Most Proposed Topic :
Healthcare Advances, Research and Innovations (new projects / technology)
Authors: (including presenting author): :
Lui BKP(1), Lam SS(1), Chan LY(1), Lee KN(1), Chan LW(1), Tong PY(1), Tao YCK(2), Wong HC(2), Soo WLA(2), Leung YH(3), Ho PK(3), Lam WH(3), Kwok KW(3), Pang HSI(1), Kwong SFS(2), Wong MYA(3), Kng PLC(1)
Affiliation: :
(1) Department of Medicine & Geriatrics, Ruttonjee and Tang Shiu Kin Hospitals (2) Physiotherapy Department, Ruttonjee and Tang Shiu Kin Hospitals (3) Occupational Therapy Department, Ruttonjee and Tang Shiu Kin Hospitals
Introduction: :
The COVID-19 pandemic unfolded the benefits of tele-rehabilitation when elders were unable to attend GDH. Post-COVID, we piloted a hybrid model of onsite-cum-tele rehabilitation to develop enablers and resolve barriers for a sustainable Tele-GDH service model.
Objectives: :
1) Test acceptance of tele-rehabilitation by frail elders
2) Identify target patients and needs which can be supported by tele-rehabilitation
3) Systematically consolidate hardware and logistics for delivering a novel Tele-GDH service model
4) Obtain staff feedback to further inform tele-rehabilitation development at GDH
Methodology: :
111 GDH elders and caregivers were invited over November & December 2023 to participate in the GDH tele-health program as a supplementary option.
Inclusion criteria screened as medically stable, suitable for maintenance rehabilitation, smart phone owner, patient consent and caregiver to assist. Hardware from hospital IT to install Citrix CMS, Telehealth apps. Logistics included multi-disciplinary staff training to become tele-GDH ambassadors. GDH scheduling to incorporate goal setting with a hybrid mode. Patient educational package which included installation of HA Go app, training, operation and payment. Home exercise equipment packages to facilitate tele-rehabilitation were purchased and designed with patient instruction with QR code training video. Patients were instructed onsite with return demonstration.
Result & Outcome: :
Results & Outcomes:
(1) Acceptance
23.4% (26 out of 111 patients) agreed to join and 18 tele-training session were
arranged in Nov & Dec
(2) Type of patients included 8 stroke patients (44.5%); 7 patients with fall (39%); 1 patient with parkinson’s disease (5.5%); 1 patient needed rehabilitation training due to deconditioning (5.5%) and 1 patient with atypical fracture (5.5%)
(3) The tele-rehab session was conducted on the 8th session and 1 month after discharge by physiotherapist, occupational therapist and nurse. Each session was counted as one GDH attendance and lasted for 60 minutes
(4) Tele-rehabilitation service model
- All patients did home exercises after tele-training session
- 71% were able to complete their home exercises by themselves
- 29% did home exercises with assistance from caregivers. They did on a daily to weekly basis with each session lasted for 10 mins to 35 mins
(5) Patient satisfaction survey was conducted and positive feedback were received
Limitations:
As majority of our patients were frail elderly and over 80 years old, they were not familiar with HA Go App. Despite explaining at least 3 times with trial practice, registration, identity confirmation, payment via electronic platform, etc. were too complex for them.
Staff suggested:
- Create virtual appointment for elderly to learn and practice tele-care via HA Go app, not just learnt by watching video
- Simplify the steps in using HA GO app
- Design the push notification in a bigger and easier identifiable symbol so that it could be recognized by our elderly easily
- Longer display time of push notification so that our elderly could have time to open it
Conclusion:
Telehealth is a key direction in Hospital Authority and has a place in the tele-rehabilitation journey of GDH frail elders as an option or as a supplement for booster rehabilitation. The acceptancy, identification of target patients, rehabilitation needs, hardware setup, logistics and staff training are key foundation steps to further advance this hybrid Tele-GDH model.
