monitoring of ED capacity to help paramedics make better decisions about which hospital to head to, and expanding Ambulance Victoria off-loading teams to 14 major public hospitals.
She said both initiatives would also get ambulances back on the road faster.
Mr Andrews said the combination of COVID-19, a "nasty strain of the flu" and burn-out had created a unique situation in Victoria's health system.
"Any system with a couple of thousand people away each day, and that's just COVID absences, flu on top of that, fatigue and all sorts of other perfectly legitimate reasons that people would perhaps be not able to report to work, that makes life really, really challenging," he said.
Meanwhile, there are concerns that regional Victorian hospitals have been overlooked in a $162 million state government package designed to recruit 400 extra healthcare workers to address staff shortages.
A study published late last month found deadly ambulance ramping at Victorian hospitals was already on the rise before the pandemic hit.
"Daniel Andrews has been in charge of Victoria's health system as Minister or Premier for 11 of the past 15 years – he cannot escape responsibility for this crisis," said Shadow Health Minister Georgie Crozier.
