Authors (including presenting author) :
SW Ng (1), SK Kwong (1), WK Ko (1), WS Wong (1), HH Sze (1), CS Cheng (1), MH Cheung (1), WS Tsui (1), M Li (1), P Pong (1). WF Ho (1), HP Sy (1) , SY Lai (1)
TC Chan (2), J Luk (2), C Chan (2), A Lee (2), M Tse (2), S Pang (2), G Chan (2), Y Y Hwang (2)
Affiliation :
(1) Department of Family Medicine and Primary Healthcare, HKWC, (2) Department of Medicine, HKWC
Introduction :
With rising health awareness and expectations from general public on holistic health care services, the public healthcare system which carry the mission of providing affordable and accessible services for our citizens, face the challenges of increasing service demand, which bring about problems including long waiting time of Specialist Outpatient Clinics (SOPD). It is high time the Primary Healthcare system, largely supported by Family Medicine Departments cross clusters, further enhanced their gate- keeping role, in order that specialist care services can be directed to indicated patients in need in timely manner.
Objectives :
The Department of Family Medicine and Primary Healthcare of HKWC collaborate with different Medical Sub-specialties to run two types of services, namely Joint Clinics and Case Discussion Sessions. Moreover, there are Senior Triage Clinics seen by experienced Family Medicine Specialists. All with the following objectives:
- Ensure only indicated cases are referred to Medical SOPDs, so as to reduce the waiting time
- Enhance inter-professional sharing of Family Physicians and Medical Specialists
- Promote capacity building of Family Physicians of managing various clinical problems with higher complexity
Methodology :
When doctors in HKWC Family Medicine Clinics encounter patients who may require inputs from Medical Specialists on case management, they can get support from the following services:
- Joint Clinics ( patients with complex medical conditions are seen by the service coordinator - a Family Medicine Specialist, and a Medical Specialist )
- Case Discussion Sessions ( the service coordinator - a Family Medicine Specialist, discusses the cases with a Medical Specialist and provides feedback to the case doctors afterwards )
- Senior Triage Clinics ( patients with less complex medical conditions are seen by a Family Medicine Specialist with related experience )
Result & Outcome :
From Aug 2023 to Dec 2024, there were 1103 new cases managed by the aforementioned services, with only 160 Medical SOPD referrals being finally generated in the period for the cases who have utilized the services. The new case attendance vs the number of SOPD referrals generated are as follows: General Senior Triage Clinic ( 54 vs 18 ); Geriatrics Joint Clinic and Case Discussion ( 48 vs 21 ); Geriatrics Senior Triage Clinic ( 66 vs 9 ); Cardiac Joint Clinic and Case Discussion ( 505 vs 35 ); Cardiac Senior Triage Clinic ( 58 vs 3 ); DM Joint Clinic and Case Discussion ( 107 vs 1 ); Neurology Joint Clinic and Case Discussion ( 110 vs 14 ); Neurology Senior Triage Clinic ( 10 vs 0 ); Renal Case Discussion ( 132 vs 51 ); and Haematology Case Discussion ( 13 vs 8 ).
