Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
CH Lau KN Lam
Affiliation :
Intensive Care Unit
North District Hospital
Introduction :
Telemedicine is increasingly adopted, not only between healthcare providers and patients but also among healthcare providers themselves, as a means to overcome manpower, geographical and logistic barriers to specialist access under resource limitations. In accordance with the strategic direction of HA, the ICUs of NDH and AHNH jointly pioneered a model of provider-to-provider telemedicine service (Tele-ICU) between frontline staff and remote specialists during non-office hours.
Objectives :
To enhance the quality of communication between the frontline on-site junior doctor and remote off-site senior doctor during non-office hours
To enhance the quality of supervision and training of junior doctors
To enhance teamwork among ICU staff
To improve the overall quality and safety of our critical care service
Methodology :
With the support of hospital administration, a head-mounted device (Smart-glasses) is piloted as the hardware enabling hands-free audio-visual telecommunication at the frontline. Through specific telemedicine software solutions which may incorporate augmented reality (AR) +/- artificial intelligence (AI) functions, communication with remote specialists is enhanced. Since its pilot launch in July 2023, it has been utilized in the following key areas
1. Remote supervision to frontline ICU doctors under emergencies, especially when direct in-person support is deemed impractical e.g. airway crisis, cardiac arrest
2. Remote co-assessment of urgent consultations in general wards or AEDs
3. Remote consultations with other specialties e.g. Neurosurgery
4. Provision of procedural supervision and simulation training from a first person vantage point
Result & Outcome :
As at 4th January 2024, our Tele-ICU service has been used in more than 60 acquaintances, which covered a broad range of situations, including management of airway crisis, ventilator setting and troubleshooting, cardiopulmonary resuscitations (CPR), performance of emergency diagnostic ultrasound/ echocardiogram, co-assessment of critical patients, as well as neurosurgical tele-consultations. A pilot survey conducted among our ICU doctors and nurses (N=35) showed that over 90% agreed there was improvement in teamwork (91%) and remote collaboration (95%), while 83% and 77% also agreed there was improvement in patient care and workflow efficiency.
This telemedicine service will further roll out to the AED and Community Outreach and Services Team (COST) at NDH. It is expected that frontline collaboration will be enhanced in these departments. Further evaluation is needed to demonstrate the effect on patient outcomes in the future.
