Imagine the following scenario in a doctor’s office in Hong Kong. “Doctor, you have seven online patients and two colonoscopies to perform today.”
The doctor logs onto the tele-console – three patients with their identities verified are already waiting. He clicks on the first patient and a Mr Chan appears on screen.
Chan has had a colonoscopy during which a polyp was removed. The doctor shares on-screen the colonoscopy and pathology reports, which with Chan’s permission can be accessed and reviewed by his other doctors at anytime.
The doctor orders a follow-up colonoscopy for Chan in five years. At a click, a reminder is sent to the patient for him to add the appointment to his e-calendar. The doctor then clicks a button for the next patient.
A referral letter comes on-screen. This is a Mr Cheung who was just diagnosed with colon cancer. Next to his name is a folder in which are found his colonoscopy and pathology reports. Through the e-health system, the doctor notes that Cheung has diabetes mellitus, hypertension and is taking several medications.
The doctor explains their findings on the lesion by sketching on a tablet, which Cheung can see and screen-capture. The doctor then orders a CAT scan at an imaging centre close to Cheung’s home. Medicine, if needed, can be electronically prescribed and picked up at a pharmacy convenient to the patient. The console also comes with a directory of imaging centres, laboratories and pharmacies in the vicinity.
The above scenario sounds futuristic but is no fiction. It would be the norm had Hong Kong been serious about information technology.
Some would say similar systems are already in use. However, these are mostly closed-circuit systems within a single medical group and are not conducive to the widespread uptake of telemedicine. If a patient wishes to engage health professionals outside the group – be they a traditional Chinese medicine practitioner, physiotherapist, dentist, pharmacist, psychologist, dietitian, X-ray centre or laboratory – and continue to have seamless service, we need an inclusive platform open to all healthcare service providers.
An open, inclusive platform gives patients free choice from among the entire community of healthcare professionals. With that in place, we can look forward to a vibrant, competitive online healthcare ecosystem that complements the government’s primary healthcare blueprint in the pipeline.
Dr David T.Y. Lam, legislative councillor
Antibiotic resistance needs more attention
In view of the dangers posed by antibiotic resistance, as university students researching issues of public health, we would like to suggest some measures the Hong Kong government should take into consideration.
First, under the Antibiotic Stewardship Programme, prescriptions of strong antibiotic use are occasionally reviewed by a team of specialists to ensure the use of antibiotics is appropriate. According to data from the Centre for Health Protection, there was an increase in antibiotic prescription in Hong Kong from 2016 to 2020.
Yet there was no indication how many cases of antibiotic prescription have been reviewed by the programme. Better, more consistent record-keeping would give the public more confidence in the programme and the measures the team is taking to monitor overuse of antibiotics.
Hong Kong health authorities should consider effective measures implemented by other countries to combat antibiotic resistance. In some countries, for example, doctors use point-of-care tests to help determine whether patients should be treated with antibiotics. According to one study, GPs in Scandinavian countries use rapid antigen detection testing for the diagnosis of streptococcal pharyngitis and C-reactive protein devices for ruling out serious respiratory tract infections. In this way, doctors can identify less serious cases that do not require antibiotic prescription.
In this era of heightened attention to public health issues, it is hoped that the Hong Kong health authorities can take the above measures into account to address the overuse of antibiotics and eliminate the growing threat of antibiotic resistance to effective healthcare provision in the city.
Larry Chu Chun Yin and Oscar Leung Pak Lam, Hong Kong Baptist University, Kowloon Tong
Bring reliable internet to Hong Kong’s outlying islands
I write with reference to the recent letter by Lee Ross (“Pandemic has revealed city’s internet limits”, April 3). In a contemporary and cosmopolitan city that actively encourages citizens to work from home, Hong Kong’s supporting infrastructure has been tested and found woefully lacking.
It is deplorable that in our otherwise well-equipped home office in Yung Shue Wan, for instance, we do not have stable internet availability and cannot reliably remain connected for business or personal communications. Frequent and random outages are common, lasting from a few minutes to a few hours at times, often disrupting the normal flow of a business day.
It is embarrassing to have to inform a client by phone that an urgent working file has been completed but simply cannot be sent because of another internet service disruption of unknown duration, following on other previous lapses in the same day.
The issue is not simply network congestion or even the reduction in transmission rate and throughput from broadband to narrowband speeds. Rather, it is complete blackouts in the form of dropped connections occurring frequently. The missing link in our distribution and communications infrastructure is fibre optics.
In the late 20th century, with its state-of-the-art technology, sophisticated switching and routing hardware and tens of thousands of kilometres of fibre backbone cabling, Hong Kong’s advanced fibre optic network was the envy of many developed countries. Unhappily, more than two decades later and well into the 21st century, this does not extend to Lamma Island.
There have been plans made by government and other parties without the necessary action taken to make this happen. I daresay that if he was alive today, Hong Kong’s own Charles Kao Kuen, a Nobel laureate popularly acknowledged as “the father of fibre optics”, would be sadly disappointed in the current state of our so-called smart city.
The required solution is long overdue. Please may we now see tangible, rapid progress towards fibre optic connectivity for Hong Kong’s island communities, with interim relief where needed.
Perhaps Chief Executive Carrie Lam Cheng Yuet-ngor could drive this forward before she leaves her post in less than 90 days. Hong Kong’s island dwellers will thank her, and we will also be better-equipped to contribute to Hong Kong’s rejuvenation and continued growth and success.
Sharon Chandler, Lamma
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Quelle/Source: South China Morning Post, 11.04.2022
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