Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2025
Summary
Videocalls and remote patient monitoring have become integral to the Queensland Children and Adolescent Renal Service (QCARS), enabling care for children with chronic kidney disease across Queensland, Northern NSW, and occasionally internationally. The service combines virtual consultations with advanced remote monitoring technology to improve access, continuity, and quality of care.
Implementation sites: Statewide
Partnerships: Rural hospitals
Lead Organisation: Queensland Children’s Hospital
Aim
To deliver equitable, family-centred, and efficient renal care to paediatric patients regardless of geographic location, reducing the need for relocation or frequent travel to Brisbane. The service aims to leverage videocall and digital platforms to support dialysis management, consultations, and interdisciplinary care.
Outcomes
- Expanded access to specialised renal care for rural, remote, interstate, and international patients.
- Improved continuity of care and reduced disruption to family life (less travel, school absence, and work loss).
- Enhanced monitoring and timely intervention through real-time remote patient data.
- Increased efficiency and cost savings (average historical saving of $505 per telehealth consult).
- Reduced failure-to-attend rates and improved compliance.
- Demonstrated feasibility and sustainability of telehealth in paediatric nephrology.
Background
QCARS provides state leading virtual care, including statewide paediatric nephrology care, and is the only centre in Queensland providing paediatric dialysis and kidney transplantation. It serves children from birth to 18 years, including those with complex multisystem disorders and a high proportion of Aboriginal and Torres Strait Islander patients. Prior to virtual care adoption, families often had to relocate to Brisbane for dialysis, creating significant social and financial burdens.
Methods
- Telehealth Models:
- In-centre videocall with local hospitals or GP practices, involving clinicians, nurses, and subspecialty teams.
- Virtual clinic via mobile devices for home-based consultations.
- Remote Patient Monitoring:
- Transition from older APD machines requiring physical visits to Baxter’s ShareSource cloud-based platform.
- Enables two-way remote management of dialysis prescriptions, real-time data review (fluid balance, blood pressure, weights), and compliance tracking.
- Integration:
- Interdisciplinary care through telehealth consults, inclusion of interpreters, and coordination with local teams for pathology and radiology.
- Technology:
- Simple, user-friendly platforms requiring minimal digital literacy; troubleshooting support provided by telehealth coordinators.
Discussion
Videocalls and remote monitoring have significantly improved access and quality of care for paediatric renal patients, particularly those in rural and remote areas. Benefits include reduced travel, cost savings, better family life balance, and enhanced clinical oversight. Challenges remain:
- Inability to perform physical examinations remotely; mitigated by involving local clinicians.
- Connectivity issues, though increasingly rare.
- Need for periodic in-person visits for certain patients.
- Digital literacy varies, but platforms are designed for ease of use.
Overall, telehealth is cost-effective, sustainable, and comparable to standard care in outcomes. Future directions include further integration of technology and addressing limitations in physical assessment.
References
Trnka, P., White, M.M., Renton, W.D. et al. A retrospective review of telehealth services for children referred to a paediatric nephrologist. BMC Nephrol 16, 125 (2015).
Key contact
Dr Glenda Moonsamy / Dr Peter Trnka
Paediatric Nephrologist / Director, QCARS
Queensland Children's Hospital