Clinical Hub shows the way forward

Monday 18 July 2022

Dr Lucille Wilkinson.jpg

With additional funding confirmed, Mahitahi Hauora's successful Clinical Hub is here to stay until at least the end of the year - news that would delight Dr Lucille Wilkinson, Associate Chief Medical Officer and Clinical Lead for the COVID Incident Management Team with Te Whatu Ora Te Tai Tokerau (formerly Northland DHB).

Dr Wilkinson is keen to see the experience of the Clinical Hub taken forward, extended and adapted for other clinical contexts.

“It’s shown us a different way of working with patients and given people more confidence about virtual care. We can probably provide care in a shorter time, and utilise the workforce in a way that allows people to work more flexibly. I think it offers huge benefits in showing us the way forward,” she says.

She describes the Hub as a ‘saving grace’ during the Omicron outbreak.

“It allowed the hospital to keep going and not be overwhelmed,” she says. “We had the same numbers of patients coming in with other conditions, so it really did save a lot a lives.”

An important part of how the Clinical Hub achieved that was giving COVID-19 patients and clinicians alike the confidence that people could be safely and effectively managed at home, with clinical assessment and monitoring done over the phone. The Hub model quickly made it clear how useful that could be.

“COVID was new, and everyone was very worried and anxious about patients being sick,” Dr Wilkinson recalls. “With the Clinical Hub, people who didn’t have registered GPs could be provided care, and as general practices came on board they saw it was okay to manage people virtually, and how to figure out if patients were going to get very sick.”

When antiviral medications became available, the Clinical Hub led the way again by developing an acuity tool to identify high risk patients who needed antivirals at the earliest opportunity.

“Those things were very important. Firstly, not having people come to hospital if they didn’t need to and reassuring them they could stay at home; and then, with the antivirals, preventing a lot of people getting sick enough to need hospital,” Dr Wilkinson says.

The Clinical Hub also played a vital role providing after hours, weekend, and overflow support to general practice.

“Our hospital is most vulnerable after hours and on weekends, so having something available so that patients could be checked on meant again that we saw less presentations.”

All this meant the hospitals saw significantly fewer presentations than they thought they would.

“Most of the people who came to us were appropriate to be in hospital, and that was a huge benefit to being able to manage and therefore provide the appropriate care.”

The Mahitahi Hauora Clinical Hub is exploring opportunities with both the hospital and primary care to evolve into a long-term virtual solution.