Created in the early chaos of COVID-19, the Victorian Virtual Emergency Department began as a rapid-response collaboration between Northern Health and La Trobe University. It has since grown into a statewide service that is changing how emergency care is delivered.
Emergency departments are under constant pressure. Rising demand, an ageing population, and workforce strain all make it harder to get the right care to the right patient at the right time.
For Professor James Boyd, Chair of Digital Health and Innovation at La Trobe University, digital health is about finding practical ways to improve that system for both patients and clinicians.
“A lot of the stuff we’re doing is around trying to explore how we optimise the service, improve the service, or build the capacity in the service by using technology,” he says. “Now, it doesn’t work all the time so there’s a need for both traditional and digital health solutions, but if we can supplement it and make things better, that’s what we’re trying to do.”
One of the clearest examples is the Victorian Virtual Emergency Department (VVED). Prof Boyd says the project began at the very start of the pandemic, when Dr Loren Sher, then co-lead of the Northern Health Emergency Department, contacted him with an idea. With COVID restrictions in place, the question was how to create a virtual model of care that could safely triage patients and, where appropriate, help them while avoiding them coming into the emergency department at all.
“She realised she wanted a digital health person,” Prof Boyd says. “So she rang and said, ‘I’ve got this idea. Can you help me make this happen?’”
The answer was yes. Dr Sher secured a small grant from Northern Health, Prof Boyd brought support from La Trobe, and together they assembled a small team. Within a matter of weeks, they had built an interim registration system, put triage processes in place, and used Healthdirect to establish the telehealth component.
“Within about six weeks we had something up and running and we had patients coming through,” Prof Boyd says.
At first, the service ran only in the afternoons, with around 10 to 15 patients being treated each day. But the model worked. It expanded to a 24/7 service for Northern Health, then scaled statewide.
“The technology has improved and we’ve refined that service and made the systems better since then,” Prof Boyd says.
Today, the VVED includes multiple pathways, including paediatrics, residential aged care, diabetes, and geriatrics. Prof Boyd describes it as one of the biggest success stories he has worked on – and one of the most rewarding.
Agile, collaborative, and built to keep improving
For Prof Boyd, one of the reasons VVED succeeded was the way it began: quickly, collaboratively, and without getting paralysed by potential obstacles.
“Loren had a vision and it was just getting the right team together to make it work in the first instance,” he says. “It was very agile. We sorted the problems as we went through. We made it work.”
That agility was matched by a commitment to evaluation from the beginning. Prof Boyd says the team looked at service numbers, patient feedback, and whether people presented elsewhere afterwards, then used that information to refine and improve the model over time.
“It’s not static, it has changed and continues to change,” he says.
That reflects his broader view of digital health. Technology should not be forced onto a system or create extra work. It has to fit naturally into existing workflows and respond to the needs of both patients and healthcare professionals.
“The worst thing you can do is try and impose technology onto the system,” Prof Boyd says. “It has to be seamless in terms of what you’re doing with the existing service and workflow, but somehow integrate it and make it better.”
He sees VVED as a strong example of that principle in action. Beyond diverting people from physical emergency departments, he points to the way the model has connected different parts of the health system – including Ambulance Victoria, residential aged care, and urgent care settings – in a more coordinated approach.
“It’s so much more integrated than many of the other services I’ve seen,” he says.
That integration, backed by evaluation and economic modelling, has helped demonstrate the value of the service as it continues to evolve. And while the model was born in a crisis, its influence now extends well beyond Victoria.
“There are models now across all of Australia – maybe not the same model, but the same principles,” Prof Boyd says. “If you can divert people safely from physical ED, it’s a good thing.”
The research group formed around the VVED have co-located in Innovation Central Melbourne and we continue to find new ways to engage them. ICM first worked with the VVED in collaboration with Cisco. Read more about what three students from La Trobe University did with Dr Sher and her team when they were given academic and industry support, a tight timeframe, and a supervisor.
