LCQ19: Designated clinics and tele-consultation service under the Hospital Authority
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Question:
Early last year, the Hospital Authority turned some general outpatient clinics into designated clinics for confirmed cases of the Coronavirus Disease 2019 (COVID-19), and provided confirmed patients of COVID-19 with tele-consultation service. Such designated clinics and the tele-consultation service (the clinics and the service) have ceased operation since January 30 this year. In this connection, will the Government inform this Council:
(1) whether it knows the average daily number of appointments during the operation period of the clinics and the service, and among such appointments, the respective attendances making appointments through the mobile application "HA Go" and by telephone; among the attendances making appointments by telephone, the number of appointments made via the "Care Booking Line", as well as the number of dedicated telephone lines provided by each designated clinic in their Telephone Appointment Systems;
(2) whether it knows the total service attendances during the operation period of the clinics and the service, and among them, the respective attendances of patients who were attended to by doctors at designated clinics and through tele-consultation service; the attendance of high-risk patients who made their appointments via the Care Booking Line, and the respective average waiting time of each high-risk patient and non-high-risk patient from making appointments to receiving medical attention;
(3) whether it knows the total operating expenses of the clinics and the service;
(4) whether it has assessed the specific implementation effectiveness of the clinics and the service; if so, of the details; if not, the reasons for that; whether it will re-launch such services in light of the development of the epidemic; and
(5) as there are views pointing out that the tele-consultation service in Hong Kong has greater development potential and can be used as a feasible option for general patients to receive medical attention, whether the Government will sum up the relevant experience in providing tele-consultation service for confirmed patients of COVID-19 and extend tele-consultation to other medical services, so as to promote the telemedicine development in Hong Kong?
Reply:
President,
In relation to the Hon Chan Pui-leung's question, the reply in consultation with the Hospital Authority (HA) is as follows:
In order to strengthen support for COVID-19 infected persons in the community, the HA activated designated clinics for confirmed cases of COVID-19 (designated clinics) since mid-February 2022 and started providing tele-consultation services to infected persons in the community at the end of July 2022. In response to the Government's cessation of issuing isolation orders from January 30, 2023, COVID-19 infected persons are no longer isolated and are free to go out for medical consultations, the designated clinics and tele-consultation services provided by the HA for isolated COVID-19 infected persons were also terminated on the same day.
(1) and (2) During the activation period of the designated clinics, infected persons could make an appointment at designated clinics through the "Book Tele/DC" function on the HA's one-stop mobile app "HA Go" or calling the relevant designated clinics. Infected persons with higher risk (including elderly aged 70 or above, children aged 5 or below, women at 28 or more weeks of pregnancy, and immunocompromised patients) could also call the "Care Booking Line" of the relevant designated clinics to make an appointment for medical consultation services. For those infected persons who intended to receive tele-consultation services, they could make an appointment through "HA Go". In general, patients would be provided with the earliest consultation timeslot on the same day or the next day when making an appointment through the mobile app or by phone. From the mid of February 2022 to the end of January 2023, the HA's designated clinics and tele-consultation services have provided a total of over 511 600 attendances, of which around 130 100 attendances were provided to infected persons with higher risk aged 5 or below or 70 or above. Various designated clinics have provided over 296 600 attendances, of which around 88 000 attendances were provided to infected persons aged 5 or below or 70 or above. As for tele-consultation services, over 214 900 attendances were provided, of which around 42 100 attendances were provided to infected persons aged 70 or above. Among the overall attendances, more than 67 500 attendances were provided to infected persons with higher risk making appointments via the "Care Booking Line".
(3) To meet the overall needs of COVID-19 infected persons and other patients, the HA needs to flexibly deploy manpower to adjust various services in response to the development of the epidemic. Therefore, the operating expenditure of designated clinics and tele-consultation services for 2022/23 is not readily available. Taking reference of the attendance cost of General Outpatient Clinics (GOPCs) of the HA, the basic operating expenditure of designated clinics and tele-consultations services is estimated at about 300 million, excluding the costs of other additional resources required such as the implementation of strengthened infection control measures, the accessories required for designated clinics and tele-consultation services, additional manpower and support in the consultation workflow for COVID-19 infected persons, prescription of COVID-19 oral drugs for appropriate infected persons and related drug delivery services.
(4) Designated clinics and tele-consultation services can effectively support the infected persons in the community, especially the medical needs of persons with mild symptoms, and are an important part of the multi-tiered triage and treatment strategy. This enables the public hospitals of the HA to concentrate on caring for infected persons who required to stay in the hospitals, thus strengthening the ability and capacity of the healthcare system.
In accordance with the latest development of the epidemic situation, the HA has strengthened its services to sustain support for COVID-19 infected persons in the community. At present, all GOPCs provide treatments for COVID-19 infected persons. The HA has also reserved consultation quotas for infected persons with higher risks to make appointments. They may also call the HA support hotline 1836115. In addition, the HA has enhanced the support of outreach medical teams for infected persons in residential care homes.
The HA will continue to closely monitor different service needs, and adjust services according to the situation and demand with a view to providing appropriate treatment for patients.
(5) The HA has been striving to introduce modern technology to provide patient-centered healthcare services, in order to provide a better experience for patients and to improve service quality. As technology evolves, the HA is actively implementing telehealth so that suitable patients can receive the healthcare services of the HA without visiting hospitals or clinics personally. This also helps alleviate the over-crowded situations in hospitals or clinics.
Since the outbreak of the COVID-19 epidemic, the HA has been striving to re‑engineer various service models, where practicable, and explore the use of information and telecommunication technology in different types of workflow to continuously provide medical services.
With reference to the experience during the epidemic, the HA is currently providing tele-consultation services through "HA Go" and other platforms for suitable patients. Relevant services are being implemented in some Specialist Out-patient Clinics, nurse clinics, allied health services and outreach services. However, telehealth has its limitations and may not be suitable for all patients or circumstances. For example, patients who need to undergo clinical examinations by the doctors are required to visit hospitals personally to complete the whole examination procedure. Generally speaking, the HA will provide tele-consultations services to follow-up patients who are stable, do not need clinical examinations, and are physically located in Hong Kong.
The HA will continue to actively promote the application of telehealth to appropriate healthcare services progressively, with a view to benefiting more patients in need. The Government will also continue to explore with the HA more opportunities to make use of telehealth. On the other hand, when developing primary healthcare and the associated eHealth supporting system, the Government will further study the feasibility of providing telehealth services and how to provide more convenience for it.
Ends/Wednesday, February 15, 2023
Issued at HKT 15:22
Issued at HKT 15:22
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