ABSTRACT
Background: The COVID-19 pandemic created unprecedented challenges to health care delivery. There was a need to transition to outpatient telehealth visits that involve distanced real-time interaction between patients and providers using audio and video capabilities without direct physical interaction. We co-designed a virtual cardiology clinic at our centre that services all correctional facilitates across New South Wales, which is Australia’s most populous state with a land mass bigger than Texas. Objective: We describe the creation of a virtual care specialist outpatient cardiology clinic for correctional services in NSW and assess the service delivery compared to the pre-COVID face-to-face clinics. Methods: Patients were triaged to in-person or virtual clinics via an online referral system. A co-ordinated approach between our centre and Justice Health and Forensic Mental Health, enabled streamlined access to referrals, patient clinical records, investigations and appointments, with future plans of a reciprocal EMR arrangement. The virtual clinic comprised of a clinician, Justice HealthCare Coordinator and an in-facility nurse. Consultations are performed via telehealth with audio and video capabilities, and real-time access to 12-lead electrocardiograms, blood results, medication and observation charts via the EMR portal. We retrospectively reviewed changes in clinic waiting lists, clinic utilisation and patient transfers pre and post implementation of the virtual clinic. Results: 30 clinics were performed with 127 appointments completed over a 6-month period, with 113 virtual and 14 face to face appointments, resulting in 113 patient transfers saved. The waiting list reduced from 66 to 0 with a 33% increase in clinic utilisation during the 6-month period. Conclusion: Implementation of a telehealth cardiology clinic for correctional services in NSW resulted in a reduction in our waiting list, reduced patient transfers and increased clinic utilisation.