# Unlocking the promise of virtual care in hospitals: the Smarter Hospitals Project protocol

## TL;DR

This project explores how virtual care can be better integrated into hospital outpatient settings to improve healthcare access and outcomes in Australia.

## Contribution

The study introduces a multi-method approach to evaluate and optimize the use of virtual care in hospitals, focusing on workforce readiness and equity.

## Key findings

- The project will analyze patterns of virtual outpatient care use and its impact on health service outcomes.
- A co-designed change methodology will be tested to improve workforce readiness for virtual care integration.
- Realist evaluation will identify contexts and populations where virtual care is most effective and economically beneficial.

## Abstract

Virtual models of care comprise consultation by telephone, video-conferencing and remote-monitoring of health conditions, which are supported by digital patient information and wearable devices. Integration of virtual and in person care across health systems is a priority to create and sustain healthy nations by improving access to services, along with healthcare experiences, efficiency, and outcomes. Our collaborative project between health services, agencies, consumers, and clinicians across Australia seeks to provide the required evidence and solutions to optimise the integration of virtual care in hospital outpatient settings

Our five-year project contains three embedded sub-studies that use a multi-method approach. Firstly, linked hospitalisation data will be used to produce fundamental new knowledge of patterns of virtual outpatient care use and the associated health service outcomes, including for priority populations. The second sub-study will use realist evaluation to determine the context, circumstances, and populations in which virtual care is used successfully, and economic impact of virtual hospital care for communities. We will then test the effectiveness of a co-designed Specialised Change Methodology for improving workforce change readiness and capability for integrating virtual models of care compared to current practice within health redevelopment settings. Statistical and qualitative analytic techniques will be applied with the resulting data to address the project aims.

Ethics approval has been obtained (Study 1: HREC/97793/DOH-2023-383794; Study 2: 520231303852269; Study 3 520231586954286). Research dissemination will be channelled through established communities of practice in Australian states with whom the project is connected to reach networks of clinicians, consumers and health managers. Further targeted outputs will be devised in collaboration with the projects consumer, clinician and health system partners to guide the implementation and use of virtual modalities in outpatient hospital care, with equity as a central consideration.

The online version contains supplementary material available at 10.1186/s12913-025-13129-2.