News

2020-10-15

會長通訊:現在是時候談論“遠程醫療”了 | President's Message:It is time to talk on “Telemedicine”

現在是時候談論“遠程醫療”了       我在2020 年9 月22 日西醫工會的網絡醫學研討會上對各會員說,由於2019 冠狀病毒病不會在短期內消失,因此本會的醫學延續進修活動將會繼續透過Zoom 和面書進行直播。根據我們食物及衞生局局長的說法,2019冠狀病毒的疫苗要到2021 年冬季才能在香港使用。因此,我們將盡最大努力在未來2 年內為會員盡可能組織更多的網上醫學延續進修活動。 隨著我們於2020 年9 月27 日在九龍彌敦道363-373 號恆成大廈803 至 804 室西醫工會新辦公室的裝修工程開始,我們希望新辦公室能於2020 年11 月上旬開始投入服務。本會非常感謝各會員和朋友的慷慨捐助,新辦公室將擁有更大的空間,約600 平方尺的聚會場所,場地可容納30 人。我們將會安裝適當的視聽設備及器材為會員組織更多活動,包括網絡研討會。 隨著冬季的蒞臨,流感和2019 冠狀病毒病將在社區中傳播漫延,我們應該依靠衞生防護中心提供的有關每種病毒的本地監測數據。各會員應該認識到,流感和2019 冠狀病毒病的症狀相似並重疊,但兩者同時感染的例子已有記錄在案。唯一的區別是嗅覺及味覺衰退是感染新冠病毒的特有癥狀。我們必須注意,地塞米松被看作是救治2019 冠狀病毒病重症病人的一大突破,但皮質類固醇實際上會延長流感病毒的複制。我們應該鼓勵所有市民在這個冬天進行流感疫苗接種。 隨著2019冠狀病毒病全球大流行,一些會員已經實踐了某種程度遠程醫療,我在2020年9月14日通過ZOOM在施政報告諮詢會議上向林鄭月娥女士亦強調了這一點。   遠程醫療和患者管理   我說隨著人工智能、大數據、雲端和網絡安全技術的爆炸性增長,基於傳感器的硬件的成功研發,從而以更低的價格改進了功能以及智能設備與Internet Plus 計劃的無縫集成,現在是在2019 冠狀病毒大流行期間實施遠程醫療和患者管理的最佳時機。   人工智能和大數據技術可幫助醫生在短的時間內從大量數據中獲得見解。雲和網絡安全技術允許這種轉換以經過認證的安全方式發生在連接到網上的任何地方。將其與MEWS 之類的系統相結合,使醫生能夠更詳細地管理患者,並減輕他們本來就繁重的工作量,而又不犧牲其護理質量。   因此,除了通過我們針對高風險群組的教育和疫苗接種舉措,促進了我們先前在預防醫學方面的成就之外。我們建議香港的下一次醫療改革應著重於通過遠程醫療和患者管理加強預防藥物和早期疾病管理,在醫生與病人的關係上,診症將不再局限於單向性的病人求診,而是持續、主動及協作的醫療護理,以期及早找出病患並作出診治。在公共醫療的層上,配以類似「改良早期預警評分」(MEWS) 的長期自動化監察和評估系統、政府將會更有效率地按病者的風險及需要而作出資源調配。   政府可以推行什麼方針在香港開展遠程醫療和患者管理?   在推行方面,政府應該考慮通過各社區裡的「診所醫生」,從自己的病人名單中,選取和登記有需要及合適參加「遠程患者管理」計劃的病人,並負責教育這些病人正確的使用方法,幫助他們取得「居家協作診治」的成效。此舉將會是,通過社區「診所醫生」網絡,來實踐「把資源投放於病人端」(Hospital Decentralization)的施政方法;將會為正在面對沉重壓力的公共醫療系統,帶來一定的舒緩作用。   另外政府可以從兩方面提供撥款: 1「. 病人端」- 資助合適參加「遠程患者管理」計劃者,購買經「診所醫生」或合資格組織認可的醫療器具,以及支付相關的診治計劃和醫療雲端平台服務費用; 2「. 診所醫生端」- 資助參加「遠程患者管理」計劃的診所,提升「醫學資訊科技」的設備和知識,為落實「互聯網+ 醫療」在香港社會上的推行做好準備。   2019 冠狀病毒病導致許多患者接受遠程醫療,現在是政府將遠程醫療制度化並將遠程醫療和患者管理納入香港醫療體系的時候了。 作為第一步,本會幹事會已經成立了一個遠程醫療工作小組來研究相關問題。在2019 冠狀病毒病大流行之前,遠程醫療在香港並沒有像其他國家(例如美國和英國)那樣廣泛被使用和實踐。在2019 冠狀病毒病大流行之後,患者和醫生對遠程醫療越來越適應。 這項改革應為醫療服務提供者將高質量的遠程醫療納入其實踐創造機會及條件,並明確規定專業遠程醫療的最低要求,其中包括: 1. 為最低標準作出指引,要求醫生在斷症前需要先取得適時及合乎醫療級別的重要醫療數據; 2. 定下網絡安全標準,包括儲存及分柝醫療數據的平台保安。如美國的《健康保險流通與責任法案》(HIPAA) ; 3. 規範用作互聯網診症的「醫療器具」的準確度及安全性。如國家藥品監督管理局(NMPA) 和美國食品藥品管理局(FDA) 的醫療器械認證。 您的意見對這個重要的議題是非常需要的!   楊超發醫生 It is time to talk on “Telemedicine”   I spoke to our members in the HKDU webinar on 22nd September 2020 that since the COVID-19 would not go away soon, our CME activities will still be organized through the internet by Zoom and Facebook live. According to our Secretary for Food and Health, the vaccine for COVID-19 will not be available in Hong Kong till winter of 2021. As such, we shall try our very best to organize as many e-CMEs as possible for our members in the coming 2 years. With the start of decoration of our new HKDU ofce in Rooms 803 – 804, Hang Shing Building, 363-373 Nathan Road, Kowloon on 27th September 2020, we would expect our new HKDU ofce to operate in early November 2020. Many thanks to the generous donations from our members and friends, we shall have a meeting place of around 600 square feet which can accommodate 30 persons. We shall be installing appropriate audiovisual equipment to cater for our members’ activities including webinars. With the coming of winter time, influenza and COVID-19 will be co-circulating in the community, we should rely on the local surveillance data about each virus from the Centre for Health Protection. We should be aware that not only do influenza and COVID-19 have overlapping signs and symptoms, but co-infection with both with similar picture has been documented. The only difference is loss of smell and loss of taste which has not been reported with influenza virus infection. We must take note that dexamethasone is recommended for severe COVID-19 infection in hospitalized patients, but corticosteroids actually prolong viral replication in influenza. We should encourage all citizens to take up influenza vaccination in this winter. With the prevalence of COVID-19 pandemic, some of our members have practiced some kind of telemedicine which I have stressed in our presentation to Mrs. Carrie Lam on 14th September 2020 in the Policy Address consultative meeting through ZOOM. Telemedicine and Remote Patient Monitoring I said that with the explosive growth of Articial Intelligence (AI), Big Data,Cloud, and cybersecurity technology; successful R&D of sensor-based hardware leading to