Electronic Display

Population ageing is a worldwide phenomenon. Emergency department is indispensable in the chain of care for geriatric population, hence the need of quality geriatric acute care in the field of emergency medicine. There are two main models of acute geriatric care worldwide: 1. UK model is characteriz...

‘Aging in place’ is about providing the necessary resources for older adults to remain in their own homes and communities safely and independently.  It is generally agreed that Chinese people prefer to continue living in a familiar environment with the support of their families as they age....

CYDA (Craft Your Daily Adventure) is a mobile application that aims to re-energize the daily lives of retired elders, as statistics reveals this population group comprises with a significant proportion of solitary elderly suffering from mental depression. While our backend is complemented by sophist...

Poisoning is not uncommon in Hong Kong.  According to the Annual Report 2017 published by Hong Kong Poison Information Centre (HKPIC), there were around 4,000 cases of poisoning recorded yearly between 2013 and 2017.  While the majority of the cases had uneventful recovery, some poisoning ...

Osteoporosis is characterized by low bone mass and deterioration of bone quality, leading to increased risk of fragility fractures and the resulting mortality and morbidities. It is often called a ??silent disease?? because there are no symptoms or pain until a fracture occurs. The silence of the di...

The UK’s National Health Service (NHS) Long Term Plan puts digital solutions at the forefront of its new transformation plan – through data, analytics, AI, cloud computing and mobile. New models of care, new clinical pathways and new patient tools are helping the NHS plan, manage and deliver s...

The incidence of breast cancer has been increasing in Hong Kong. Multidisciplinary approach of breast cancer management is currently the gold standard in treatment of breast cancer.  Breast surgery is more than removal of cancer; it combines the oncological principles with the aim of minimizing...

Traditional karyotyping had been the standard test for prenatal diagnosis in Hong Kong since 1981. Chromosomal microarray (CMA), either performed by array comparative genomic hybridization (aCGH) or single nucleotide polymorphism (SNP) array has become more widely used 30 years later. CMA offers inc...

Promoting collaboration between palliative care (PC) and other specialties through a shared care model according to patients’ needs is one of the strategic directions stated in the Hospital Authority Strategic Service Framework for Palliative Care in 2017. A new Inter-hospital Palliative Care Cons...

This session will describe the approach taken by one Local Health District in NSW to create the conditions for system transformation. The focus of this transformation was to ensure the organisation, its hospitals and local multiprofessional teams were supported to deliver safe and reliable care that...

The Princess Alexandra Hospital is a 1133 bed tertiary referral hospital located in Brisbane, Australia.  The hospital provides care in all major adult specialties, except for obstetrics.  The hospital is recognised for its expertise in trauma management, cancer care, cardiac care and rehabilitati...

Simulation-based education (SBE) provides a safe and effective learning environment for learners. Historically, simulation has been widely used in military and aviation training, and was only introduced into medical education in the 1960s. In the last 20 years, concerns about patient safety have giv...

Background: Fasciotomy is essential for the prevention and management of compartment syndrome on limbs. The traditional method is to wet to dry dressing to the wide laid open wound to well prepare the wound bed for closure. Most fasciotomy wounds will require delayed primary closure and there may re...

As the survival rate in critically ill patients improves, the morbidities and the long-term complications of the intensive care unit (ICU) survivors are increasingly recognized. Among these chronic morbidities, Intensive Care Unit-acquired weakness (ICUAW) is one of the commonest. It is defined by t...

Across the world, countries are attempting to join together patchworks of fragmented primary, community, hospital and social services into more coherent health and care systems. In the English NHS, groups of local healthcare providers are attempting to reduce duplication between services, to make be...

Seasonal influenza viruses include influenza A(H1N1)pdm09, influenza A(H3N2) and influenza B viruses. In Hong Kong, there is a distinct seasonal pattern with two peaks. The winter influenza season usually occurs from January to March/April, and another summer influenza season occurs at variable time...

