Long outpatient waiting times are common, frustrating for patients and clinicians, and may have adverse health consequences. This proposal evaluates eADVICE (electronic Advice and Diagnosis Via the Internet following Computerised Evaluation), an interactive eHealth program that provides treatment advice to patients, supervised by their general practitioner, while they are awaiting a specialist appointment. eADVICE facilitates the exchange of information between the child, parents and specialists using a virtual character (“avatar”), enabling assessment, diagnosis and provision of individualised treatment advice. Researchers will first test eADVICE in incontinence and sleep disorders, because clinics for these conditions have waiting times of over 12 months.
Research questions:
1. Can the number of patients needing to see the specialist be reduced by using eADVICE-continence?
2. Can eADVICE-continence improve patient outcomes and reduce costs? In a wait-controlled randomised trial, we will compare the effects of access to eADVICE-continence at the time of specialist referral (intervention) to six months later for patients referred to the Sydney Children’s Hospital Network and John Hunter Children’s Hospital continence services. The primary outcome is reduction in need for specialist referral, with secondary outcomes including clinical, economic and process evaluations.
3. Can eADVICE be adapted for sleep clinics? We will create eADVICE-sleep and test the feasibility of using it for sleep clinics, and assess the impact, practical implications and acceptability to doctors, patients and families.
4. Can we create a scalable framework for adapting eADVICE for other health conditions? Drawing on our experience with eADVICE programs, we will create an eADVICE framework and share the lessons learned about ICT and other issues encountered during the project, to facilitate the development and implementation of eADVICE for other conditions and for future statewide scale up of the program. eADVICE provides a sustainable model of outpatient care that has applicability for many chronic subacute conditions.
Collaborators: Hunter New England Local Health District, eHealth NSW, The Continence Foundation of Australia, Agency for Clinical Innovation, WentWest (PHN), consumers