improved functionality at lower price; and seamless integration of smart devices with Internet Plus initiatives, now is the best time to implement Remote Patient Monitoring (RPM) in the midst of COVID-19 pandemic. AI and Big Data technologies help doctors generate insights from an enormous amount of data within a very short time. Cloud and cybersecurity technologies allow this transformation to happen anywhere connected to the internet in a certied secure manner. Combining this with other systems would open up the capability of doctors to monitor patients in greater detail, and to alleviate their already strenuous workload without sacricing their care quality. As such, we would suggest Hong Kong's next healthcare reform should focus on enhancing preventive medicine and early disease management with RPM, in furtherance to our previous accomplishment in promoting preventive medicine via education and vaccination initiatives to the highrisk demographics. On the patient-doctor level, RPM has the potential to transform the current one-way, discrete and transactional patient-doctor interaction to a continuous, interactive, and collaborative healthcare experience. It would help doctors and patients build a much closer relationship whereby health issues could be identified and treated at earlier stages. On the public health level, RPM would help allocate medical resources more effectively, by incorporating systems like the Modified Early Warning Score to prioritize the need for doctors’ intervention.   What can the Government do to launch Remote Patient Monitoring in Hong Kong?   To implement RPM in Hong Kong, the government should involve the active participation of community doctors. The doctors would review their own patient list, select patients who are suitable for participation in the RPM program and invite them to register for the program. The doctors would be responsible for educating these patients on the correct usage of the monitoring devices, and for providing "Home-based collaborative diagnosis and treatment" on an ongoing basis. At the macro level, this would effectively lead to the realization of "Hospital Decentralization" through the involvement of a network of community doctors. It would certainly bring relief to the already overloaded public healthcare system. In addition, the government should also provide incentives and funding in the following ways: 1. On the patient's end: subsidize those who are eligible for participation in the RPM program, help purchase medical devices approved by community doctors or qualied organizations, and help pay for related diagnosis and treatment plans and medical cloud platform services; 2. On Community Doctor's end: subsidize clinics participating in the RPM program to upgrade their equipment and to provide knowledge training in "Medical Information Technology", with a view to preparing them for the ultimate implementation of "Internet + Healthcare" in Hong Kong. COVID-19 has caused many patients to adopt telemedicine and it is time for the government to institutionalize telemedicine and incorporate RPM into Hong Kong's healthcare system. As a rst step, our Council has formed a Task Force on Telemedicine to look into the issue. Prior to COVID-19 pandemic, telemedicine is not as widely used and practised in Hong Kong as in other countries such as the US and the UK. In the wake of COVID-19 pandemic, patients and doctors became a lot more acceptive to the using of telemedicine.   The reform should pave the way for healthcare providers to integrate highquality telemedicine into their practice and clearly state the minimum requirement for professional telemedicine, which includes: 1. Dening the minimum standard of practice. Doctors should, at the very least, have access to timely and clinical grade vital signals before he/she is to make a diagnosis; 2. Stating the minimum cybersecurity requirement for the video consultation platform and the digital platform where the patient’s data are stored and analyzed, e.g. the US HIPAA Healthcare Cybersecurity Compliance; 3. Imposing certain minimum safety certification requirements on the devices, e.g. FDA/CFDA.   Your input is much needed in this important topic!   Dr. Yeung Chiu Fat Henry

