Page 86 - HA Convention 2016 [Abstracts (Day 2)]

HOSPITAL AUTHORITY CONVENTION 2016 Service Enhancement Presentations

F8.6 Young HA Investigators Presentations 14:30 Room 421

Healthcare Innovation Project — Develop Defaulter Management System to Improve Psychiatric Follow-up
Compliance
Tse PYF 1, Chiu YT 1, Chan CK1, Tang WY 2, Chan WT 2, Cheung NT 1
1Clinical Innovation, Quality Assurance and Risk Management Team, Health Informatics Section, 2Clinical Information Support

Systems Team, Information Technology Section, Hospital Authority Head Office, Hong Kong

Introduction

Recent tragedies raise public concerns on the current tracing mechanism for psychiatric appointment defaulters – the lack of
follow-up consultation in Hospital Authority Specialty Outpatient Clinic (SOPC) may possibly lead to relapse of serious mental
illness and pose a threat to the society. High risk defaulters are tracked by Community Psychiatric Team. For the 50,000
psychiatric patients with medium risk, however, efficient follow-up strategy may not be in place. SOPC staff attempts to
contact psychiatric appointment defaulters for re-booking of follow-up appointment. With an increased number of defaulter,
repeated outbound calls may induce additional workload to SOPC. To tackle this issue, HA initiates a healthcare innovation
project to improve psychiatric patients’ follow-up compliance. Information Technology and Health Informatics Division
develops a Defaulter Management System (DMS) to support defaulter tracing service provided by Mental Health Direct (MHD)
under Community Health Call Centre.

Objectives

The aims of developing DMS: (1) to identify patients who have defaulted psychiatric specialist follow-up service; and (2) to
facilitate case referral and tracing outcome sharing between SOPC and MHD.

Methodology

There are three phases of developing DMS:

• In discovery phase, problem is identified: HA needs a systematic defaulter tracing mechanism for medium risk patients who
do not attend their psychiatric appointment. Through collaborating with SOPC staff from different clusters, working culture
is blended and potential solutions are co-created.

• In incubation phase, rapid cycle prototyping is done to identify the best-suited method. SOPC staff generates the defaulter
list from Outpatient Appointment System (OPAS) and facsimile the defaulter list to MHD. MHD staff would call patients via
Call Logging System (CLS) and re-book appointment for patients whom they manage to contact. Tracing outcome would
be forwarded to SOPC for necessary follow-up action. Through the trial run, the workflow is simplified and barriers are
recognised and eliminated.

• In acceleration phase, the successful model is implemented through developing Defaulter Management System (DMS) to
replace communication by facsimile.

Wednesday, 4 May Results

DMS connects to two external systems — OPAS used in SOPC and CLS used in MHD which serves as an electronic
centralised platform between two health institutions. With DMS, psychiatric defaulters can be identified and being referred
to MHD by SOPC staffs. For the tracing outcome, MHD can share to SOPC staffs via DMS. DMS is launched to five clusters
with over 1,500 referred cases per month and almost 70% defaulted psychiatric appointments can be re-booked. Feedback
from SOPC and MHD are positive and the DMS is regarded as a useful mean to support psychiatric defaulter tracing service.
Future refinement of DMS will be made: firstly to enable re-booked appointment details to be sent directly to patients via
SMS for better patient engagement; and secondly to further integrate DMS with Patient Programme Summary in Clinical
Management System so as to enhance communication with other clinical teams for continuous patient care.

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