People living with obesity are often faced with concerns and challenges that significantly impact their desire to access care. They include stigma, mental health issues and reduced mobility.
The flexibility of virtual care encourages and enables this vulnerable population to access care in a safe and familiar environment.
Supporting individuals to achieve better health outcomes
The Nepean Blue Mountains Family Metabolic Health Service (FMHS) provides multidisciplinary, tertiary-level assessment and management of severe obesity for people aged two years and over, including in pregnancy. The FMHS was developed to support individuals and families living within the Nepean Blue Mountains Local Health District (NBMLHD) to achieve better health outcomes when faced with the challenges of obesity.
The FMHS provides services across four arms:
- KidsFit4Future, a paediatric clinic
- The Young Adult and Adolescent Metabolic Service (YAAMS)
- The Adult Healthy Weight Clinic (for non-pregnant adult patients)
- The Opal Clinic for women with obesity or history of metabolic and obesity surgery during and after pregnancy.
Since 2018, the FMHS has offered a hybrid model of in-person and virtual care for its patients. There has been a significant shift towards virtual care due to the COVID-19 pandemic, as people with obesity are at high risk for COVID-related morbidity and mortality.
The FMHS virtual services consist of patient-to-clinician consultations, group-based therapy, comprehensive education programs and supermarket tours. Services are provided using Pexip (for groups) and myVirtualCare (for individuals) videoconferencing platforms. Occasionally telephones are used. Patients use their own device at a private and secure location of their choice.
Collaboration through virtual care
All patients can get a referral into the virtual service. They are encouraged to have access to a suitable device and stable internet connection to allow videoconferencing; however, they won’t be excluded on this basis. Technology troubleshooting and telephone consultations can occur if necessary. The Allied Health Assistant supports clinicians and patients during sessions. Each arm of the FMHS has a model of care, eligibility criteria and referral process to address the needs of its patient cohort. There is collaboration across these arms, especially if multiple members of one family are being seen at any one time. They all use virtual care for group and individual interactions
Virtual care has been successfully implemented across the adult, Opal, paediatric and young adult or adolescent arms of the Service in all disciplines. This enabled continued operation throughout the COVID-19 pandemic without exposing patients and families to the increased risk that comes with in-person consultations.
Improved satisfaction noted by consumers
Occasions of service in August 2020 were equivalent to that of August 2019 (virtual care versus in-person). This means that virtual care was able to maintain the FMHS model of care throughout the COVID-19 pandemic.
Appointments labelled as 'did not attend' in August 2020 were reduced by 45% compared to August 2019 (pre-COVID-19 versus during COVID-19).
A PREM survey conducted by PwC from 22 April to 16 May 2021 with 119 respondents found that 66% of respondents had received virtual care over the past 12 months and reported higher satisfaction compared to those who had not received virtual care.
Of these respondents:
- 79% who had received virtual care had not experienced any problems with connection or technology during their virtual care appointment
- 92% stated that the care and treatment received through virtual care helped them
- 69% would speak highly of their virtual care experience to friends and family
- 82% would use virtual care again
- 68% were either "very satisfied" or “satisfied” with the virtual care they received compared to in-person appointments.