2020-09-15

會長通訊:新辦公室,新里程碑和新計劃 | President's Message:New office, new milestone and new initiatives

新辦公室,新里程碑和新計劃       我很榮幸在香港西醫工會電子藥品平台啟動後的第三天寫這篇會長通訊。香港西醫工會電子藥品平台是本會在資訊科技發展的里程碑之一。 我在2020 年8 月21 日的啟動儀式上說,自90 年代起,西醫工會在會員的幫助及鼓勵下,過去在資訊科技發展中經歷了6 個里程碑。香港西醫工會在資訊科技發展的里程碑如下:- 1. 專注於與會員溝通的香港西醫工會電子會訊; 2. 專注於延續醫學進修教育內容的香港西醫工會網站; 3. 香港西醫工會的臨床實踐管理系統; 4. 香港西醫工會參與醫管局的電子健康紀錄互通系統; 5. 由於2019 冠狀病毒病大流行,自2020 年4 月開始,香港西醫工會推出網止延續醫學進修教育; 6. 香港西醫工會電子藥品平台於2020 年8 月21 日啟動。 處於日新月異的數碼時代,加上全球新型冠狀病毒疫情的籠罩下,更加突顯數碼平台的重要性。香港西醫工會極具前瞻性,在兩年前已經開始籌劃建構一個嶄新的數碼電子醫學和藥物平台。在各大藥廠的支持下,香港西醫工會的電子藥品平台今天終於面世。我必須感謝鄧權恩醫生、鄧偉材醫生及黃品立醫生在該項目中的辛勤工作,以及平台背後的合作夥伴,Vital Base International 技術上的支持。 平台為更有效、更有心和更容易地聯繫香港醫生、醫生會員、藥廠、政府醫護連結西醫工會。而第二階段我們會為大家提供大眾可以瀏覽平台,讓大眾對醫療、藥物、健康和社會醫療政策方面有近距離的接觸。作為大家與西醫工會的橋樑。同樣對藥廠來說這平台是一個在不同專業專科領域上,可以同醫生們直接傳遞訊息和交流機會 。 平台的誕生標誌著香港西醫工會在數碼發展的後盾。進入香港西醫工會電子藥物平台非常簡單,醫生們只需要從現在的西醫工會網頁https://hkdu.org 中,選擇電子藥物網上平台便可。嶄新平台內容豐富,包括有藥物資訊,醫學臨床專輯,活動、延續醫學進修 ( 包括延續醫學進修視頻點播)。通過該平台為每個西醫工會會員提供即時可用的西醫工會電子會員卡,我們會從各方面聯繫爭取給醫生會員更多優惠。作為醫生,登上這個平台便可以有相關連結,獲得一站式醫療藥物資訊,無需花時間到不同網頁瀏覽。 我們期待您的意見和參與,以便本會可以繼續改良和優化,提供一站式的數碼平台,以滿足各會員,醫生和社會的需求,並不時更新醫療信息。 我還在啟動禮上表示,我希望本會下一個資訊科技發展項目的重點放在遠程醫療和用於公私營協作計劃的新平台上。我們將很高興收到各會員對這些議題的意見。 2020 年9 月,政府希望透過普及社區檢測計劃( 普及計劃)盡早識別社區的2019 冠狀病毒病隱性患者。我們鼓勵各會員參與這個有意義的計劃,以保護香港市民的健康。截至目前為止,我們已有100 多名醫生自願透過本會參加普及計劃。我希望我們能就這場抗疫戰中向政府表示本會的支持。我希望所有在普及計劃中提供協助的醫護人員都能一直身體健康。 我們的新辦公室正在進行裝修。很高興逐漸收到會員的捐助。我們希望得到各會員的慷慨捐助,本會對任何金額的捐款將不勝感激。新辦公室將會有更大的空間給會員。請盡快向我們展示您的支持,我相信很快便會收到您們的慷慨捐助。有關新辦公室捐款的詳細信息,請參閱附件本會通訊2163 號,我們很快會在下一次的實體活動中,在新辦公室見面。 謝謝   楊超發醫生 New office, new milestone and new initiatives   I am proud to write this message on day 3 after the launching of HKDU e-pharm platform. It is one of milestones of HKDU IT developments. I spoke in the launching ceremony on 21 August 2020 that with the help and encouragement of our members, HKDU has gone through 6 milestones in the IT initiatives in the past since the 90s. The HKDU IT milestones are as follows:- 1. HKDU Electronic Bulletin Board with emphasis of communication with members; 2. HKDU Homage with emphasis on CME contents; 3. HKDU Clinic Management System for clinic practice; 4. HKDU participation in the HA EHRSS initiatives; 5. HKDU e-CMEs since April 2020 due to COVID-19 Pandemic; 6. HKDU e-pharm platform on 21 August 2020. The importance of digital platform has been highlighted by the rapidly changing digital world and strengthened with the global new COVID-19 Pandemic. Our Council is very forward-looking and has begun planning to build a new digital electronic medicine and drug platform more than two years ago. And with the support of pharmaceutical industry, the platform comes to life today. I must thank both Drs. Tang Kuen Yan, Tang Wai Choi and Dr. Wong Bun Lap for their hard work in this project, and Vital Base International too for their partnership and technical support. The purpose of the