Telemedicine has become a more common practice in recent years, owing to COVID-19 and its convenience.
By Winkie Ng
Wilson Leung Wai-Hon takes a picture of his tongue and sends it to a Chinese medicine practitioner through WhatsApp for consultation when he feels unwell.
The 58-year-old man has started using this new mode of medical consultation, telemedicine, since the beginning of 2020.
“I am too busy to go to the clinic, but I need to consult my Chinese medicine practitioner. So I use WhatsApp for consultation,” he says.
Leung has so far used telemedicine two to three times. He says he will keep using it, even pulse diagnosis cannot be conducted. “It saves me at least an hour of waiting,” he says.
“It saves me at least an hour of waiting.”
According to the World Medical Association, telemedicine is the practice of medicine over a distance, in which interventions, diagnoses, therapeutic decisions, and subsequent treatment recommendations are based on patient data, documents, and other information transmitted through telecommunication systems.
In Hong Kong, both public and private hospitals are developing and practising telemedicine in recent years.
Hospital Authority (HA) has expanded the application of teleconsultation service to non-urgent patients like psychiatric patients or patients requiring follow-up consultations amidst the pandemic, according to its website.
Video consultation has also been applied by HA for follow-up treatment. Rehabilitation of patients is supported through its mobile application, called “HA Go”, launched on December 12, 2019.
One of the features is “TeleHealth”, where patients can attend medical appointments remotely to have consultations with doctors or nurses via the app.
The Kowloon East Cluster with three hospitals piloted video consultation in March 2020, firstly introduced in six departments, including ear, nose and throat.
Private hospitals like Matilda International Hospital and Hong Kong Sanatorium & Hospital also provide online consultations, charging one-time video consultations for family medicine for HK$320 to HK$560.
Doctors Adapting the New Mode
Lau Sin-yu, a registered Chinese medicine practitioner from Yu Yat Tong Chinese Medicine Clinic, has started practising telemedicine since mid-February 2020.
“The service was launched during the COVID-19 surge. The infection risk is higher for the infirm like the elderly and patients with chronic illness. But medical supplies were not enough,” she says. “Telemedicine was helpful in providing remote treatment and follow-up during that time.”
“Telemedicine was helpful in providing remote treatment and follow-up during that time.”
Lau explained that before treatment, patients are asked to note down their symptoms on a form. Doctors will receive it and look through the related documents attached, such as pictures of patient’s tongue or skin problems. Details of patients’ situations will be asked over phone calls. Medicine will then be delivered to their home.
“By referring to the forms submitted beforehand, we can learn about patients’ symptoms and related information to get ready, which is more efficient,” she says.
“For common internal diseases like menstrual disorder and skin problems, sufficient information can be collected from observation and interrogation for treatment,” Lau adds.
But she points out that telemedicine is not suitable for urgent cases and trauma like sprain, as palpation cannot be carried out.
Through telemedicine, she says doctors can overcome geographical limitations to treat the disabled and patients living in remote areas with internal diseases.
Mediating Doctors and Patients
David Wong, the chief operating officer of DoctorNow, sees the potential of telemedicine in Hong Kong. He is optimistic about the future of telemedicine because of its convenience and technological advancement.
DoctorNow is a video consultation application launched in January 2020, helping patients with mild illnesses such as cold, skin problems, and minor emotional distress. It also arranges follow-up consultations for patients with chronic illness.
It now has around 4,000 users, of which about 60% are locals and the rest are expatriates. It has handled about 2,000 cases, mostly aged from 30 to 50.
“Customers started using our app because of COVID-19. But what keeps them using it is its convenience, comparing to consulting doctors in physical clinics,” he says.
“Customers started using our app because of COVID-19. But what keeps them using it is its convenience, comparing to consulting doctors in physical clinics.”
For the elderly, Wong says they need help from family members to have video consultations. “They have video consultations through Zoom and WhatsApp video call, but not our app, as it is too complicated for them,” he adds.
Wong recalls difficulties they had when developing the application.
“We wanted an app with many functions, just like another Zoom. But the cost is quite high. It took about HK $3 million for invention and maintenance,” he says.
Wong says it took them a year to recruit 22 doctors, as many doctors are not familiar with conducting video consultations. Now the platform has 38 doctors.
“In the future, we plan to add more features to the app such as autonomous health management platform and selling health products,” he says.
Present and Future of Telemedicine in Hong Kong
Dr. Daniel Tong King-hung founded the Hong Kong Telemedicine Association (HKTA) in 2016. He sees telemedicine as one of the applications of technology in the practice of medicine, not a replacement for traditional medical consultation.
“Using technology appropriately in different situations can reduce medical costs and cut down waiting time for patients… It does not take away doctors’ professional responsibilities, instead, it provides easier access for patients to receive medical services,” Tong adds.
“I used to work for HA, where I saw the shortcomings of the healthcare system in Hong Kong, so I founded this association. Hong Kong should have a more effective method to run the health care system,” he says.
Tong thinks the development of telemedicine in Hong Kong is lagging behind, comparing to other countries.
The health department under the Australian government launched “Telehealth Pilots Programme” in 2012 to subsidize successful pilot project proposals to develop and deliver telehealth services.
In December 2019, the Hong Kong Medical Council laid down the “Ethical Guidelines on Practice of Telemedicine” that stipulates some generic principles for medical practitioners who substitute telehealth for traditional modes of medical care delivery and/or advice.
“Everything has to start somewhere. Though slowly, we can still create things perfectly step by step. Even though Hong Kong is lagging behind, we may take reference from others’ practices and apply them into suitable aspects. I believe telemedicine would develop pretty well here,” Tong says.
Edited by Laurissa Liu
Sub-edited by Bonita Wong