A retrospective observational study of vCare: a virtual emergency clinical advisory and transfer service in rural and remote Australia.

Background: Provision of critical care in rural areas is challenging due to geographic distance, smaller facilities, generalist skill mix and population characteristics. Internationally, the amalgamation telemedicine and retrieval medicine services are developing to overcome these challenges. Virtual emergency clinical advisory and transfer service (vCare) is one of these novel services based in New South Wales, Australia.

Design, development and implementation of the virtual, coordination, access, referral and escalation service in western New South Wales.

Problem: People in rural and remote New South Wales experience avoidable admissions, limited access to skilled clinicians and commonly travel >400 km to access specialist services within the district and >700 km for tertiary services outside.

Design: Iterative use of New South Wales Health redesign methodology in the period 2015-2020.

Setting: Western New South Wales Local Health District is geographically the largest Health District within New South Wales and includes disadvantaged communities.