Defining a core set of research and development priorities for virtual care in the post-pandemic environment: a call to action.

Objectives: To identify research and development priorities for virtual care following the coronavirus disease 2019 pandemic from the perspective of key stakeholders (patients, clinicians, informaticians and academics).

Design: Qualitative study using a modified nominal group technique.

Setting: Online semi-structured interviews and workshops held in November 2022 and February 2023.

Barriers, facilitators and next steps for sustaining and scaling virtual hospital services in Australia: a qualitative descriptive study.

Objective: To describe the barriers to and facilitators of implementing and delivering virtual hospital (VH) services, and evidence and practice gaps where further research and policy changes are needed to drive continuous improvement.

Study Design: Qualitative descriptive study.

Setting, Participants: Online semi-structured interviews and a focus group were conducted between July 2022 and April 2023 with doctors, nurses and leadership staff involved in VH services at three sites in New South Wales, Australia.

An economic evaluation of the Virtual Rural Generalist Service versus usual care in Western NSW Local Health District.

Objective: Evaluate the cost-effectiveness of the Virtual Rural Generalist Service (VRGS) model of care.

Design: A cost-consequence analysis of the VRGS model of care compared with usual care (treatment by local or locum [non-VRGS] doctors) from the perspective of the health care funder in 2022 prices.

Setting: Twenty-nine rural and remote hospitals in the Western NSW Local Health District where the VRGS has been in operation (VRGS sites).

Clinician experiences of a hybrid virtual medical service supporting rural and remote hospitals: a qualitative study.

Objectives: To explore the experiences of clinicians delivering, facilitating, and potentially affected by a hybrid virtual medical model servicing rural and remote hospitals in western New South Wales.

Design, Setting, Participants: Qualitative study using semi-structured focus groups and individual interviews, conducted between 7 April 2022 and 16 March 2023, with rural generalist doctors delivering the Virtual Rural Generalist Service (VRGS) within the Western NSW Local Health District, local site staff, and local general practitioner visiting medical officers (GP VMOs).

Main Outcome Measures: Key themes in clinician experience of the model and recommendations for improved experience, based on qualitative content analysis.

How primary and tertiary care services collaborate in urgent care delivery: an evaluation of general practice advice lines.

Background: To address the rising demand for urgent care and decrease hospital use, health systems are implementing different strategies to support urgent care patients (i.e. patients who would have typically been treated in hospital) in the community, such as general practitioner (GP) advice lines.

The Role of Information Visualisation and Anecdotal Evidence in Medical Students' Clinical Reasoning Process: A Cross-Sectional Survey Study.

Background: Medical students are often taught clinical reasoning implicitly, rather than through a formal curriculum. Like qualified health professionals, they engage in a wide range of information seeking and other practices as part of the clinical reasoning process. This increasingly includes seeking out information online and being informed by anecdotal information from social media or peer groups.

A digitally enabled health workforce for Australia.

Australia has world-class education for healthcare professionals and is recognised for its strength in digital health research but is yet to fill some important gaps in training healthcare professionals in the safe implementation and use of digital technologies. In this case study, we bring together the perspectives of clinicians, health system leaders, and academics to guide efforts in establishing a digitally enabled workforce in Australia. Building on published evidence, our recommendations include leveraging on recent momentum, building strong partnerships with healthcare organisations, academia, and the digital health industry, and ultimately an expansion of a digitally enabled clinical informatics and digital health workforce.

Self-Guided Blood Pressure Screening in the Community: Opportunities, and Challenges.

Background: Community-based health check kiosks provide opportunities to improve the detection and long-term monitoring of hypertension. We describe the sociodemographic and cardiovascular characteristics of first-time and repeat users of these kiosks.

Method: This was an observational study.

Factors influencing fidelity to guideline implementation strategies for improving pain care at cancer centres: a qualitative sub-study of the Stop Cancer PAIN Trial.

Background: The Stop Cancer PAIN Trial was a phase III pragmatic stepped wedge cluster randomised controlled trial which compared effectiveness of screening and guidelines with or without implementation strategies for improving pain in adults with cancer attending six Australian outpatient comprehensive cancer centres (n = 688). A system for pain screening was introduced before observation of a 'control' phase. Implementation strategies introduced in the 'intervention' phase included: (1) audit of adherence to guideline recommendations, with feedback to clinical teams; (2) health professional education via an email-administered 'spaced education' module; and (3) a patient education booklet and self-management resource.

Community perspectives on the use of electronic health data to support reflective practice by health professionals.

Background: Electronic health records and other clinical information systems have crucial roles in health service delivery and are often utilised for patient care as well as health promotion and research. Government agencies and healthcare bodies are gradually shifting the focus on how these data systems can be harnessed for secondary uses such as reflective practice, professional learning and continuing professional development. Whilst there has been a presence in research around the attitudes of health professionals in employing clinical information systems to support their reflective practice, there has been very little research into consumer attitudes towards these data systems and how they would like to interact with such structures.

A Qualitative Study of Aboriginal Peoples' Health Care Experiences With Chronic Obstructive Pulmonary Disease.

