Authors (including presenting author) :
LEUNG F(1), YONG R(2), YIM E(3), CHEUNG J(4), LAM PL(5), CHAN E(6), CHUNG D(7), POON E(8), LO TC(9), CHING CYN(9), POON YHP(9)
Affiliation :
(1) Clinical Psychology Department, Kowloon Hospital
(2) Department of Dietetics, Pamela Youde Nethersole Eastern Hospital
(3) Medical Social Work Department, Ruttonjee & Tang Shiu Kin Hospitals
(4) Department of Occupational Therapy, Tuen Mun Hospital
(5) Department of Physiotherapy, Queen Mary Hospital/ David Trench Rehabilitation Center
(6) Department of Podiatry, Pamela Youde Nethersole Eastern Hospital
(7) Prosthetics & Orthotics Department, Queen Elizabeth Hospital
(8) Speech Therapy Department, United Christian Hospital
(9) Allied Health Grade Department, Cluster Services Division, Head Office
Introduction :
During the COVID-19 pandemic, treatments considered not urgent was recommended to be postponed in order to ensure safety. In addition, social distancing with spacing out treatment sessions were also adopted in hospital setting to minimize the risk of cross-infection. In this connection, tele-care has been evolved to support the allied health (AH) services.
Objectives :
To implement AH tele-care services to various patient groups with the support of digital means and a mobile rehabilitation application via the HA Go Prescription to deliver rehabilitation in a remote manner.
Methodology :
Various AH Co-ordinating Committees (COC(AH)) and department in-charge, including clinical psychology, dietetics, medical social work, occupational therapy, physiotherapy, prosthetics and orthotics, podiatry and speech therapy, were engaged to work on the patient selection targeting for protocol-driven tele-care service models. Apart from the professional input, different communication devices and IT enablers, such as scheduling in the Out-Patient Appointment System and user guide of digital means for both patients and therapists, were secured in place. An AH Tele-Care Operation Guide was also released to set out the applications of tele-care, patient selection, workflow, communication kit with patient and documentation requirements. In addition, resource materials for patient empowerment was also consolidated with increased number and variety of training videos in the mobile rehabilitation application applicable for a wider spectrum of patient groups. The utilization of tele-care service was retrieved and reported to disciplines on a monthly basis for fine-tuning of the service models.
Result & Outcome :
The utilization of tele-care services increased during each wave of COVID-19 with a monthly average of 21,861 AH attendance of all disciplines delivered by tele-care mode from Feb to Nov 2020. AH tele-care services was adopted as a new normal as illustrated by a relatively stable monthly telecare utilization of 14,000 attendances from Oct to Nov 2020. Around 55% of the telecare services were implemented for out-patient services except medical work service applied 68% of their tele-care services in in-patient setting. There was an increasing trend of tele-care application to day hospital and primary care service in dietetics, occupational therapy and physiotherapy. All disciplines also identified 2 to 3 categories of patient groups who would benefit most with well-defined protocols. The roadmap for the pilot run was confirmed to evaluate the effectiveness, patients’ level of acceptance and satisfaction. Both the clinical psychologists and speech therapists launched the pilot program on Parenting and Developmental Speech and Language disorders respectively. 80% - 87% of parents satisfied with telecare services as a whole. Around 60% parents agreed that telecare are comparable to face to face consultation and willing to pay for such service. With accumulative experience and outcome evaluation of the pilot run, AH will further refine the protocol-driven tele-care services leading to a new normal of our practice. The active participation of various COC(AH) and frontline colleagues contributes to the success of this innovative mode of AH service.