The increase in the number of older adults in Hong Kong characterizes an increase in the number of people living with chronic and progressive diseases. There are evidence that palliative care can improve the quality of life to those patients. The challenge to provide high quality of palliative care ...

To study genetic sequence variants underlying unresolved Mendelian disorders and improve interpretation of already identified high penetrance variants, a collection of 13,000 individuals with a rare disease and their relatives has been whole genome sequenced with an average 30x coverage. Participant...

Innovating for better care via a common mobile patient app platform to is one of the key strategies in the Hospital Authority (HA) in enhancing patient experience and health outcome. To empower patients in improving their own health, a common patient app platform (HA Go) is built in 2019 so that pat...

Hong Kong trauma system started from 1994. Before that, there is no interdisciplinary collaboration. This year, Professor Donald Trunkey, an US trauma expert advised on the development of trauma services through a multi-disciplinary approach. 24-hour trauma service has embarked the next year sequent...

Before we can engage colleagues, in the speaker’s opinion, we should admit that there is real crisis in physician morale. Over half of physicians are burned out. This affects everyone. The lecture has been dedicated for anyone who has to lead people on a daily basis, and in particular in a busy wo...

ICU beds are expensive and critical resources in modern healthcare. Its under provision would jeopardise the quality of healthcare, while its over provision overburden the limited resources. However, there is no hard and fast rule on what is the optimal number of ICU beds for a given population. Hon...

Background Our hospitals Digestive Medicine Centre has a diverse patient population including those who may not understand English and/or Chinese. Patients who come to our centre for colonoscopy arrangement require adequate and clear instructions of bowel preparation. As colorectal cancer is the se...

Financial technology promises to bring improvements to many areas in banking and finance, including payment, deposit, and wealth management. How will traditional financial institutions and technology companies respond to these opportunities? What challenges will they face? How should they work with ...

Evidence points to many benefits of "early palliative care" to improve patients' quality of life while living with a serious illness. Yet most trials of early palliative care have not included patients with hematologic malignancy (HM). Unfortunately, patients with HM are also known to have heavy sym...

There are challenges of teaching junior doctors on patient safety. For junior doctors, particularly interns, those at the start of their professional career, found it difficult to identify with patient safety as a discipline, so they did not prioritize it. In part this was because those with little ...

Osteoarthritis of the knee is a common degenerative disorder affecting the local population. The prevalence of knee osteoarthritis is 13% in female and 7% in male based on a local study. In end stage osteoarthritis, surgical intervention is warranted when conservative measures failed. High tibial os...

When asked, most people will answer the question "why did you go into healthcare?" with "because I wanted to make a difference". Yet once in the work force, this often becomes increasingly difficult due to overburdened systems, lack of sufficient staff, poor morale....the list can go on. The researc...

Phalangeal fractures of the hand are common and potentially debilitating. The majority of these fractures may be treated conservatively. Surgery may speed recovery and avoid complications such as malunion and arthrosis in selected cases. A variety of procedures offer either relative or absolute stab...

Most doctors provide a high standard of care to their patients. In addition to expertise in their specialty, they must also demonstrate important generic professional capabilities which are essential to providing safe and effective patient care. These broader human qualities – such as being able t...

In patients with acute leukemia, peripheral blood and bone marrow samples are periodically examined to monitor response to therapy and recovery of normal hematopoiesis. This is traditionally done by assessing cell morphology, a practice that lacks sensitivity and is prone to errors. Assays that can ...

Myopia, or near-sightedness, is an ocular condition where there is a mismatch between the optical power and length of the eye. The combined optical power of the eye is too strong for its corresponding axial length, causing incoming light to focus in front of the retina. The most common form worldwid...

Natural killer (NK) cells are normal white blood cells capable of killing cancer cells without prior sensitization. Unlike allogeneic T cells, NK cells do not cause graft-vs-host disease. Furthermore, allogeneic NK cell infusions are attractive for cancer therapy because of non–cross-resistant mec...

Princess Alexandra Hospital is one of Australia’s leading tertiary referral teaching hospitals and has a bed platform of 1133 beds. The hospital provides care in most major adult specialties including acute medical, surgical, mental health, cancer, rehabilitation and allied health services. The ho...

