Authors (including presenting author) :
Cheng CH (1), Wong IM (2), Leung SY (1), Maria Leung KW (1), Yiu KH (2), Choo KL (2)
Affiliation :
(1) Department of Family Medicine, the New Territories East Cluster, Hospital Authority, Hong Kong
(2) Department of Medicine, North District Hospital, New Territory, Hong Kong
Introduction :
Family Medicine Department (FM) refers around 300-400 cases to Department of Medicine (MED) of North District Hospital (NDH) per month. The majority of them are routine cases with a waiting time of about 130 weeks.
Objectives :
We have set up a Case Discussion Platform (CDP) on a regular basis between ND GOPCs and MED, aiming to reduce MED referral through discussion of referred cases
Methodology :
The list of medical referrals from FM was drawn monthly from the Clinical Data Analysis and Reporting System (CDARS). A designated FM specialist would purposively select representative cases of high volume and from high referrers. The referrers would be invited to propose questions to ask at the teleconference. The selected cases and questions would be sent to a designated physician of NDH MED who in turn will coordinate with corresponding subspecialists. At the teleconference, a FM trainee would present the cases and the MED specialists would give their advice on the management. If the cases can be handled at GOPC, the GOPCs will call back the patients and cancel their medical appointment. Referral rates from ND GOPCs to MED SOPC before and after CDP would be compared and analysed.
Result & Outcome :
RESULT
5 FM/MED teleconferences were conducted between 12 Oct 2020 and 3 Dec 2021. A total of 37 cases were discussed. Among them, there were 8 (21.6%) cardiac cases, 8 (21.6%) rheumatology cases, 7 (18.9%) hepatology cases, 14(37.9%) other cases. Among all the discussed cases, 15 (40%) can have their medical appointments cancelled. The medical referral rate from FM to MED was reduced from 1.77% (April 2020 to Sept 2020) to 1.58% (Oct 2020 to Mar 2021) (P< 0.001).
CONCLUSION
A regular case discussion platform between family medicine and medical department can help to reduce medical referral, which may in turn contribute to shorten the MED SOPC waiting time. Although the actual cases discussed were limited, through purposive selection of high volume cases and active involvement of referrers, the behavioral change could be promoted. This format of discussion could be expanded to involve other specialties in the long run.
