Authors (including presenting author) :
Cheung HY (1), Wu A (1), Chan R (1), Lam KF (1), Lai CL (1), Man D (1), Ho YK (1), Chung KH (1), Pang V (1), But YY (1), Wong KK (1), Hau YW (1)
Affiliation :
(1) Department of Psychiatry, Pamela Youde Nethersole Eastern Hospital
Introduction :
In response to “Coronavirus Disease 2019 (COVID-19)”, the Hospital Authority has activated the Emergency Response Level since January, 2020. The Hospital Authority has implemented service curtailment to reduce the risk of cross-infection (Hospital Authority, 2020). The Psychogeriatric Outreaching service to Residential Care Homes for Elderly (RCHE) was seriously affected as the outreaching service was suspended except for crisis intervention and mentally unstable patients (violence or suicidal risk). The revised outreaching service was augmented with phone care, video visiting and drug refill. Telecare and televisit by nurse and telemedicine by doctor were implemented to provide alternative means of patient assessment with evaluation and management to continue the approach of patient-centered and community service model, and to minimize emergency service required, e.g. attendance at Accidents & Emergency Departments and walk-in attendance at Psychiatry Out-patient Clinic of Pamela Youde Nethersole Eastern Hospital (PYNEH).
Objectives :
To evaluate the effectiveness of telemedicine. To examine the user satisfaction of telemedicine.
Methodology :
A videoconferencing software "Zoom" was adopted for Telemedicine and Televisit Psychiatric Service. RCHEs of Hong Kong East Cluster covered by Psychogeriatric Team were invited to participate in telemedicine. Telecare and televisit by psychogeriatric outreaching nurse would be provided before the telemedicine session by psychiatrist or when necessary. Patient’s mental status, treatment response and tolerance, and other special condition would be evaluated as in-person assessment. Nursing intervention such as counselling, psychoeducation and medication education would be provided if necessary. Patient's condition and nursing intervention would be recorded with setting of telemedicine/telecare specified. Patients having unstable mental status (except violence or suicidal risk) and treatment revision would be arranged for telemedicine sessions. A five points likert-scale questionnaire with 4 questions was used to examine the user satisfaction on telemedicine.
Result & Outcome :
From February 2020 to November 2020, a total of 34 (97%) RCHEs have participated in telemedicine. 943 (94%) patients received telecare and 60 (6%) patients received televisit service. 391(18.1%) patients attended telemedicine sessions. There is no significate increase (p< 0.01) in attendance at Accidents & Emergency Department or walk-in attendance at Psychiatry Out-patient Department of PYNEH after implementation of telemedicine. The RCHEs were satisfied with telemedicine and televisit service. In conclusion, telemedicine is a satisfied alternative option when on-site psychogeriatric outreaching service is not feasible or undesirable in special situations.
