Authors (including presenting author) :
WU WY(1), KWAN CK(1), KO HL(1), TONG KY(1), LY YFC(1)
Affiliation :
(1) Department of Physiotherapy, Tin Shui Wai Hospital
Introduction :
Telecare using ZOOM is a hot topic recently. ZOOM allows online meetings with video and audio connection via Internet. It enables the patients to have ZOOM follow-up with different health-care specialties without the need of going outdoor. Thus, the risk of getting infected during the covid-19 pandemic decreased. On the other hand, Hospital Authority has been promoting a mobile application “HA Go”. This app served multiple purposes, including the “HA Go prescription” from allied health. It allows the prescription of exercise in the form of videos, which can remind the patient to follow the exercise schedules and enable them to review the exercises themselves. Even after carer training, we would not know whether the patient and the carer were doing well at home unless there was a community follow-up. Post-discharge telecare was a possible solution to fill this gap in our services. A ZOOM follow-up after discharge might be able to monitor the patient’s condition, and reinforce or correct the skills of caring at a lower cost. With the help of “HA Go prescription”, it is also possible to prescribe the tailor-made set of videos related to patient’s exercise and carer training.
Objectives :
1. To share the experience on using ZOOM follow-up and “HA Go prescription” as post discharge telecare. 2. To review the outcome and change in patient’s physical performance on using ZOOM follow-up and HA Go prescription
Methodology :
Patients who admitted to convalescent beds and required carer education before discharge in TSWH were included for analysis during the period of 13 Jul 2020 – 2 Oct, 2020 (12 weeks). This study aims to recruit 10 patients. Two appointments of ZOOM follow up would be made on the day of discharge. “HA Go prescription” would be prescribed as needed on the day of carer training. Outcome measures including: [1] carer satisfaction level (0-6, 6 means the most satisfactory); [2] patient satisfaction level (0-6, 6 means the most satisfactory); [3] MFAC (cat 1-7); [4] Fall rate and [5] Compliance rate of “HA Go Prescription” would be assessed at the day of discharge, 2nd week and 4th week after discharge via ZOOM follow-up.
Result & Outcome :
Nine patients were included in the study during the period of 13 Jul, 2020 – 2 Oct, 2020. All patients and their respective carers participated in both appointments of ZOOM follow-up. The mean carer satisfactory level score ranged from 5.56-6.00 (±0.51) while the mean patient satisfactory level score ranged from 5.71-6.00 (±0.36). 78% of the patients demonstrated improvement in mobility level at the 4th week as compared with the day of discharge. The median MFAC score was category 4 at the day of discharge. The median MFAC improved to category 5 and category 6 at the 2nd week and 4th week respectively. One patient required walking aid prescription during the first ZOOM follow-up. Improvement in MFAC score was demonstrated at the second ZOOM follow-up. No fall incident was noted during the study. Exercise and transfer technique videos were prescribed to 6 patients via “HA Go Prescription”. The compliance rate of “HA Go Prescription” is 50% among these patients. Conclusion: Telecare using ZOOM follow-up and HA Go Prescription could be a feasible mean of post-discharge follow-up. ZOOM follow-up could be arranged after the carer education and work as a reinforcement after discharge. On the other hand, the “HA Go Prescription” could prescribe video demonstration and exercise selectively if face-to-face education was not possible, especially during the covid-19 pandemic. Both the patients and their carers appreciated the services of ZOOM follow-up and “HA Go Prescription”. They were keen for the programme on approach. They also agreed that the Tele follow-up improved their confidence of home care. The main difficulties of the programme was the compatibility of the hardware and software from the side of the patient and the carer. They required more technological support from the therapists and relatives.