‘Tele-medical Care and Medication Guidance Pilot Project in Sai Kung Rural Communities’ is one of the pioneering tele-medical projects in Hong Kong responses to the challenges rural elderly face to attend General Outpatient Clinic (GOPC) follow ups under the COVID-19 pandemic. Sai Kung District Community Centre (SKDCC) attempts to share a solid and replicable experience in order to facilitate the long-term development of tele-medicine in Hong Kong through this pilot project to improve rural elderly’s access to the primary care system.
According to SKDCC, “Tele-medical care implies the use of Information Communication Technology to promote patient outcomes by increasing access to care and medical knowledge to cope with chronic diseases for better livelihoods, and it is intended to overcome geographical limitations during COVID-19 outbreaking, connecting service users who are not in the same physical location. Meanwhile, it integrates a service model with medical and social expertise and emphasizes providing whole-person care for the service users. It is not limited to taking care of physical health, but also mental and social well-being.” The core value of tele-medical care is to enhance accessibility and flexibility of socio-medical care in Sai Kung rural communities.
The service period lasted from 1/9/2020 to 30/9/2021, which was 13 months in total. The case files of the corresponding candidates were then evaluated by the pilot project committee and 40 targeted service receivers were selected. After the recruitment procedure, the nurse in charge attended the first home visit and conducted a briefing on the proposed service.
Followed by the home visit conducted by the nurse, the doctor in charge also completed a home visit with the elderly within 3 weeks. The first face-to-face consultation aimed at further evaluation in the health condition of the elderly.
After the first face-to-face consultation, there were 4 regular follow-ups in the format of tele- consultation. The nurse visited the elderly’s home alongside with the equipment for checking basic body health parameters and supported the elderly throughout the tele-consultation sessions. Tele-consultation usually lasted for around 20 minutes. After the consultation session, the doctor prescribed drugs according to the health condition of the elderly. Besides, the nurse also gave advice and health education on self-care strategies for the elderly accordingly. If the elderly’s health condition was considered as stable, follow-ups would then be arranged in the frequency of once in two or three months. After the tele-consultation, the nurse would review the drugs of the elderly and communicate with the caregiver if needed.
Our pilot project service users living in rural areas have welcomed the use of telemedicine with the support from outreach health care team despite a low acceptability in tele-consultations by the public. Those elderly with impaired mobility will be at most need of tele-medical care and most willing to utilise this service. The TMMG project has achieved a high satisfaction level (8.939 out of 10) from the participants, among which most of them agreed tele-medicine is convenient and accessible. It has extended their access to primary care service across geographic borders.