Introduction:  In healthcare, a paradigm shift in thinking is required as many healthcare workers often excuse or condone acts of violence from patients. Although few people come into a healthcare environment with intent to harm, violence is real in healthcare settings due to the nature of illn...

The World Health Organization (WHO) defines palliative care for children is the active total care of the child’s body, mind and spirit and also involves giving support to the family. With the social and medical advances, more infants or children can live longer with medical complex condition. Many...

Many patients experience severe to excruciating acute pain during a wide range of medical procedures.  Excessive pain is an important medical problem that can have long term negative consequences for patients.  For example, children often find it scary to visit the dentist (cavities) or the doctor...

As a rapid emerging interdisciplinary field, the science of big data is playing a disruptive role in many sectors in recent years. The application of big data science is considered as strategically important to many established sectors of science and business world. The big-data has the unique adv...

Hong Kong has one of the highest penetration of mobile phones and tablets in the world, providing a great platform for HA not only to provide better service to our patients, but also to engage and connect our entire workforce anytime, anywhere. The HR App, a tailored made mobile App for HA staff, pr...

Introduction: In Canada, the healthcare and social services sector accounts for the highest number of non-fatal injuries that result in lost-time claims. According to the Association of Workers Compensation Boards of Canada, in 2017, accepted lost-time injury statistics show that the health care/soc...

Use of dried blood spots (DBS) to screen newborns for inborn errors of metabolism (IEM) began as a pilot study in Hong Kong (HK) in 2015. Results from the pilot study showed the collective incidence of the 24 screened conditions to be 1 in 1,682. The pilot study demonstrated feasible logistics and a...

Community geriatric assessment services was established in 1994 by HA to better serve elderly from residential care  homes of the elderly (RCHE), who are high volume users of HA services. CGAS vision of seamless care was to provide timely geriatric management together with social sector partner...

Initiated in February 2017, “Dementia Community Support Scheme” (DCSS) is a two-year pilot scheme launched by the Food and Health Bureau (FHB), in collaboration with the Hospital Authority (HA) and the Social Welfare Department (SWD). The pilot scheme was funded by the Community Care Fund and im...

The Endovascular technique was rapidly developed in last two decades with the needs in community.The endovascular procedure becamethe main trend when treating peripheral vascular diseases. The endovascular procedures were minimal invasive, patient’s length of stay was short, yet stents implanted r...

‘Disruption’ is a term that has been used in business sectors to describe a process in which an underrated product or service starts to become popular enough to replace, or displace, a conventional product or service. Disruptions in medicine often refer to events or processes that cause us to ch...

Use of dried blood spots (DBS) to screen newborns for inborn errors of metabolism (IEM) began as a pilot study in Hong Kong (HK) in 2015. Results from the pilot study showed the collective incidence of the 24 screened conditions to be 1 in 1,682. The pilot study demonstrated feasible logistics and a...

Performance Management is an important issue in organization performance. The current performance appraisal tool in Hospital Authority is Staff Development Review (SDR), which was implemented since 1994. The objectives of current SDR are focused on development based on the achieved result; strengthe...

The concept of active aging has been promulgated for promoting well-being in older people. Rehabilitation plays an important role in helping elderly patients resume daily functioning and make adjustment to the environment. Functional task training is the core Occupational Therapy (OT) intervention t...

Many factors contribute to the wellness and sustainability of our people and our environments, including culture, community, lifestyle and design. The contemporary hospital’s place in our communities reaches past the confines of single-use, isolated institutions with finite lifespans. Hospitals ar...

Timely initiation of dialysis is vital to chronic kidney disease stage 5 (CKD5) patients. Literatures reviewed that unplanned urgent initiation of dialysis was associated with poorer outcomes and early pre-dialysis education enhanced greater likelihood of elective dialysis. Pre-dialysis education is...

