Authors (including presenting author) :
LAU NLK(1), CHAN YMM(1), KOO LPC(2), CHAN KFH(2), LY YFC(1)
Affiliation :
(1)Physiotherapy Department, Tin Shui Wai Hospital (TSWH), (2)Physiotherapy Department, Tuen Mun Hospital (TMH)
Introduction :
Physiotherapy service for paediatric is developing in TSWH. There is inadequate experienced paediatric physiotherapist supporting the service for cases with high complexity.
In the past, physiotherapists in TSWH would consult our experienced colleagues in TMH via telephone for those cases. However, its efficiency was limited as real-time re-assessment and feedback from patient and care giver was not possible. Therefore, a more comprehensive consultation pathway to support physiotherapists of TSWH was needed. With the rapid development as Smart Hospital and TELE-care system in Hospital Authority, a preliminary program of TELE-care Joint Consultation Service was developed.
Objectives :
This pilot Tele-care program aims to: 1) enhance quality of patient care; and 2) foster staff training by enhancing skills and knowledge in paediatric physiotherapy.
Methodology :
The indicated paediatric cases of TSWH with: 1) slow progression; or 2) suspected co-morbidities were selected by physiotherapist in TSWH monthly. Once verbal consent was obtained from the caregiver, an online consultation using online video conference software (ZOOM) was scheduled. Patient’s information would be sent to the responsible physiotherapist in TMH via department e-mail with encryption for accessing patient’s clinical details via Clinical Management System.
A real-time consultation by TSWH physiotherapist on-site and TMH physiotherapist via ZOOM would be carried out, which the experienced TMH physiotherapists would provide real time coaching and management plan advice. Referral to other specialist for further management could also be made as indicated.
Result & Outcome :
From September to November 2020, three sessions of joint consultations were held as pilot. A total of three cases were discussed, with an averaged consultation time of 60 minutes per session. Joint assessment was carried out, then advice on management and home exercises were given. In one of the case, which was initially referred for torticollis, was included due to suspected Erb’s palsy as noticed during the assessment. The case was referred to Paediatric Orthopaedics clinic immediately for further management by paediatric specialist.
Overall, feedback from caregivers was positive, which they highly appreciated the comprehensive consultation and opinions made by physiotherapists from both hospitals. Moreover, physiotherapists in TSWH was also in support of the program as it can provide great opportunities for learning with real-time consultation and advices from experienced staff.
As this Tele-care service model can negate geographical limitations and provide real-time feedback, it has proven its superiority over traditional telephone consultation in term of quality of clinical service and timely specialist support for indicated patient. Hopefully this pilot program could provide insights for further development of Tele-rehabilitation and thus Smart hospital as a whole.