Aboriginal Australians experience a high prevalence of chronic obstructive pulmonary disease (COPD), with high rates of potentially preventable hospitalisations. However, little is known about Aboriginal peoples' experiences of living with COPD and how they navigate health care systems. This study used thematic analysis and Aboriginal methodology to explore Aboriginal peoples' lived experiences of COPD, their health care journey from receiving a diagnosis of COPD to the clinical management, and the impact of COPD on their daily lives.

Impact of the COVID-19 pandemic from the perspective of patients with cardiovascular disease in Australia: mixed-methods study.

Objectives: The study explored the perceived impacts of COVID-19 and its associated policies and social restrictions on health, self-management and access to healthcare.

Design: Cross-sectional observational (online survey) and qualitative study (semi-structured interviews and thematic analysis).

Setting: Australia.

A Taxonomy for Health Information Systems.

The health sector is highly digitized, which is enabling the collection of vast quantities of electronic data about health and well-being. These data are collected by a diverse array of information and communication technologies, including systems used by health care organizations, consumer and community sources such as information collected on the web, and passively collected data from technologies such as wearables and devices. Understanding the breadth of IT that collect these data and how it can be actioned is a challenge for the significant portion of the digital health workforce that interact with health data as part of their duties but are not for informatics experts.

Pathogenic Roles for RNASET2 in Clear Cell Renal Cell Carcinoma.

A specific splicing isoform of RNASET2 is associated with worse oncologic outcomes in clear cell renal cell carcinoma (ccRCC). However, the interplay between wild-type RNASET2 and its splice variant and how this might contribute to the pathogenesis of ccRCC remains poorly understood. We sought to better understand the relationship of RNASET2 in the pathogenesis of ccRCC and the interplay with a pathogenic splicing isoform (RNASET2-SV) and the tumor immune microenvironment.

Educating primary care physicians about eating disorders: Pilot data from a microlearning programme.

Background: Over two-thirds of people present to their primary care physician (or general practitioner; GP) as a first point of contact for mental health concerns. However, eating disorders (EDs) are often not identified in a primary care setting. A significant barrier to early detection and intervention is lack of primary care physician training in EDs; compounded by the significant time commitments required for training by already time-poor general practitioners.

Implementation of Artificial Intelligence Applications in Australian Healthcare Organisations: Environmental Scan Findings.

Artificial Intelligence (AI) has great potential to improve healthcare, but implementation into routine practice remains a challenge. This study scoped the extent to which AI and Natural Language Processing (NLP) is being implemented into routine practice in Australian healthcare organisations. An environmental scan of publicly available data was undertaken to identify AI applications.

Fighting the Same Battles on a New Battleground: Embedding Technologies in a Virtual Care Environment.

The pandemic necessitated the rapid design, development and implementation of technologies to allow remote monitoring of COVID-19 patients at home. This study aimed to explore the environmental barriers and facilitators to the successful development and implementation of virtual care technologies in this fast-paced context. We interviewed eight staff at a virtual hospital in Australia.

Using eHealth Data to Inform CPD for Medical Practitioners: A Scoping Review with a Consultation Exercise with International Experts.

Introduction: eHealth data analytics is widely used in health care research. However, there is limited knowledge on the role of eHealth data analysis to inform continuing professional development (CPD). The aim of this study was to collate available research evidence on the use of eHealth data for the development of CPD programs and plans for medical practitioners.

How digital health translational research is prioritised: a qualitative stakeholder-driven approach to decision support evaluation.

Objectives: Digital health is now routinely being applied in clinical care, and with a variety of clinician-facing systems available, healthcare organisations are increasingly required to make decisions about technology implementation and evaluation. However, few studies have examined how digital health research is prioritised, particularly research focused on clinician-facing decision support systems. This study aimed to identify criteria for prioritising digital health research, examine how these differ from criteria for prioritising traditional health research and determine priority decision support use cases for a collaborative implementation research programme.

Attaining consensus on a core dataset for upper limb lymphoedema using the Delphi method: A foundational step in creating a clinical support system.

Lymphoedema is a condition of localised swelling caused by a compromised lymphatic system. The protein-rich fluid accumulating in the interstitial tissue can create inflammation and irreversible changes to the skin and underlying tissue. An array of methods has been used to assess and report these changes.

Patient Use, Experience, and Satisfaction With Telehealth in an Australian Population (Reimagining Health Care): Web-Based Survey Study.

Background: The COVID-19 pandemic triggered a rapid scale-up of telehealth services in Australia as a means to provide continued care through periods of physical restrictions. The factors that influence engagement in telehealth remain unclear.

Objective: The purpose of this study is to understand the experience of Australian people who engaged in a telehealth consultation during the pandemic period (2020-2021) and the demographic factors that influence engagement.

Factors influencing blood pressure control in patients with atrial fibrillation and hypertension in Australian primary care.

Objective: This study explored factors that may influence blood pressure (BP) control in patients with atrial fibrillation (AF) with hypertension.

Methods: Cross-sectional retrospective analysis of the MedicineInsight database which includes de-identified electronic health records from general practices (GPs) across Australia. BP control was assessed in patients with diagnosed AF and hypertension (controlled BP defined as <140/90 mm Hg).