Phone checks on high-risk patients to rise

PUBLISHED : Friday, 02 October, 2009, 12:00am
UPDATED : Friday, 02 October, 2009, 12:00am

A successful telemedicine service will be expanded to more public hospitals this month to reduce readmissions of high-risk patients.

The Hospital Authority plans to extend the 'telephone nursing consultation programme' to all public hospitals in two years. Under the scheme, nurses call discharged patients to check on their condition and patients can dial the hotline for health information and advice.

The Hong Kong East group of public hospitals has pioneered the programme for newly discharged high-risk patients aged over 65 for the past five years. The group runs Pamela Youde Nethersole Eastern, Ruttonjee and Wong Chung Hang hospitals.

At 4am daily, a computer automatically scans patients' records to identify high-risk patients. A designated team of nurses makes a first call to these patients within 48 hours after their discharge, and a second call within 72 hours. They give medication advice and teach patients how to take care of themselves at home.

Most of the patients have heart diseases, lung disease, diabetes or hypertension. Some patients call the centre when they are not sure whether a change in their condition means they should go back to the hospital for a consultation.

The director of community service for the Hong Kong East group, Wong Chun-por, said the programme had served more than 20,000 elderly patients in the past five years and was proved to be successful. Wong, a consultant physician at Ruttonjee Hospital, said an evaluation this year found the readmission rate within 28 days among high-risk patients had dropped from 27 per cent to 21 per cent.

'The beauty of the programme is it provides prompt follow-up to our patients. The patients also know how to get advice instead of spending time travelling to hospital or to book an unnecessary medical appointment.'

The group had drawn up clear protocols for nurses so they knew in what situation they should ask a patient to return to the hospital.

The Hong Kong East group processes 15,000 calls a year, 60 per cent of which relate to medication problems. It costs about HK$30 to deal with each call. By cutting the readmission rate, the programme saves the hospitals 1,900 patient admissions, or 8,000 patient bed days, a year, equivalent to HK$23 million.

'It is a highly efficient and personalised service,' Wong said.

The Kowloon Central group, which manages Queen Elizabeth and Kowloon hospitals, has been running the same project for two years.

From this month, the programme will expand to hospitals in New Territories East, including Prince of Wales, Alice Ho Miu Ling Nethersole and North District. The Hospital Authority plans to expand it to all public hospitals in two years.

Wong said it had been a global trend over the past decade to provide medical advice by phone.

A similar service in Britain, NHS Direct, for example, had been in service for 10 years to provide health information and referrals. The service was delivered by more than 50 call centres.

Wong said there was great potential to expand telemedicine in Hong Kong to take care of other chronically ill and mental patients.

On call

The Hong Kong East group of hospitals deals with 15,000 calls a year under the programme

The cost of processing each call is, in HK dollars: $30