Authors (including presenting author) :
Chan TC
Affiliation :
Occupational Therapy Department, Queen Mary Hospital
Introduction :
Since the introduction of smartphone, some communication with patients has been shifting to using messaging app, i.e. whatsapp. After the outbreak of COVID-19, hospital were adapting to a new normal situation where patients may wish to settle their medical needs and enquiry by tele-medicine. As occupational therapists, we tends to explore different new tools and framework to deliver our services. “Whatsapp” were chose for the task because of its popularity in Hong Kong.
Since the demand for the use of tele-care were increasing, more structural management of the message system, i.e. whatsapp were needed. Digital contents that are frequently being used should also be prepared and aligned by all therapist. The projects aims to find out the feasibility, target case types, digital contents and patient satisfaction of newer way of communication with patients.
Objectives :
In order to meet the demand for increasing need of tele-care services, several case types of patients, includes 1) pre-discharge patients with possible home environment barriers, 2) first time home oxygen therapy user, 3) Cases with tendon injury that require dynamic splintage and home exercise.
We identified these case who are willing to use whatsapp as a mean as communication, they may or may not have carer to help with. We take advantage on “shortcut function” of “Whatsapp Business” and develop video or text contents that are agreed among therapist. We aim to find out the number of cases in need of and willing to use this communication channel, utilization by therapist, develop suitable digital contents and survey on patient satisfaction of this extra services.
Methodology :
Multiple digital contents were developed based on different patient types and needs.
In pre-discharge cases, virtual home environment screening were important for discharge care planning or assistive devices recommendation. In order to guide carer to take home environment photos and take some basic measurement of home environment, sample environment photos were sent as a guide for carer. Therapist can also send pre-made photo guide to direct carer to do photo taking of their home. For example, the width of front door is critical for in-and-out of wheelchair, therapist can pick a pre-made shortcut, i.e. door with/ without gate, door with/ without kerb, carer can take photo and measurement according to the photo guide.
For first time home oxygen therapy users, they have lots of information to take up. To start with, quotations from different services provider are essential for them to choose a rental plan, furthermore, they need some tips and instructions to take care of the new machine at home. Since most users were elderly patients, they usually cannot take so much information at once, old style pamphlets are good but sometimes images and video speaks more; so digital contents, pamphlets and education video were made as contents and sent to them as reference. Video contents were focused on how to clean nasal cannula and perform bathing with oxygen generator, a visualised way for patients to have reference at home.
Another category chosen were cases with tendon injuries that require dynamic splintage. Dynamic splinting program are hard to follow for some patients, digital pamphlets were designed, educational videos were made and sent to patients as reference.
Cases in 2020 were saved, contents of conversation were counted and sampled for analyse.
Result & Outcome :
We identified 3 categories of occupational therapy services that were most carried out by whatsapp. They were, in descending orders: virtual home screening, deliver home oxygen therapy information/ educational videos and providing assistive devices information.
Utilisation of the whatsapp channel by therapist were seen increased. Number of patients established communication through whatsapp were increased from 7.3 cases per month to 27.1 cases per month, i.e. Jan 2020 and Dec 2020. Most patients welcome the addition way of communication. Further questionnaire can be sent to patients for quantitative analyses in the future. Use of whatsapp and pre-made digital content demonstrate efficiency, time-saving for therapist to deliver therapy in one different way. The pilot demonstrate good feasibility of tele-care or tele-rehabilitation. More cases types and refinement of digital contents will be areas for improvement in the future.