e-pharm platform is to build up more effective, more open-hearted and easier way to unite HKDU members, Hong Kong doctors, pharmaceutical companies and government health care system. In the second phase of the e-pharm platform, we will provide a platform for the public to have close access to health, drug and health care policies. And as a bridge between everyone and Hong Kong Doctors Union. For pharmaceutical manufacturers, the platform is an opportunity to communicate directly with doctors in different specialty areas. The birth of the e-pharm platform signifies a backup to the development of the HKDU in the digital platform. Access to the e-pharm platform is very simple, doctors only need to choose e-pharm platform from the current HKDU web page at the link https://hkdu.org. The new platform is rich in content with drug information, medical clinical albums and CME activities (including online CMEs on demand). With the instantly available HKDU e-membership card through this platform for every HKDU member, we can work with our partners from all aspects of contact to win preferential treatment for you all. As a HKDU member, you can get links on this platform and get one-stop medical information without having to spend time browsing different web pages. We look forward to your views and participation so that our Union can continue to improve and optimize to provide a one-stop digital platform to meet the needs of the members, doctors and the society and keep medical information updated from time to time. I also spoke in the launching ceremony that I wish our next IT initiatives would focus on Telemedicine and new PPP platform for public and private collaborations. We shall be most happy to have your views on these topics too. September 2020 is the month in which the Government wants to catch asymptomatic COVID-19 carriers in town through the Universal Community Testing Programme (UCTP). We encourage your participation in this meaningful project to help protect the health of Hong Kong citizens. Up to now, we have more than 100 doctor volunteers enrolled into the UCTP through us. I wish we can show our support to the Government for a good cause. And I hope all health care workers helping in the UCTP stay healthy for many years to come. Our new office renovation is underway. Donors are coming in. I am looking for your contribution in one way or the other. After all, our office is always open to our members. There would be more space for members to stay around. Please show us your support as soon as possible, and of course, we would not be surprised to have your generous support soon. For details of donations to the new office, please find attached reminder circular no. 2163 mailed with this Bulletin. See you in the new office in our next physical function soon. Cheers, Dr. Yeung Chiu Fat Henry

