Overview
Initiative type
Service Improvement
Status
Deliver
Published
June 2026
Summary
This service pilot initiative identifies a feasible service model to deliver cardiac ultrasound services through telehealth using robotic technology.
Dates: January 2022 - June 2026
Implementation sites: Royal Brisbane and Women's Hospital, on behalf of Metro North HHS, Central West HHS and North-West HHHS
Partnerships: Healthcare Improvement Unit - Clinical Excellence Queensland and Office of the Chief Operating Officer, Equipment vendors, AusHSI, Queensland University of Technology, Information Technology Teams (including Cybersecurity, Networks, Biotechnology Services)
Aim
This service pilot aimed to provide regular and reliable access to cardiac ultrasound services in rural and remote areas using a combination of robotic and telehealth technologies.
Outcomes
- Weekly ultrasound services have been delivered to two rural and remote Hospital and Health Services.
- This close-to-home model reduces the requirement for patients to travel great distances to access similar care and significantly reduces time to care.
- Novel and simplified digital transformation and telehealth-based solutions are used to deliver this service.
- This service model significantly reducing the risk of musculoskeletal injury in the cardiac sonographer workforce
Background
Cardiovascular disease remains the number one cause of death for rural Australians with poorer outcomes compared to metropolitan residents. Limited access to cardiac services is a major contributing factor, and emerging telehealth delivery models such as the Tele-Cardiac Investigations program (Cardiology, Royal Brisbane and Women's Hospital, Metro North Health) offer progress in addressing this issue.
Cardiac ultrasound is a baseline investigation in screening, diagnosing or monitoring most cardiovascular conditions, however the requirement for specialised staff to perform this examination in-person has previously prohibited the potential for deployment in a telehealth service model.
In addition, cardiac sonographers are a limited and specialised workforce in metropolitan areas which does not have the capability to expand into rural and remote due to workforce availability and low-cost effectiveness.
Consequently, patients in rural and remote areas have significant delays to care due to extensive wait times and are required to travel great distances to access cardiac ultrasound services which incurs significant costs to patients and the health system.
The recent development of robotic technologies that permits robot-assisted ultrasound examination, coupled with telehealth modelling, now enables capacity to remotely deliver cardiac ultrasound services in rural and remote areas.
Methods
Metro North Health (led by Cardiology, Royal Brisbane and Women's Hospital) partnered with Central West and North West Hospital and Health Services to develop and deploy a pilot telehealth-based echocardiography service model - a TeleEcho Service. This service enables equitable access to advanced cardiac diagnostic services, and its delivery was achieved through five years of development under the TeleEcho Program involving industry partnership, research and service development modelling (including a formal Medical Device Clinical Trial), a novel digital solution (supported by Queensland Health IT, Cybersecurity, Networks and Biomedical Technology Service) and funding support from the Department of Health, including directly from the Healthcare Improvement Unit (Clinical Excellence Queensland.
This deployment is an Australian first delivery of cardiac ultrasound in a routine service setting and represents a major milestone of the established Tele-Cardiac Investigations Service, which aims to enhance the cardiac diagnostic capabilities of Queensland Health across rural and remote Queensland.
The TeleEcho service model comprises of both a Hospital and Health Service partnership referral and procedure support service arrangement, as well as a dual location clinic model; a 'command' site - which is a specialist cardiac health service with an existing cardiac sonographer workforce, and a 'remote' site - a non-specialised local health clinic that only requires a single member of a local health workforce team.
The robotic system (RMI Oceania Pty Ltd) resides at the remote site and holds an ultrasound probe of a standard clinical ultrasound device (Canon Medical Systems ANZ Pty Limited). The robotic system as well as ultrasound device are both remotely controlled in real-time by a cardiac sonographer sitting in the command site. Two-way audio-visual communication is also included as part of the robotic system, enabling the sonographer and patient to hear and see each other, with the remote site clinic attendant also physically in-room with the patient to support both the patient and procedure. All remote connections are performed within the Queensland Health network; and completed cardiac ultrasound examinations are exported directly to the command site standard imaging archive for standard reporting as per routine practice.
Discussion
This project required two key enablers to progress and succeed:
The first enabler was developing knowledge of potential local service opportunities through inter- Hospital and Health Service engagements; this was a primary driver for progressing the TeleEcho Service concept. The Tele-Cardiac Investigations Service of Cardiology, Royal Brisbane and Women's Hospital (Metro North Health) has been operating for nine years in partnership with Central West and North West Hospital and Health Services, and develop a mutual understanding of the need for local cardiac ultrasound services. This partnership additionally enabled suitable co-design of the service model during development that ensured a smooth and feasible implementation.
The second enabler and learning of the project was early engagement with Queensland Health digital teams. Presenting the potential service model and exploring digital solution options with digital teams very early in the development of the service model enabled key and critical advice that guided suitable deployment of the TeleEcho Service's in-house digital solution.
An additional benefit of this service model is the provision of a more ergonomically safe working environment for sonographers. The risk of musculoskeletal injury to sonographers is extremely high with some reports suggesting up to 90% of sonographers are currently working in pain. This arises due to sonographers maintaining arm extension for prolonged periods and applying contact pressure to the patient in order to complete an examination. Whilst enabling rural and remote patients to gain local access to cardiac ultrasound services, this model additionally enables a more ergonomic method in how cardiac sonographers perform the examination, alleviating the currently very high risk of occupational injury.
The next steps of this novel TeleEcho service are to sustain this existing model as business-as-usual, as well as develop a statewide expansion plan to allow this telehealth model to reduce travel burdens and delays to care across Queensland, and subsequently improve cardiovascular health outcomes in underserved and populations.
Key contact
Cathy West
Cardiac Scientist
Metro North Hospital and Health Service
Email: cathy.west@health.qld.gov.au