Overview
Initiative type
Service Improvement
Status
Deliver
Published
June 2026
Summary
Provide a model of immediate assistance to rural hospitals via an alternative system for admission of patients, inpatient ward rounds and specialist medical opinion when a Senior Medical Officer (SM)O) is not available on site.
Dates: August 2025 - ongoing
Implementation sites: Mackay Hospital and Health Service
Partnerships: Telecare Australia
Aim
To provide a virtual model of medical care which offers:
1. An internal solution for local admissions, where/when there is no available admitting officer, including directly from urgent care
2. Stepped down care from a larger tertiary or regional site seeking an admission to a rural facility.
Outcomes
During periods when no local Senior Medical officer (SMO) was available at four rural facilities during November 2025 to January 2026 (92 days).
- 79 days covered
- 29 admissions (reduced transfers to Mackay Base Hospital)
- 11 discharges (discharge summaries completed)
- six appropriate inter-hospital transfers
- one unplanned readmission
- 382 inpatient virtual ward rounds (patients reviewed)
- 68 Residential Aged Care patient reviews
- five deaths (expected)
Background
Rural and remote areas of Australia face significant challenges in retaining and attracting healthcare professionals, leading to workforce shortages and impacting access to medical care for local residents. High workloads and prolonged on-call periods put clinicians at risk of burnout. It is well documented that rural and remote communities often experience poorer health outcomes, lower life expectancy and increased rates of chronic disease compared to metropolitan areas. There is no easy solution to this problem and a multi-faceted and long-term approach to funding, improved resources, social and psychological factors, working conditions etc. is required.
This project does not aim to provide a response to the significant and ongoing challenges of staffing rural facilities but aims to provide a model of immediate assistance for Mackay Hospital and Health Services' (MHHS) rural hospitals (Rural Facilities) by offering an alternative system for admission of patients to inpatient wards, inpatient ward rounds and specialist medical opinion when a SMO is not available on site.
Rural Facilities may often have bed capacity but cannot admit and manage patients during periods where no SMO is available. Rural Facilities can initiate an interim virtual emergency support arrangement with Retrieval Services Queensland (RSQ) to access SMO support for emergency presentations during these periods. However, RSQ SMO's do not have admitting rights to MHHS rural site facilities and inpatient management is out of scope for the RSQ service. Patients requiring admission must be transferred to Mackay Base Hospital (or other facilities) during these periods. Additionally, rural facilities cannot accept transfers (step downs) from Mackay Base Hospital during these periods. This impacts patient flow and bed capacity across the MHHS footprint.
Methods
This situation prompted MHHS Division of Rural Services and Virtual Health to explore the possibility of establishing a partnership with an external agency to provide capability for scheduled and ad-hoc cover for rural facilities. The service aligns with RSQ Telehealth Interim Support Service and provide SMO with admitting rights during periods when the local SMO is unavailable.
A market scan identified Telecare Australia, a prominent provider in the field of virtual healthcare. With a team of over 200 expert clinicians spanning 33 specialties, Telecare Australia has established itself as a leader in the industry. Since 2023, the organisation has been engaged in a public-private partnership with the MHHS providing specialised outpatient and inpatient consultations, as well as remote reporting functions.
Telecare Australia has successfully implemented a Rural Hospital Virtual Support model in five regional hospitals across Victoria, enhancing access to quality healthcare in underserved areas. This innovative approach has not only improved patient outcomes but has also strengthened the overall healthcare infrastructure in the region.
Root cause analysis clarified the current state / situation and was articulated as problem statements:
Regional: High demand on internal bed pressure resources, impacting patient flow. Too many admissions for health service capacity.
Local: Health services with available beds, with limited admissions capacity and capability. Unable to accept admissions due to lack of admitting officers available after hours and/or all hours.
Intersect: Regional health services seeking outflow patient options (stepped down care), and/or direct admissions, where there is no available admitting officer.
A project team comprising stakeholders from MHHS Virtual Health, the Rural Services Division, and Telecare Australia was established. Over a six-month collaborative effort, the team developed a Virtual Care Rural Hospital Support Model Service Profile, which received Executive Leadership Team Synopsis approval in October 2025. The implementation of the new model began in late November 2025.
Rural Facilities submit shift requests through a dedicated portal, with confirmations provided within one hour by a Telecare representative. Shifts are conducted virtually by Telecare Senior Medical Officers (SMOs) who are credentialed for MHHS and possess admitting rights, and full access to clinical systems, including the ieMR. This enables them to create real-time clinical notes, orders and treatment plans, mirroring the capabilities of on-site clinical teams. SMOs perform daily ward rounds at scheduled times, collaborating with a Rural Facility nurse who is present with the patient via video conference. For ad-hoc on-call situations, the SMO is connected directly to the patient bedside or to the Emergency Department (ED) to support RSQ clinician assessments for category 3, 4, and 5 patients, to contribute to decisions regarding patient admission, transfer, or discharge.
This service is also employed alongside the Rural Facility's on-site medical officers to enhance capacity in managing patient loads. For instance, Telecare handles inpatient ward rounds and ad-hoc task requests, allowing the on-site medical officer to focus on ED attendances.
Discussion
The Mackay Virtual Care Rural Hospital Support Model presents a promising and scalable solution to address the shortage of Senior Medical Officers in regional and rural hospitals. By leveraging the established partnership with Telecare Australia and their extensive experience in implementing virtual models in Victoria, this initiative adopts an innovative approach to a longstanding issue. It shifts reliance from the public sector medical officer pool and short-term locum arrangements to the private market.
Embracing virtual care opportunities has enabled us to effectively address workforce capacity challenges in rural facilities. Telehealth, with its inherent flexibility, is particularly well-suited to this innovative strategy. This model directly supports rural facility workforces in managing their caseloads and work-life balance, thereby reducing fatigue and burnout. Consequently, it enhances staff retention rates and improves overall community health outcomes.
Key contact
Cathie La Riviere
Manager, Virtual Health
Mackay Hospital and Health Service