Authors (including presenting author) :
Edwin YH Chan1, Felix Tsui1, YS Ng1, ML Chan1, BC Wong 1,Jun Liang1
Affiliation :
1Department of Family Medicine & Primacy Health Care, Community Care Division, New Territories West Cluster, Hospital Authority
Introduction :
The GOPCs target to serve the underprivileged patients, especially those with chronic illnesses. COVID-19 poses a great impact to the service. In addition, tightened infection control measures made the patient-flow within the congested clinic environment very challanging. With the undue fear of viral outbreaks in the community, the number of attendance at GOPCs dropped, especially those with chronic illness follow-up, reflected by the highest default rate 23% in February 2020 in NTWC.
Therefore, NTWC GOPCs introduced teleconsultation to meet the challenges. Also, the extensive network of GOPCs in the community plays an important role in the COVID-19 surveillance.
Objectives :
Review how the GOPCs in NTWC overcome the challenges in patient care, their role in COVID-19 surveillance and related outcome during the COVID-19 pandemic.
Methodology :
Concerning the patient-flow, triage stations have been set up at all GOPCs upon the activation of emergency response on 25th January 2020. One direction pathway of patient-flow was designed with enhancing social distancing. Also, separate waiting areas, designated routes and special consultation rooms were reserved for suspected COVID-19 cases.
For, patient defaulted their chronic illness, if they decided not to attend in-person, they could choose either medication refill by their representative only or having teleconsultation together with the refill based on the clinical condition. There were regular comprehensive risk assessments for hypertensive and diabetic patients. In NTWC, teleconsultation was also introduced to perform part of the risk assessment.
For COVID-19 surveillance, Deep Throat Saliva (DTS) test was ordered by doctors for suspected cases (Tier 4) whereas DTS specimen collection packs were distributed at GOPCs as a self-initiated testing (Tier 7 H).
Result & Outcome :
GOPCs act a good surveillance point for Covid-19, for NTWC, total 40757 Tier 4 samples were disturbed from the period of 19 Feb to 10 Dec 2020. The positive rate for the whole Tier 4 program was around 0.38%.
Also 40854 Tier 7 samples were disturbed from the period of 27 July to 13 Dec 2020. The positive rate for the whole Tier 7 program was around 0.15%
In addition, 816 teleconsultations, including doctor consultation and risk assessment, were carried out from May till November 2020 for those who have difficult to attend the clinics.
