Authors (including presenting author) :
Yuk DKL(1), Ma BHM(1), Au KM(1), Chan BHL(1), Ng JSW(1), Leung MMT(1), Ding CQ(1), Yau THT(1), Cheng WSW(1), Chan LM(1), Lee DLS(1), Chow CCS(1), Lam SK(1), Yee PM(1), Au Yeung YS(1), Wan YM(1), Cheung CC(1), Wong YY(1), Cheng HM(1), Chim CK(1), Lee ISC(2), Choi CSW(2), Leung CB(2), Hui E(1)
Affiliation :
(1) Community Services Outreach Team, Prince of Wales Hospital, NTEC, (2) Information Technology Department, NTEC
Introduction :
The first confirmed case COVID-19 in residential care home for the elderly (RCHE) in Hong Kong occurred in July 2020, with subsequent outbreak within the same RCHE and resulted in 7 deaths from this outbreak. Up to November 2020, there were clusters of outbreaks in 5 RCHEs in Hong Kong, involving more than 110 confirmed cases of RCHE residents.
With the support from Cluster Management, Shatin Community Geriatric Assessment Team (CGAT) piloted a new telemedicine service model since HA activated the “Emergency Response Level” in January 2020. Since then, we have been adopting the dual mode of CGAT outreach services, with telecare supplementing on site visits, especially during the periods with surge in number of confirmed COVID-19 cases in the community.
Up to December 2020, there were 97% (36 out of 37) RCHEs in Shatin district joined our CGAT telemedicine pilot programme. More than 170 telecare sessions had been performed, and reviewed approximately 1300 residents via telemedicine.
Objectives :
To describe a new service model in CGAT utilising telemedicine to assess, monitor and follow-up RCHE residents, with the aim of minimising service disruptions and provide continuation of care during times of crisis, from COVID-19 to social unrest, adverse weather conditions and beyond.
Methodology :
Standardised workflow and consent record forms were established. CGAT doctors and nurses discussed with the managers of all Shatin district RCHEs, for the scope and potential benefits of telecare to supplement usual CGAT outreach services. On-site testing of hardware and network signals in RCHEs were performed by CGAT staff to ensure the technical feasibility of using telemedicine as a remote consultation modality. Education briefings to RCHE staff were performed by CGAT staff to facilitate their setup and daily utilisation of the teleconsultation hardware and software.
HA Corporate iPads connecting to the internet either via HA Wifi or Corporate 4G SIM cards were installed with the Zoom application. HA staff login Zoom via accounts registered with HA email to enhance cyber security. On the RCHE side, Zoom applications were mostly installed in iPads, followed by Android tablets or smartphones, connecting to the internet via RCHE wifi or commercial 4G cards.
Some of the originally on-site CGAT outreach sessions have been replaced with teleconsultations at COST office since the commencement of this pilot programme, including regular CGAT clinic follow-ups and visiting ad-hoc sessions.
Result & Outcome :
Up to November 2020, there were 97% (36 out of 37) RCHEs in Shatin district joined our CGAT telemedicine pilot programme. More than 170 telecare sessions had been performed, and reviewed approximately 1300 residents via telemedicine.
RCHE user satisfaction survey revealed 69% of RCHE staff agreed that Zoom application for telemedicine easy to use, and that CGAT telecare allowed timely treatment of clients’ health problems. 73% of RCHE staff agreed they were overall satisfied in using telecare as a mode of CGAT consultation. Meanwhile, CGAT staff satisfaction survey revealed 83% of CGAT doctors and nurses strongly agreed that they were confident to continue using telecare, and 78% strongly agreed that CGAT telecare consultations should be extended to more RCHEs.