2020-08-26

有線新聞:全民檢測下周二開始 西醫工會:政府指新東、新西缺醫護 參與人員有兩小時訓練

【有線新聞】下星期二開始的全民檢測,18區都有檢測中心,西醫工會引述政府指,新界仍缺醫護人手,而參與的人員會有兩小時的訓練。 全民檢測9月1日開始,港版的氣膜實驗室是如何,只安排個別傳媒安排進內看。由政府新聞處發放片段見到,食衞局常任秘書長,同時是檢測工作組組長的陳松青、資訊科技總監林偉喬與內地支援隊隊長余德文等,穿上保護衣、鞋套及腳套,視察氣膜實驗室。有華昇診斷中心代表講解,實驗室內有多部檢測機器。 市民星期六開始,可以登入這個網站預約全民檢測,市民到時要輸入個人資料,以及選擇的社區檢測中心及時段,每30分鐘為一時段。 政府指有超過5,000名醫療人員報名幫手採集樣本。西醫工會會長楊超發原先已報名參與,星期三再收到電郵,要重新選擇服務的區域,相信是因為有部分區仍缺人手,政府要再調配,「新界東及新界西都短缺,很多醫護人員大多都在港島及九龍住,可能工作在那邊多。」 他指每隊會有1名領隊,約7名副領隊及約10名負責採樣的隊員。招募直至星期五下午,參與的醫護人員星期四開始會有訓練。楊超發:「訓練課程訂了一小時,穿衣、換衣及採樣,另外呼吸器的面型測試,都是差不多一小時,合共兩小時。」 他希望到時採樣,醫護人員及市民之間最好有透明膠板隔住,減低感染風險。   詳細內容:有線新聞

