Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Authors (including presenting author) :
Tong MH, Wong KM, Wong KY, Chan LZ, Lee K, Yip HK, Ki KM, Lee LS, Chan PW, Wong HS, Chim CK
Affiliation :
Community Outreach Services Team(COST), New Territories East Cluster(NTEC)
Introduction :
Smart devices could help health care professionals detect deterioration in patients’ condition, contributing to hospital admission reduction, complications avoidance and patient health improvement. Thus, NTEC COST has adopted smart devices and mobile apps to support high-risk elderly patient with DM or COPD since August 2020.
Objectives :
1. To detect early signs of COPD exacerbation or unnoticed hypoglycaemia
2. To prevent avoidable emergency admission
3. To empower patients’ self-management
Methodology :
In 8/2021, “Flash glucose monitoring(FGM)” program was started to provide continuous glucose monitoring to DM patients at home for 14 days.
In 11/2021, smart device “O2 Ring” was initiated to monitor COPD patients at home. Patients wore O2 Ring at least 3 days for continuous monitoring of SpO2.
In 2/2022, “Pearl8” SpO2 monitoring device was introduced to provide instant feedback and record of COPD patients performing breathing exercises at home.
Patient instruction sheet of different smart devices and home visit protocol were designed.
Data of glucose/SpO2 profile/Breathing exercise retrieved via reader or mobile apps were used for timely medical or nursing interventions.
Evaluation included Pre-post HbA1C/CAT Score and unplanned admission, patient satisfaction
Result & Outcome :
FGM project: 135 patients were recruited (mean age 76.7). 489 episodes of hypoglycaemia were detected. 57%(n=77) required medical consultation; and 71.4%(55 out of 77 patients) required drug titration and re-empowerment. Average post HbA1C reduced from 8.53%(range:5.7%-15.8%) to 7.65%(5.5%-11.9%).
O2 ring project: 40 patients were recruited (mean age 80.1; 33 out of 40 patients had CAT scores >10). 42.5%(n=17) required Pearl8 assisted breathing exercise training. 7.5% (n=3) required medical consultation. Average post CAT score had markedly reduced to 13.5(range: 1-32) as compared with the average of pre CAT score of 17.7(range: 4-34) which indicated effective intervention.
95% of COPD patient (n=38) and 100% of DM patient (n=135) had no hospital emergency admission. Both groups were satisfied with the programs.
Conclusion
Aforementioned programs demonstrated promising result in using smart devices to detect early symptoms deterioration and to provide timely intervention to patients, empowering their self-care beyond conventional means. Smart technology can improve community care for high-risk elderly patients in a more proactive and preventive approach.
