Authors (including presenting author) :
Tseng CK(1), Yip KC(1), Wong T(2), Cheng YF(1), Kwok CT(1), Ling SO(1), Mok YW(1), Poon YN(1), Yim CW(1), Ng PK(1), Kwan HY(1)
Affiliation :
(1)Department of Respiratory Medicine, Kowloon Hospital
(2)IT Operations Centre, KCC
Introduction :
Traditionally, the informed consent process for high-risk treatment or invasive procedures has been paper-based, which could be cumbersome and prone to errors. In December 2023, RMD started adopting e-consent for their patients, marking a significant step forward in patient-centered care. However, changing existing clinical practice could be challenging.
Objectives :
To identify barriers in adopting e-consent and review the effectiveness of step-wise approach in staff engagement for new project.
Methodology :
The e-consent system was designed by corporate IT & HI division which supported digital transformation of informed consent process. It could be utilized via the Clinical Management System (CMS) on handheld tablets. Prior to initiation, an e-consent work-group led by an RMD doctor was formed, with members from nursing team supported by corporate IT representatives. A new workflow was prepared to ensure smooth implementation. Training sessions were organized. Each doctor had to demonstrate his ability to complete e-consent at the end of the class. It was initially adopted for out-patients undergoing bronchoscopy. Following successful initial adoption and positive feedback, it was extended to all procedures discussed in our specialist clinic. When all doctors got familiar with the system, they voluntarily started using it for in-patients thus facilitated its successful rollout to all RMD patients. Doctors are reminded to mark “complete” after procedures were done.
Result & Outcome :
Since the implementation of e-consent on 20 December 2023, 549 endoscopic procedures were performed in RMD till 31 Dec 2024. More than 95% of them were consented digitally. About 5% completed on paper for patients being illiterate and signed by thumb-print.
Patients appreciated the convenience of digital consent process. Healthcare providers noted improved efficiency and reduced paperwork. The digital system ensures that all necessary information is captured accurately and stored electronically. All the details on the consent form could be verified digitally via CMS on any computer or tablet on day of procedure. Completion of procedure was marked on the e-consent to prevent it from being reused and to close the workflow-loop. It facilitates regulatory compliance by providing a clear audit trail while reducing administrative burden. Moreover, it significantly contributes to environmental sustainability by decreasing paper usage and hospital’s ecological footprint.
By leveraging digital technology, the informed consent process was enhanced. Our experiences demonstrated that detailed preparation, adequate training and staff engagement are important for successful adoption of new technology and change of practice. Ways to facilitate e-consent for illiterate patients should be explored to optimize its utilization.
