Globally, digital transformation has been sweeping through healthcare, and Australia’s health and social care landscape is no exception. The Australian Government’s National Digital Health Strategy 2023-2028 [1] outlines several key initiatives aimed at fostering a digitally empowered healthcare environment. As healthcare becomes increasingly digital, the integration of virtual care services is becoming more common. Nurses, who make up the largest group of health professionals in Australia, are at the forefront of this rapidly evolving digital care environment. They play a crucial role in delivering and advocating for these innovative care models. This editorial examines virtual care within the context of urgent care, focusing on the role of nurses in care planning and delivery while exploring the associated challenges and future opportunities.

Virtual care

Virtual care encompasses a range of services, including telehealth, telemedicine, and remote monitoring, allowing healthcare providers to interact with patients remotely using digital tools [2]. Virtual care approaches have long been utilised in areas such as chronic disease management [3], symptom control [4] and follow-up care. In recent years, however, there has been a significant rise in virtual care programs designed to address the urgent and acute care needs of patients. The Australian Government funded Healthdirect program’s virtual care clinics, for example, provide urgent medical care for non-life-threatening conditions through telehealth. These services allow patients to consult with emergency-trained health professionals without needing an appointment, addressing issues like respiratory illness exacerbations or minor injuries-all from the comfort of their homes. [5]. Medicare Urgent Care Clinics further enhance access to care by providing bulk-billed urgent care for conditions that don’t require emergency department visits. These clinics, located in general practice settings, are open extended hours and aim to reduce hospital pressure by offering timely care for minor injuries and illnesses [6].

A growing body of evidence from Australian studies shows promising results for virtual care pathways in urgent care. For instance, the Victorian Virtual Emergency Department program offers virtual consultations to self-referring patients or those referred by their GPs. During the COVID-19 pandemic, the Victorian Virtual Emergency Department successfully diverted patients from emergency departments, preserving critical resources for high-acuity cases [7]. An observational study of this model of care demonstrated that the service was considered helpful and clinically appropriate, preventing 70% of community-triaged patients from presenting to the physical ED [8]. Similarly, the value of virtual care coordination and clinical advisory programs, particularly in rural and remote healthcare in Australia, is also beginning to emerge [9, 10]. For example, the VCare initiative in New South Wales supports rural clinicians by providing specialist advice and coordinating patient transfers. This service, which responded to over 1,600 high acuity cases in just two months, demonstrates the potential of virtual care in streamlining healthcare delivery [9]. In regions like rural Queensland, where geographic barriers complicate access to specialist care, approaches such as telehealth have become equally valuable. By connecting rural clinicians with tertiary specialists in real-time, these platforms offer decision support, procedural guidance, and care coordination. Clinicians report that these services not only improve patient outcomes but also alleviate professional isolation, fostering a sense of collegiality [10].

Nursing care in the virtual environment

Nurses are integral to the success and sustainability of virtual care programs, playing a key role in delivering care in digital spaces. Often, nurses are the first point of contact for patients accessing virtual urgent care, where their skills in assessing symptoms, gathering health histories, and navigating patients to appropriate care pathways are indispensable. [11, 12]. For example, Healthdirect’s virtual care clinics depend on nurses to triage self-referring patients with conditions such as respiratory illnesses, minor injuries, or pain, ensuring timely and effective care [5]. Similarly, specialised programs like the South Australian government’s Child and Adolescent Virtual Urgent Care Service underscore the pivotal role of nurses in managing everyday virtual care. Their skills and adaptability are crucial in making virtual care effective and accessible [13].

However, the role of nurses in virtual care extends well beyond direct patient care, encompassing the use of their interprofessional collaboration and care coordination skills within a digital environment. Programs like the South Australian Virtual Care Service exemplify this expanded role, relying on the expertise of nurses to work seamlessly with paramedics and doctors in delivering both on-site and virtual emergency care. This innovative model brings specialised clinical assessments directly to patients, often eliminating the need for hospital emergency visits. Its success is built on the exceptional nursing skills of assessment, monitoring, communication, and care coordination, which are vital in ensuring effective and timely care delivery [14].

In addition to their core roles in providing and coordinating care in virtual environments, nurses play a critical role in advancing the integration of digital technologies within healthcare systems [15]. Beyond their clinical duties, nurses act as digital navigators, guiding both patients and colleagues in adopting and using new technologies. Their contributions are key to fostering an organisational culture that supports and sustains digitally enabled healthcare, facilitating smoother transitions and promoting the effective adoption of virtual care models [15, 16].

Challenges opportunities and way forward into the digital future

Nurses are key to the success of virtual care models, yet integrating virtual nursing care into healthcare systems presents significant challenges. These challenges are particularly evident when it comes to effectively engaging with digital technologies and embedding virtual care approaches seamlessly into existing workflows and processes. While digitally facilitated care, such as virtual care, holds immense potential to enhance healthcare delivery, evidence underscores several barriers that must be overcome to ensure its successful implementation [17, 18]. Firstly, skills and training gaps are a major challenge. Many nurses lack familiarity with digital technologies and often do not receive enough training to confidently use telehealth platforms. This lack of preparation can limit their ability to provide efficient care in virtual settings. Secondly, organisational challenges also make it harder to adopt virtual care, including poor coordination, unclear policies, and limited technical infrastructure. These issues can lead to inconsistencies in care delivery and lower staff morale. Additionally, technological barriers—such as concerns about data security, usability problems, and maintaining patient confidentiality—pose risks to the reliability of virtual care systems. These challenges can make it difficult for nurses to fully engage with and support technology-based care approaches [19].

Effectively addressing these barriers requires the implementation of targeted and comprehensive solutions. Virtual care platforms must be designed to be user-friendly, with tailored training programs that help nurses build confidence and skill in using digital care tools. Involvement of nurses in design and delivery of virtual care technologies and care models is an important step in ensuring user-friendliness [20]. Continuous support, including troubleshooting, is essential to ensure optimal engagement [21]. This is particularly relevant in Australia, where research has shown low levels of digital literacy among nurses and allied health professionals, highlighting the need for strategies to improve their digital skills [22]. Healthcare organisations also have a responsibility to provide the resources and support nurses need to succeed. Clear policies, well-structured procedures, and strong organisational support can empower nurses to effectively deliver virtual care to enhance patient outcomes and drive the success of virtual care models [17].

Conclusion

As healthcare continues its transition into the digital era, nurses are positioned at the forefront of this transformation, playing a critical role in championing, implementing, and delivering virtual care solutions. Their clinical expertise, adaptability, and ability to integrate patient-centred approaches into digital environments are pivotal to ensuring that virtual care models achieve their full potential. However, the successful implementation of virtual care requires more than just technological innovation. Robust digital infrastructure, thoughtful workforce planning, and comprehensive training programs are essential to equip nurses with the skills and confidence needed to thrive in these new environments. Clear policies, structured procedures, and ongoing organisational support are equally important to empower nurses to navigate and lead in digitally enabled care settings. To maximise the effectiveness of virtual care, it is imperative to actively involve nurses in the design and development of digital technologies and care models. Their insights can ensure that these solutions are intuitive, aligned with real-world workflows, and capable of enhancing efficiency and care quality.

As healthcare becomes increasingly digital, nurses have an important role to play as advocates and leaders. By contributing to the development of virtual care models and digital health technologies that balance innovation with compassion, nurses can help ensure these advancements deliver real benefits to patients and communities.

Authors

References

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