2020-08-22

TVB News:政府縮短助全民檢測醫護工時及增時薪 工會指仍存不便

政府預計要招募最少數千名醫護人員協助全民檢測採樣工作。西醫工會指,政府縮短全日工作時數,由至少八小時減至六小時,又調高時薪,但對醫護人員仍有不便。 全民檢測的採集樣本工作,由本地醫護等組成,註冊醫生、護士或牙醫會出任組長或助理組長,隊員由醫療學科學生或有感染控制知識的人擔任。 西醫工會表示收到政府通知,會調高時薪,組長加至900元;有感染控制知識的組員加至400元,學生的時薪維持不變。工時由每日最少兩更、每更四小時,即共八小時,改為每更六小時,可只做一更。若做足兩更,中間有一小時休息及吃飯時間。 不過工會認為對執業醫護仍有不便。 西醫工會會長楊超發表示:「我們很多私家醫生在外面開工,是差不多五時至八時,打算一時至五時,中間四小時出來幫手檢測。因為你由兩時做到八時,在診所工作的醫生、護士很難調配出來幫手。公家方面,他通常放五時,其實他可以幫夜晚五時至八時,如果你從兩時開始,公家醫生要請假出來,又要上頭批核。」 有護理系五年級的大學生說,收到校方的招募電郵,但仍有顧慮。 中大護理系學生陳同學說:「只有外科口罩及手套,個人保護裝備、全身穿的那些都可能沒有。但我們要幫手採集(樣本),幫助病人採集時,可能會引發咳嗽、打噴嚏等反應,我們就很容易感染。其實三百元對我們來說是很吸引,但都害怕感染到。」 政府指採樣過程如出問題或意外會有保險保障。   詳細內容:TVB NEWS

2020-08-16

有線新聞:最快本月24日推行全民檢測 消息:政府冀招募約二千醫護收集鼻腔及咽喉樣本 蔡堅:想知道醫學上準確性

 【有線新聞】政府最快本月24日推行全民自願檢測,消息指政府傾向由醫護協助市民收集一個鼻腔和一個咽喉樣本,再做混樣測試。政府上星期約見多個醫學團體,希望招募約2,000名醫生、牙醫、護士等。 政府宣布進行全民自願檢測一直未有公布詳情,多個醫學團體上星期四與食衞局局長見面,局長向他們表示最快本月24日就會推行全民檢測,為期14日。 政府想招募私家醫護協助採集樣本,消息指政府傾向參考英國做法,每個人採取一個鼻腔及一個咽喉樣本,這樣出現假陰性的機會較低。同時兩個樣本可以做混樣,而不用鼻咽樣本,採樣時風險會較低。同時研究在一些較空礦地方做,例如社區會堂等。 有西醫團體透露政府會在各區設立帳篷,分早、午、晚三個時段為市民採樣。西醫工會會長楊超發:「社區會堂在室內風險怎樣都比室外大,我想球場、平台風險少很多。如果社區會堂一定要要空氣非常流通,因為它沒有負壓的元素,變相就要加一些過濾器,減少空氣中的病毒。」 他又說政府給他們的文件提到帳篷內會有主管、副主管和收集員,車馬費分別是每小時800、600和300元。目標是招募2,000多名醫生、牙醫及護士,甚至中醫和醫學生,即是每區約100人,要求團體於星期三回覆。他們會獲發外科口罩和手套,但就沒有提到會否有保護衣、眼罩等。楊超發:「不夠的。你看我現在有戴帽,有戴眼罩,遲些去做時可能要戴頭套,保護衣都需要。」 同樣有份開會的醫學會就說,最重要是如何保護醫生和市民,如果醫生因此感染如何賠償等,現階段難評估多少醫生願意參與。醫學會會長蔡堅表示:「檢測的敏感度、準確性,即是我們會否知道幫他做一件事都要,即使不是怕基因,都想知道醫學上準確性如何,是否值得做。」 除了華大基因,內地來港專家原本同凱普、金域開會談,幫手做全民檢測,但凱普實驗室負責人回覆時說,據他了解,政府會將全民檢測全部交給華大做。   詳細內容:有線新聞