Authors (including presenting author) :
Tong WC, Kwong WF
Affiliation :
Orthopaedics and Traumatology, Queen Mary Hospital
Introduction :
The demand of total joint replacement surgery surged due to aging population. In addition,
patients will have life-long follow up after surgery. As a result, this burdens the O&T joint SOPC
and increased the workload of the surgeons. In general, the consultation time of each patient is around 15 minutes and there are around 70 caseload per weekly clinic with limited surgeons. With a view to enhance the service by efficient consultation time and caseload of doctors’ consultation, reforming patient journey and mode of consultation in post-op phase is a solution in building up telehealth clinic. Benefits of telehealth including saving travelling time and queuing time of patients and caregivers, enhancing caregivers’ engagement and promoting patient centric care especially during the period of COVID-19.
Objectives :
1. To enhance the service by efficient consultation time and caseload of doctors’ consultation
2. To build up telehealth service in nurse clinic
Methodology :
Traditionally, patients undergone primary joint replacement surgery i.e. UKR, TKR, THR required to attend face-to face consultation with doctors at post-op 6 weeks, 3 months, 6 months, 1 year and after. Patient journey was reformed at the post-op 6 months doctor clinic which will be replaced by the nurse telehealth clinic. Suitable patients are selected by surgeons at the post-op 3 months clinic. For instance, patients with normal lower limbs range of motion and x-ray findings. X-rays taking are not necessary for the telehealth follow-up as agreed by surgeons. The service was commenced on 1 st March 2023. The new nurse telehealth clinic was designed with ROM measurement of
patient’s operated limb by patient provided photos which breakthrough the current limitation of any physical assessment in tele health consultation via HA-Go. General knee condition and functionality can be well reviewed, compared and documented objectively.
Photos of operated limbs were taken by patients or caregivers and uploaded to HA team drive after O&T specialty nurse anatomical landmark measurement by commercial App.
In addition with the success of pilot, the new doctor telehealth clinic was established with identical model designed was commenced on 5th August 2024. Patient will be undergone primary joint replacement surgery are recruited preoperatively by surgeons. Photos of patient’s operated limbs with ROM marked were measured by nurses prior to the doctor consultation.
Result & Outcome :
There were 38 patients participated in nursing telehealth service in 4 months. On average, four to five cases were shared in each doctors’ clinic session. As a result, it saved 60 to 75 minutes of doctor’s consultation time per clinic. To our delight, the satisfaction online survey score is 68 out of 76. Patients reflects that they can reduce unnecessary radiation exposure.
In addition, 50 patients were participated in doctor telehealth service in 5 months. On average, 2-3 patients attended in each clinic session. 7-8 minutes saved per patient consultation as compared with the tradition. The satisfaction online survey score is also 68 out of 76.
Stakeholders including patients, caregivers and health care professions are all satisfied with the new telehealth services.
