Replies to LegCo questions

LCQ12: Telephone booking service in general out-patient clinics

Following is a question by the Hon James To and a written reply by the Secretary for Health, Welfare and Food, Dr York Chow, in the Legislative Council today (December 6):

Question:

The Hospital Authority (HA) implemented the automated phone appointment service in the general out-patient clinics under the Kowloon West Cluster in October this year. Patients with episodic illnesses may make appointments by telephone for consultation and treatment on the same day or the following working day. In this connection, will the Government inform this Council whether it knows:

(a) the total number of persons who have obtained the consultation slots through the above telephone booking system so far, and a breakdown of this number by age groups (above 60, 45 to 60, and below 45) and their respective percentages; the percentages of these numbers in the total number of persons who obtained the consultation slots in the same period; and the percentage of persons who did not turn up after obtaining consultation slots through the above service;

(b) the respective numbers of consultation slots reserved daily by the above clinics for patients who use the telephone booking system and for those who come in person, and, among those who make use of the booking system and those who come in person, the respective average daily numbers of patients who fail to obtain consultation slots;

(c) if the situation in which patients queue in person for consultation slots at the above clinics in the middle of the night has not recurred since the implementation of the above booking service;

(d) the number of complaints received by HA in relation to the above service so far, with a breakdown by the nature of the complaints;

(e) as some patients have told me that, when all consultation slots of a designated clinic have been allocated, the booking system cannot immediately search and arrange an available consultation slot in another clinic within the same cluster, whether HA will improve the functions of the automated telephone booking system of out-patient service in view of the above situation; and

(f) if HA will make other arrangements to improve the phone appointment service such as deploying additional staff to receive appointment calls by elderly with hearing impairment; if it will, of the details of the relevant arrangements; if not, the reasons for that?

Reply:

Madam President,

In response to public demands for improving the crowded queuing conditions in general out-patient clinics (GOPCs), reducing the risk of cross-infection among patients, and making optimal use of the resources in public general out-patient service, the Hospital Authority (HA) has implemented a telephone booking system in the GOPCs on Hong Kong Island since last August on a trial basis. As public reactions to the telephone booking service have been generally favourable, and there has been no significant impact on the utilisation of out-patient service including that by the elderly, the HA has extended the service to other districts since October this year. The telephone booking service is in its early days of territory-wide operation, and understandably the system still has room for improvement. We appreciate that it takes time for all the parties involved to adapt to this new system. The Administration will closely monitor the operation of the telephone booking service, and regularly review and enhance the system where appropriate.

Our reply to the different parts of the questions is as follows:

(a) Since October 17, 2006, the Hospital Authority (HA) has implemented the telephone booking service in 20 GOPCs under the Kowloon West Cluster. This service is applicable to patients who do not require regular follow-up consultations (i.e. patients with episodic illnesses). Since its implementation, it is estimated that the telephone booking service has been used by an average of around 58 000 times per month for booking a consultation, accounting for about 79% of the total attendance of patients with episodic illnesses.

A breakdown of the GOPC telephone booking service users by age groups between October 17 and November 7, 2006 is shown in Table 1.

According to the statistics of HA recorded since the introduction of the telephone booking system on October 17, 2006 until November 7, 2006, patients who had obtained consultation slots but subsequently failed to turn up account for about 7% of the total number of patients who made use of the telephone booking service.

(b) The numbers of consultation slots available at the GOPCs under the Kowloon West Cluster between November 20, 2006 and November 26, 2006 are shown in Table 2.

HA does not set aside consultation slots for patients with episodic illnesses. The number of consultation slots available to patients with episodic illnesses per day depends on the remaining number of slots left after bookings by other categories of patients (including chronically ill patients who require regular follow-up). In this regard, prior to the introduction of the telephone booking service, the Kowloon West Cluster had started to arrange gradually pre-booking of follow-up consultations for chronically-ill or elderly patients who require regular follow-up, thereby freeing them from having to obtain consultation slots separately and attending follow-up consultation too frequently. Currently, patients who need to obtain consultation slots on the same day or the previous day are mainly those with episodic illnesses, who, as mentioned above, do so mostly through the telephone booking service.

HA has no statistics on the number of patients who made use of the telephone booking service but failed to obtain a consultation slot. As regards patients who go to the clinics in person to queue for consultation slots, the number is limited and the clinic staff will usually assist these patients to make a booking for the next one or two consultation sessions, and allow the patients to decide whether to accept the bookings.

(c) Since the implementation of the telephone booking service in October this year, there has been significant improvement to the situation of patients queuing outside clinics. Queues which used to start building up outside clinics in the early morning hours have so far disappeared. Most clinics no longer have long waiting queues outside in the morning. Occasionally, some clinics may have a handful of patients (on average about five or six patients) waiting outside for consultation slots. For afternoon and evening sessions, clinics generally have no more waiting queues outside.

(d) As at November 23, 2006, the Kowloon West Cluster received a total of 13 written complaints and 43 enquiries through telephone. Details of the complaints are shown in Table 3.

(e) If a particular clinic has exhausted its consultation slots, the computer system of the telephone booking service will automatically be diverted to nearby clinics to search for remaining time slots available for booking, so as to maximise the use of resources in general out-patient services. So far until last week, HA has not received any complaint or enquiry about the system failing to divert to other nearby clinics. If there are further particulars, HA will follow up as necessary.

(f) We understand that some patients may encounter difficulties in using the telephone booking service in the early days of its implementation. HA has been embarking upon a series of improvement measures including the following:

(i) Step up publicity and teach patients on how to effectively use the telephone booking service, including the registration and booking procedures as well as the time of the day when booking can be more easily made, etc;

(ii) Set up patient service counters and make available assisting staff to deal specifically with problems related to the telephone booking service encountered by patients and assisting them in using the booking service;

(iii) Streamline the flow of making appointments through the telephone booking system and allow flexibility for the elderly in entering their date of birth (they may choose to enter only the year of birth) to make it easier for them to adapt to the use of the telephone booking service;

(iv) Improve the computer system of telephone booking service, including remaking the interactive voice response with authentic human voice, and improving its content, speed and tone, to make it more user-friendly;

(v) Allow flexibility in the transitional period by assisting patients (especially the elderly) who come to the clinics in person to book a consultation slot. In the long run, it is hoped that all users will be familiarized with the use of telephone booking system;

(vi) Arrange medical consultations for individual disabled patients (including people with hearing impairment) directly without the need to use telephone booking; and

(vii) Liaise with different District Councils and community organisations, such as the Senior Citizen Home Safety Association, in order to make use of community resources to provide assistance to people who need help in using the telephone booking service.

Given the huge volume of out-patient services, it is necessary for HA to automate and computerise its various operations with a view to achieving the optimal use of resources, while maintaining and improving the level of out-patient services. The telephone booking service enables the HA to use its resources in general out-patient service more efficiently. Switching to or adding a manually-operated telephone booking service on top of the existing automated computer system would create both resources and technical difficulties. Nevertheless, we will continue to monitor the situation closely and consider other means of improving the booking system.

The Administration and HA will continue to closely monitor the operation of the GOPC telephone booking service in various districts, keep in view the use of the telephone booking service by the public, and consider the suggestion of the local community positively. Having regard to the actual operation of the system and patients' need, HA will review regularly the operating mode of the telephone booking system and enhance accordingly, with a view to improving service quality as far as practicable within existing resources.


Ends/Wednesday, December 6, 2006
Issued at HKT 12:51

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Attachment:
Tables to LCQ12