Northland gets acute clinical telehealth network

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Picture:  Whangarei ICU’s Michael Kalkoff discusses a case with Kaitaia Hospital senior medical officer Damian Marsh and registered nurse John Walker via RITA.

Northland DHB has developed a mobile telehealth cart linking its rural hospitals to the intensive care unit at Whangārei Hospital.

The carts link rural hospitals in Kaitaia, Bay of Islands and Dargaville and will extend to Rawene next year.

ICU consultant and clinical lead for the project Michael Kalkoff says the new service allows 24/7 remote patient assessment and management in the acute clinical setting and enhances assistance and decision making for acute retrieval requests from rural hospitals.

It also provides Whangārei Hospital with an after-hours telestroke service.

“The carts create a truly integrated acute clinical telehealth network,” he says.

“The 24/7 remote access capability allows for multiple clinicians in different locations to assess patients together in a multidisciplinary approach.”

The acute retrieval service, RITA (Rapid Information Telehealth Assessment), uses Zoom videoconferencing with the carts controlled from a computer workstation, tablet or cell phone.

The mobile carts are moved to the patient’s bedside and from there all other functionality is controlled at the ICU end, enabling rural hospital teams to be hands off with the technology and concentrate on their patient, Kalkoff explains.

The ICU end can control the call and functions of the two cameras, including a powerful zoom.

“RITA enhances Whangarei ICU’s remote acute assessment capabilities to rural hospital emergency departments and wards, patient safety through direct rapid patient assessment, as well as advising on patient management of the acutely unwell patient,” he says.

“This includes assisting with decision making in determining the safest way to transport the patient.”

The Northland Telehealth and Mobility team developed the cart in conjunction with Northland DHB intensive care physicians, Connect NZ, healthAlliance and the University of Queensland Centre for Online Health.

Kalkoff says an evaluation of the service shows that the telehealth cart system increases patient safety, helps to ensure adequate resource allocation and reduces unnecessary flights to hospital.

In the evaluation, 72 per cent of clinicians recorded that using the device added to the advice that they were able to provide and around one third of cases showed change in acute management

He says in one case a one-year-old baby did not have to be transferred by helicopter to Whangārei Hospital after being assessed via telehealth and stabilised with the help of specialist teams.

In another case RITA was used by the hospital’s ICU team and remote on-call renal specialist linking in to a rural clinical team in Kaitaia to discuss a patient’s situation and treatment was able to be started before the patient could be flown to Whangārei for further treatment.

“Seeing the patient as well as enabling a collegial discussion with all teams involved improved the level of support that was provided,” Kalkoff says.

If you would like to provide feedback on this news story please contact the editor Rebecca McBeth.

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