Broadband Innovation Fund
Virtual Services - Foetal Monitoring Case Study II |
Virtual foetal monitoring gives specialists peace of mind |
| Obstetricians in Warrnambool can keep track of a woman's labour in real time from their consulting rooms or from home, providing added reassurance during difficult births. Being able to monitor an 'at risk' pregnancy remotely gives specialist obstetrician and gynaecologist Dr Liz Uren added peace of mind and means she does not have to be at a patient's bedside to offer expert advice. |
| What it does |
| The state-of-the-art system gives Dr Uren online access to medical equipment that keeps track of the foetal heart rate, the mother's heart rate, and the rate of contractions during labour. The combination of these three elements is known as a 'trace'. "It really allows us to see how the baby is coping during labour because some babies are a bit unwell to start with," said Dr Uren who works at the Wentworth Women's Clinic and St John of God Hospital in Warrnambool. "What I can do – either from the clinic or from home – is log on and see what's happening in real time. If a midwife rings and is unhappy with a trace I can have a look and offer immediate advice or reassurance. It's a fantastic time saving technology when you need to act fast." Dr Uren said the old method of faxing through a copy of the trace was very time consuming for staff and there were also problems with the quality of the image. "By the time the fax came through it was often easier to get in the car and drive down." |
| How it works |
| Virtual foetal monitoring was first introduced at St John of God Hospital in late 2006 as part of the South West Alliance of Rural Health (SWARH) Virtual Services Project (VISP), funded by Victorian Government agency for information and communications technology Multimedia Victoria. The project uses a converged broadband network to enable medical specialists at a range of SWARH facilities, including St John of God, to treat patients remotely and observe their progress using online hook-ups to medical monitoring equipment and videoconferencing facilities. Dr Uren, who has now used the system thousands of times, accesses the SWARH network with a password and then makes a mobile phone call to an automated security service which identifies her as a user and opens the gateway to the foetal monitoring system. "I’ve had the occasional problem such as when we changed to a different firewall software package at home but over two-and-a-half years of consistent use it’s been very reliable." |
| The benefits |
| Although she only lives a few minutes away from St John's, Dr Uren said the monitoring system was invaluable when she received calls from concerned midwives at 3am in the morning. "It means I can get up and have a look at what they’re talking about straight away. Obviously if there’s a real problem I get dressed and go down to the hospital but often that's not necessary and I can go back to sleep." Dr Uren is regularly on call for St John's and ends up accessing the foetal monitoring system at least once a week. "I was quite anxious at the beginning about whether the trace on the screen would be as good as the original paper read out, but it is. I can interpret on screen just as well as looking at the old print-out." Dr Uren also uses the system to keep track of some patients she is concerned about. "Sometimes I take a look at the trace of a particular patient before I go to bed at night. It gives you an ability to see how things are travelling clinically without having to harass nursing staff who are already very busy." Another benefit of the technology is the extra confidence it gives Dr Uren to monitor a labour for a period of time before intervening medically. "Because I can watch it while I'm working I'm more prepared to give a labour more time. Sometimes you can have a trace that isn't terrible but it's a bit unsettled so the technology allows you to watch it for a while rather than deciding on a caesarean at the first sign of a dip. You want every patient to have as good a turn at labour as they possibly can." |
| Future opportunities |
| Dr Uren said the system was also an excellent teaching aid for less experienced staff. "It’s really good because the information is recorded and stored and you can use it to show people what the different traces and data patterns indicate." "Technology like this can't take the place of seeing a patient if the situation is critical but I think its going to have a whole range of benefits for remote medicine in years to come." |
