Sustainability outcomes of virtual care for people with intellectual disability.

Background and Aims
The delivery of specialist services to people with intellectual disability has undergone a shift to be more inclusive of online and virtual care options. Triggers for this shift include expansion of specialist services to more rural and remote areas of NSW and the COVID-19 pandemic. Anecdotal evidence from staff and clients of the NSW Intellectual Disability Health Teams suggests that virtual care provides a range of benefits; however, research evidence is lacking in this area. This study aims to determine if the delivery of virtual care services is feasible, acceptable, inclusive, and accessible to people with intellectual disability, their carers, and specialised intellectual disability clinicians. The findings of this study will inform the future direction of virtual care service delivery for people with intellectual disability. This presentation focuses on sustainability outcomes of virtual care.
Methods
This mixed-method study involved online surveys and interviews with specialised intellectual disability clinicians, clients, and carers to explore their experiences of providing or receiving virtual care. Clinician survey questions were drawn from the NSW Health Clinician Experience Measure. A modified Easy Read version of the NSW Health patient virtual care survey was developed for
clients/carers to ensure research participation was accessible for people with intellectual disabilities. The research team sought consultation from people with intellectual disability, Aboriginal representatives, and specialist clinicians throughout the research planning and development of surveys.

Results
Twelve interviews and 22 surveys were conducted with clinicians. Eleven interviews and 13 surveys were conducted with clients/carers. The overall experience of virtual care services for people with intellectual disability was positive from the perspective of clients, carers, and clinicians. Participants reported a range of benefits of virtual care services that promote sustainability,
including: 1) reduction in resource requirements in comparison to attending in-person clinics, including transport, accommodation and NDIS funded supports, 2) increased flexibility for clients and carers including less time off work, and 3) efficiencies in service delivery. These benefits were reported to reduce carer strain and improved access to specialist health services for rural and
metropolitan clients and carers.

Implications
Sustainability in health care services for people with intellectual disability can be achieved using virtual models of care. Further opportunities for increasing sustainability exist through sharing virtual care resources and guidelines across the intellectual disability health service network, providing clinician training in virtual care, and through improvements to health infrastructure that supports
virtual care.