Remote after-hours semi-urgent care cuts down on ED presentations: EMPHN

A recent evaluation of the My Emergency Doctor service used by Eastern Melbourne PHN (EMPHN) shows that it has helped to cut down on emergency department presentations and ambulance trips, and also provides value for money.

EMPHN first trialled the My Emergency Doctor app in 2018 for after-hours care and then expanded it for semi-urgent and urgent after-hours care in 2019, including for people living in residential aged care facilities.

Specialist emergency doctors who are all fellows of the Australian College of Emergency Medicine (FACEMs) provide online emergency consultations by telehealth, including writing prescriptions and referrals for x-rays and pathology. EMPHN says it was the first PHN in Australia to pilot the service.

The PHN has since completed an evaluation of the service, which showed that approximately 2800 ED presentations and 360 ambulance trips were expected to have been avoided in the EMPHN region over an 18-month period, based on current usage.

The service provides access to after-hours emergency care to isolated populations in eastern and north-eastern Melbourne where there is limited access to after-hours clinics and home visiting doctors.

According to EMPHN, the MED AH service has successfully treated 8402 patients from January 2020 to June 2021. The average MED waiting time was 14 minutes.

The evaluation also identified significant economic benefits from the MED AH service, with a return on investment of $1.93 for every $1 spent on the program, EMPHN says.

The PHN also surveyed over 1000 users, 48 per cent of whom said they would have gone to ED or called an ambulance. “MED was able to manage 73% of these patients in situ, enabling 358 ED presentations and 54 ambulance trips to be avoided,” the PHN says.

“MED was also able to identify 15 additional patients who required ED assessment that would have delayed access to care. A high proportion of patients recommend or would use the service again (99%).”

The service has since been contracted by Eastern Health to provide a new model of care to low-acuity patients presenting at Box Hill, Maroondah and Angliss hospitals.

Eastern Health nurses triage patients presenting at the ED and direct stable and non-urgent cases to a remote specialist, who then assesses them in a private room using a web-enabled device.

My Emergency Doctor is also used by Goulburn Valley Health and Western Victoria PHN.

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