On 23 January 2020, the first index case of COVID-19 was diagnosed in Hong Kong. Since then, the number of cases has risen at an alarming rate. In anticipation of the outbreak, the Hospital Authority in Hong Kong actively cut down clinic sessions since February 2020 to reduce clinic attendances and hospital admissions in order to reduce cross infection among patients. 


Every year there are some 13.5 million attendances in the outpatient clinic across 7 clusters in the Hospital Authority. COVID-19 has severely disrupted the public healthcare services, leading to accumulating clinic caseload and potentially delay in diagnosis and treatment.


With the tremendous support from the Information Technology and Health Informatics team of Hospital Authority Head Office, United Christian Hospital and Tseung Kwan O Hospital were the first hospitals in Hong Kong to pilot the use of telemedicine during COVID-19 to mitigate the service disruption. At the early phase, Zoom was adopted as the official app for telemedicine. However, there were concerns over the potential vulnerability with Zoom and patients’ privacy. A series of security assessments on the Zoom client was performed to ensure that patient’s data were encrypted, and vulnerabilities had been resolved. Zoom client was subsequently incorporated into HA Go, the official app of Hospital Authority. Patients could attend a tele-consultation through the HA Go app. The app had a comprehensive list of functions, including making future appointments, delivering health educational videos to patients via push notifications, payment, checking of the latest investigation results and appointments. All these minimize patients’ stay in the hospital and thus avoid exposing them to the coronavirus. Here we share our experience in the Kowloon East Cluster on developing and implementing a telemedicine program for public health care service.

Smart Hospital development is one of the strategic development directions in Hospital Authority. Kowloon East Cluster(KEC) starts smart hospital development since the year of 2017. Smart Operation Theater (Smart OT) is one of the smart core team in KEC smart hospital development. Patient safety and operation efficiency is the focus of smart application development in Operation Theater. Smart OT in KEC is the first operation theater in Hong Kong to achieve complete electronic documentation and paperless workflow. Different self-initiate IT systems including Anesthetic Care Information System (ACIS), Peri-operative Nursing Information System (PNIS), Pre-anesthetic Assessment System (PAAS), Auto-charting of Vital sign (E-vital), Electronic Surgical Safety Checking with Patient Verification System, Smart Dashboard and Smart Dangerous Drug Cupboard etc. Apart from IT systems for operation workflow, smart initiatives like 手術之phone, VR for patient pain control, and tele-nurse-consultation for pre-anesthetic assessment are developed to improve patient satisfaction. KEC Smart OT team is a reliable partner with HAIT. Smart project like mobile surgical instrument tracking system (M-SITS), Geek project like Hololens and non-tactile control of patient film are under co-development.

Smart technology has been applied to a wide range of healthcare services around the globe with the aim of promoting patient safety and staff productivity. Since the implementation of Inpatient Medication Order Entry (IPMOE), the Pharmacy Department of every Kowloon East Cluster (KEC) hospital has proactively introduced intelligent systems, which include Automatic Medication Unit Dose Dispensing System, Smart Medication Cabinet and automatic drug prepacking machines, to manage different areas of pharmacy operation. These automated systems have enhanced the efficiency of drug supply and improved the accuracy of medication inventory. 


In recent years, smart initiatives have been implemented among KEC Pharmacies to enable closer inter-hospital collaboration. For example, Haven of Hope Hospital (HHH) is an extended-care hospital without overnight pharmacy service. After the implementation of IPMOE in HHH in 2018, pharmacists from Tseung Kwan O Hospital (TKOH) have provided after-hours IPMOE verification support for HHH inpatients, allowing timely verification of new inpatient drug orders to facilitate drug requisition from Smart Medication Cabinet by nurses. The workflow of drug supply upon patient transfer from United Christian Hospital (UCH) or TKOH to HHH has been streamlined to ensure timely and continuous provision of drug treatment. With the use of automatic prepacking machines, HHH Pharmacy has also served as the Cluster Prepacking Centre to support the operation of other KEC Pharmacies in a cluster-collaborative and cost-effective approach.


The introduction of smart technology to pharmacy services has been challenging yet fruitful. Other healthcare disciplines have given positive feedback on the adoption of intelligent medication management systems. Individual KEC Pharmacies are devoted to the development of new innovative strategies to improve medication safety, ensure security of controlled drugs, save nurses’ time in record keeping and manage ward stock inventory in a real-time manner.