LCQ3: Telemedicine services
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Question:
It is learnt that in 1998, the Hospital Authority (HA) started to provide remote video consultation service through video conferencing systems on a limited basis to a small number of elderly people living in residential care homes for the elderly (RCHEs). In this connection, will the Government inform this Council:
(1) whether it knows if HA still provides the aforesaid consultation service at present; if HA does, of the number of consultations provided in each of the past five years, as well as the hospital clusters and hospitals providing the service; if not, the reasons for that;
(2) as it is proposed in the 2022 Policy Address that HA will make a wider use of telehealth services to improve patient experience, whether the authorities have plans to extend telehealth services to more RCHEs; if so, of the details; if not, the reasons for that; and
(3) as there are views that despite the publication of the "Ethical Guidelines on Practice of Telemedicine" and the related "Questions and Answers" by the Medical Council of Hong Kong, they are still unable to allay the concerns of the healthcare sector about the risk of bearing additional legal liability for providing telemedicine consultation services, whether the authorities have studied the enactment of legislation on telehealth services, so as to clarify the relevant legal liability issues; if so, of the outcome; if not, the reasons for that?
Reply:
President,
Thank you, President and also thanks the Hon Lai for raising the question.
The Hospital Authority (HA) has been striving to enhance service quality and patient experience by all means, including optimising the use of technology, particularly the telehealth which is one of the key development directions. In recent years, the HA has been actively promoting telehealth such that suitable patients can receive services without having to visit hospitals or specialist out-patient clinics (SOPCs). Apart from providing tele-consultation services to confirmed COVID-19 patients during the epidemic, the HA has also introduced telehealth services in different SOPCs, nurse clinics, allied health services and outreach services.
The HA has all along been providing services to support patients in residential care homes for the elderly (RCHEs). The "Community Geriatric Assessment Teams" (CGATs) of the HA provide outreach services and visit RCHEs regularly, offering services to patients in RCHEs suffering from more serious or complicated conditions and are unable to attend appointments at SOPCs due to mobility difficulties. At the same time, they also enhance training for carers in taking care of patients in RCHEs. Furthermore, CGATs provide medical and nursing care through telehealth to patients in accordance with patients' clinical needs and actual operations.
(1) All seven hospital clusters of the HA have been providing telehealth services to patients in RCHEs. Also, since the onset of the COVID-19 epidemic in early 2020, all hospital clusters of the HA have strengthened relevant services in response to relevant needs. From April to December in 2022, about 47 000 attendances were recorded for CGAT's telehealth services which covered the enhanced services for RCHEs during the COVID-19 epidemic. The enhanced services were extended to subvented and private RCHEs as well.
(2) Thanks to support from the Government, healthcare service providers and patients, the practice of telehealth has becoming more popular amidst the COVID-19 epidemic. Individual private hospitals and medical institutions also provide telehealth support services for patients as well as COVID-19 infected persons. These patients were able to receive healthcare services without leaving home during the critical period and the over-crowded condition in hospitals and clinics was also relieved.
In this context and under the premise of optimising application of technology, the Chief Executive proposed in the 2022 Policy Address to strengthen telehealth services for improving patient experience. As such, the HA will progressively apply telehealth to suitable non-COVID clinical services, including SOPC services. The HA is currently piloting telehealth services through "HA Go" mobile application and the Clinical Management System being used by healthcare staff. Who are suitable patients? The HA will take the stability of patients' conditions into consideration. Patients who do not require clinical examination but have the need to receive follow-up consultations in Hong Kong will be provided with consultation service via telehealth. We are also aware of the limitations of telehealth that it may not be applicable to all patients or every medical condition. For instance, for patients who require examination by doctors or have to undergo testing like blood taking or imaging, they would need to visit hospitals or clinics. For patients staying overseas, and the doctor in Hong Kong does not possess a licence to practice in that area, he or she in fact could not provide medical services legitimately.
The HA will regularly review the effectiveness relating to the application of telehealth, including enhancing the clinical workflow for providing telehealth services so as to better meet patients' needs and enhance cost-effectiveness. The Government will also continue to explore with the HA opportunities to develop telehealth further. 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 users with more convenience.
(3) As for the guidelines, the purpose of issuing the "Ethical Guidelines on Practice of Telemedicine" (Guidelines) by the Medical Council of Hong Kong (MCHK) issued in December 2019 is to prevent doctors when providing telemedicine from violating the "Code of Professional Conduct" (Code) which shall be observed by all registered doctors in Hong Kong. The Guidelines cover a wide spectrum covering areas including doctor-patient relationship, patient privacy and the way to reserve medical records. If doctors violate the Guidelines, they may violate the Code and the MCHK will exercise disciplinary actions against them. The MCHK issued Questions and Answers to the Guidelines in March last year for doctors' reference when they provide telemedicine services, such that the quality and safety of telemedicine service are guaranteed.
Due to the COVID-19 epidemic, the number of citizens requiring telehealth has increased sharply. The Government invited the MCHK to brief the industry on the contents of the Guidelines and the stance of the MCHK, with a view to addressing concerns of various sectors on providing telehealth services for COVID-19 patients.
Therefore, all locally registered doctors should comply with the "Code of Professional Conduct" and serve in the best interests of patients when delivering telemedicine, they should exercise their professionalism in judging the appropriateness for patients to receive telehealth services under different situations.
The Government will continue to closely monitor the rolling-out and penetration of telehealth in Hong Kong and to adopt appropriate measures to promote its development when necessary. Thank you, President.
Ends/Wednesday, February 15, 2023
Issued at HKT 19:10
Issued at HKT 19:10
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