Overview
Initiative Type
Model of Care
Status
Close
Published
June 2025
Summary
The Royal Brisbane and Women’s Hospital (RBWH) TeleSleep service was developed to provide equitable access to sleep study and treatment services for regional and remote Queenslanders.
Through telehealth-supported technology and local clinician partnerships, the TeleSleep pilot enabled patients to complete home-based sleep studies and receive continuous positive airway pressure (CPAP) treatment including education, mask fitting, machine operation and follow-up care in their own communities.
Implementation sites: Rockhampton Hospital
Partnerships: Central Queensland Hospital and Health Service
Project Type: Model of Care
Project Status: Deliver
Lead Organisation: Respiratory and Sleep Investigation Unit, RBWH
Aim
The TeleSleep initiative aimed to:
- deliver high-quality, accessible sleep diagnostic and treatment services to patients in regional Queensland without requiring travel to Brisbane
- support local clinicians through tele-supervision and upskilling to manage sleep assessments and CPAP therapy
- evaluate clinical effectiveness, patient satisfaction, workforce outcomes, and financial sustainability of a telehealth-enabled model of care.
- reduce travel-related costs, CO₂ emissions, and patient transport subsidy expenses for Queensland Health.
Outcomes
The 43-week pilot produced clear benefits across patient, clinical, and system domains:
- Access and Uptake: 41 patients underwent sleep studies locally, with 35 (85%) diagnosed with obstructive sleep apnoea (OSA) and 50 patients (including some diagnosed elsewhere) commenced CPAP treatment as part of the service.
- Treatment Compliance: 80% of patients commenced on CPAP therapy maintained compliance at seven days.
- Patient Satisfaction: 100% of surveyed participants were satisfied and would recommend the service; 53% indicated they would not have pursued testing if travel to Brisbane was required.
- Cost and Environmental Impact:
- Savings of $42,000 in patient travel subsidy costs
- Reduction of 33 tonnes of CO₂ emissions
- Service delivery cost of $38,220, compared with an estimated $96,588 if delivered in Brisbane
- Workforce Benefits: Remote clinicians gained hands-on sleep science skills, supported in real-time by RBWH experts using wearable camera technology.
- System Efficiency: Freed metropolitan sleep laboratory capacity for higher-acuity patients.
Background
Regional Queenslanders face major challenges in accessing sleep medicine services due to distance, cost, and limited local workforce capability. Prior to TeleSleep, around 30% of RBWH’s patients travelled from regional areas, with some deferring care altogether. The shortage of sleep-skilled staff in rural settings also limited sustainable local service delivery. Traditionally, patients from areas such as Rockhampton, Wide Bay, and Mackay were required to travel hundreds of kilometres to Brisbane for testing, incurring significant financial, logistical, and personal burdens. Recognising these barriers, RBWH’s Respiratory and Sleep Sciences Department collaborated with Rockhampton Hospital and Queensland Health’s Telehealth team to trial a virtual model of care. The initiative aligned with the state’s strategy to improve regional health equity and service decentralisation.
Methods
The TeleSleep model integrated telehealth technology, local facilitation, and remote expert supervision through six key steps:
- Patient Selection and Referral: Eligible patients were referred via standard GP or specialist pathways and triaged by RBWH sleep physicians.
- Home Sleep Study: A portable, Level 2 sleep monitoring device was fitted locally in Rockhampton under live tele-supervision from RBWH sleep scientists using wearable camera glasses.
- Telehealth Consultation: Results were analysed centrally at RBWH and discussed with patients remotely.
- CPAP Education and Initiation: Patients diagnosed with OSA received virtual education and mask fitting through telehealth, supported by local staff under RBWH guidance.
- Remote Monitoring: CPAP devices transmitted nightly usage and performance data via cloud systems for shared review by clinicians in both locations.
- Follow-up and Support: Ongoing troubleshooting and clinical review were conducted virtually, with eligible patients receiving Queensland Health-funded CPAP equipment mailed directly to their homes.
This design ensured consistent quality, local patient convenience, and workforce capability development.
Discussion
The RBWH TeleSleep pilot demonstrated that telehealth-enabled sleep diagnostics and therapy can safely and effectively replace traditional in-person models for suitable patients. It addressed the “tyranny of distance,” enhanced regional clinician capacity with continual expertise from Brisbane for every appointment, and improved patient satisfaction while delivering substantial cost and environmental efficiencies. The use of low-cost camera glasses provided an innovative, scalable solution for remote supervision and training.
Minor challenges included integration with hospital information and billing systems and promotion of service awareness among local referrers. Despite these, the model proved sustainable and transferable. RBWH would welcome support to render TeleSleep business-as-usual. With the conclusion of this pilot, they have been forced to revert to Rockhampton patients travelling 600km to Brisbane once more for their sleep care. Expansion to other key regions of Queensland could further reduce costs, inequities and strengthen statewide sleep health service access.
TeleSleep won the 2024 ‘Fostering Innovation’ QuARRIES award (Quality Awards Recognising Remarkable Initiative and Excellence in Service) at RBWH as well winning the New Investigator category at the 2025 Australasian Sleep Association conference.
Key Contact
Darren O'Brien
Director, Respiratory and Sleep Investigation Unit,
Royal Brisbane and Women's Hospital