The development of telemedicine has accelerated during the COVID-19 pandemic. Applications in the emergency department (ED) include pre-ED evaluation and screening, minimising staff exposure to infected patients, post-ED discharge monitoring and treatment, staff education, and coordinating resources and transfer.1 Telemedicine has the potential to revolutionise healthcare by shifting care from hospitals to homes and mobile devices.2 From systematic reviews on different modes of delivery, real-time videoconferencing tends to be the best mode of care in the ED setting.3
The 24-hour Outpatient and Emergency Department of Gleneagles Hospital Hong Kong (GHK) under the Hong Kong University Health System is one of the first EDs in Hong Kong that provides telemedicine service to patients. The telemedicine programme is a joint venture between GHK and a leading telecommunication company in Hong Kong. The programme enables real-time videoconferencing, and direct delivery of medication and medical documents to the clients’ home. After pilot testing in May 2020, the programme has been commercialised since November 2020. In parallel, GHK has set up an in-house telemedicine platform for patients who are not subscribing to the telecommunication company platform. During the COVID-19 pandemic, the telemedicine service was extended to COVID-19 patients to improve access to timely medical assessment and antiviral therapy.
In this talk, we will discuss our experience in pioneering telemedicine service in a private ED, based on the Cochrane Effective Practice and Organisation of Care (EPOC) framework, and the challenges in integrating telemedicine with regular clinical services in the private healthcare sector. A roadmap for possible future development is also presented. Our experience shows that telemedicine is feasible in local private ED settings for low-acuity conditions, highlighting the importance of case selection. It has the potential for improving access to health care at times when public and private EDs are overwhelmed in future pandemics.
