Page 81 - Hospital Authority Convention 2017

Symposiums

S2.1 Tele-medicine 13:15 Theatre 1

The Application of Tele-medicine in the Virtual Doctor Programme
Thompson M
Portslade Health Centre, UK HOSPITAL AUTHORITY CONVENTION 2017
What is tele-medicine? What is tele-health? E-health? M-health? What are their applications? What are the pitfalls to their
applications? We look at the history of tele-medicine, its development in recent years, evidence relating to its application and
our own experience of developing a service in Zambia and its potential.

S2.2 Tele-medicine 13:15 Theatre 1 Tuesday, 16 May

Tele-medicine Consultation in Castle Peak Hospital for Stable Psychiatric Outpatients in Custody
Cheng KM
Department of General Adult Psychiatry, Castle Peak Hospital, Hong Kong

Background
In Hong Kong, persons in custody receive primary medical care within the institutions of the Correctional Services
Department (CSD). Nevertheless, they need to attend psychiatric specialist outpatient clinics (SOPCs) of the Hospital
Authority for their mental problems. All along, these patients have to be escorted by CSD staff to attend follow-up at
psychiatric SOPCs. For security reasons, they have to be escorted by at least two CSD staff and be handcuffed on every
occasion. Such an exposing arrangement inevitably causes much embarrassment and stigmatisation. Furthermore, other
patients in the SOPC may also feel uncomfortable seeing such a scene. To address the above problems, this study aims at
assessing the benefits of using tele-medicine consultation for a group of stable psychiatric outpatients in custody.

Methodology
Eighty six stable outpatients in custody fulfilling the inclusion and exclusion criteria were recruited for tele-medicine
consultations in CPH from June 2014 to May 2016. They were compared with 249 matched outpatients in custody attending
the usual face-to-face consultations at other SOPCs. Baseline characteristics, difference in General Health Questionnaire
scores before and after consultations (PrePost GHQ), the correlation of PrePost GHQ between the first and second tele-
medicine consultation sessions, patient satisfaction, significant adverse events and cost analysis were measured. Data were
analysed by U-test and Pearson correlation.

Results and Outcomes
Compared with the standard consultation group, the tele-medicine group showed a significantly better result in the
PrePost GHQ (Z = -2.268, p = 0.023). The correlation between the first and second tele-medicine sessions also showed a
moderate positive relationship (r = 0.406, p = 0.029). The satisfaction survey showed a favourable response to tele-medicine
consultations. No significant adverse events were identified. An average of $1,850 escort cost was saved for each tele-
medicine consultation. The results suggested that tele-medicine consultation is a promising alternative for stable outpatients
in custody.

79