Cystic Fibrosis Telehealth Virtual Clinic Initiative

This is a pilot/feasibility study comparing the routine multidisciplinary CF clinic structure with a hybrid model including Telehealth virtual clinics over a period of 1 year. Data will be prospectively collected from 3 CF patient cohorts within the Royal Prince Alfred Hospital CF Clinic: a. Patients living in regional NSW b. Patients living in metropolitan NSW, 15km away from the RPA CF centre c. Patients colonised with multi-resistant bacteria The Telehealth group will receive a portable spirometer to be used at subsequent telehealth visits and instructions on how to use the device. This will be provided at their initial (recruitment) visit. Patients will be advised that they will have access to CF Telehealth virtual clinics over the following 12 months. International CF guidelines recommend attendance at CF clinic every 2-3 months. At least 1 of their routine clinic visits during this time will need to occur in hospital. All other visits can be via telehealth. Further information: Telehealth sessions will use a secure online pexip platform made available through Sydney local health district. Duration of sessions for vary between 1-2 hours to incorporate usual clinical care involving the multidisciplinary CF team (including physicians, nurses, physiotherapists, dietitian and sub-specialists). Clinics will occur every 3 months as recommended by national and international CF guidelines. Telehealth can be performed by any member of the MDT CF service. Telehealth sessions will replace some routine face to face clinic visits. Usual discussions that occur within face to face CF clinic visits will occur via telehealth. Patients will need to use the spirometry apps during telehealth clinic visits and will need to connect to the online platform for their telehealth visit. Patients will need to email portable spirometry results prior to their visits, and will need to be observed performing spirometry during their telehealth visit. This is a prospective controlled (non-randomised) study. Patients who agree to participate will be consecutively enrolled in the telehealth arm. Patients who are not assigned to telehealth will be invited to partake in the study as control subjects (usual clinic based care) and asked to provide feedback on the current face to face health delivery model in the clinic. This intervention will replace some routine clinic visits. Patients will be asked to attend 2 face to face appointments (every 6 months). All other visits can be done via telehealth. We will monitor clinic attendance over this one year period. Email reminders will be used if results are not sent, followed by phone calls. The AirMD spirometry app will be used, which is freely available in the app store on most smartphones. Results of their spirometry will only be available on their phone and not stored in a cloud. Participants set up their profile on the app and will save data locally only ie on their phone. They can share results with us by sending a pdf copy of their results. Patients are free to use their spirometers any time they feel it is necessary but should send spirometry results before their telehealth visit. Spirometry will be performed again during their telehealth visit.