Genomic analysis of gastrointestinal cancers, the most common cancer types worldwide, has revealed marked histological and molecular heterogeneity linked to different pathways of cancer development with therapeutic implications. For example, colorectal cancers that progress through serrated polyps a...

Recent pedagogical focus has shifted from teacher-orientated knowledge transfer to outcome-based learning. In an undergraduate orthopaedic teaching module, Student Learning Outcomes (SLO) are explicitly specified right at the start of the module. To help students cope with the SLO through harnessing...

The approach to prenatal diagnosis has been revolutionised by advances in prenatal molecular diagnostics. The most important breakthrough in prenatal screening using maternal plasma cell-free fetal DNA as a non-invasive prenatal testing (NIPT) for fetal chromosomal abnormalities was discovered by Pr...

The Gram-negative bacterial pathogen Klebsiella pneumoniae has consistently evolved over the past two decades, generating genetic variants that exhibit mixed phenotypes of hyper-resistance and hypervirulence including carbapenem-resistant K. pneumoniae (CRKP), hypervirulent K. pneumoniae (HvKP) and ...

Risk, in regulatory terms, is usually considered in terms of risk to patients, but students and practitioners may, themselves be at risk  of harm or self-harm in environments where they are unsupported or subject to unreasonable demands. Students and doctors are at risk of poor performance because...

Influenza infection can lead to a variety of neurologic complications including influenza‐associated encephalitis/encephalopathy, acute necrotizing encephalitis, febrile convulsion, acute encephalopathy with biphasic seizures and late reduced diffusion, acute disseminated encephalomyelitisas, Guil...

One of the many education outcomes among medical graduates is to prepare their readiness to serve the public or to embark on specialist training. Clinical training would be essential to achieve these objectives. Apart from the two university-affiliated teaching hospitals (Prince of Wales Hospital an...

The World Health Organization defines palliative care as a way of caring for people with life-threatening illnesses which focuses on quality of life, through the prevention and relief of suffering by prevention and management of pain and other problems, physical, psychological and spiritual. In 2014...

Many challenges have evolved in the health care system that support the need for interprofessional collaboration. Over time, separate specialties and professions have been created to focus on specific aspects of patients’ health and care such that a single profession today cannot adequately me...

Support Operations are one of the critical functions in hospital operations. At the new 1800-bed Woodlands Health Campus (WHC) in Singapore, support operations were identified as a key area for innovation.  A coherent strategy was developed in tandem with clinical services planning to provide e...

Globally, Plasmodium vivax and P. falciparum malaria are the most important causes of malaria. Falciparum malaria is generally the most severe form of disease which causes the majority of malaria deaths. Nevertheless, vivax and knowlesi malaria can also result in severe disease and even mortality. I...

In the 21st century clinicians are confronted with increasingly complex ethical challenges in their medical practice.  These include everyday relational issues such as truth-telling, consent, medical confidentiality, assessing capacity, conflicts with colleagues, patients and their relatives ov...

Ageing in place is not only a policy target of the HKSAR Government, but also the desire of many elderly people. In the recently completed Elderly Services Programme Plan, the government pledged to provide more community support services to elderly people to enable them to live in the community ins...

Myopia is a global health threat. By year 2025, it is predicted approximately 50% and 10% of world’s population being myopic and highly myopic respectively. Notably, high myopia is associated with sight-threatening complications, including pre-senile cataract, glaucoma, retinal detachment, and cho...

Conventional non-surgical management of knee osteoarthritis (OA) stresses on improving knee muscle strength and range of motion. However, the results may not be satisfactory. Recent studies show that neuromuscular training is the key to enhance knee control and functional limitations in patients wit...

75% of S & P companies will be replaced by new firms by 2027. Innovation for big enterprise is no longer an option, it is a must. The world is changing very fast, and innovation is becoming more difficult, especially for those corporates which are still reacting slow to digital distribution. Fortuna...

In face of the rapid ageing population, the Hong Kong Government has formulated her policy in its well-stated statement “Ageing in Place as the Core, Institutional Care as the Backup”. Studies has confirmed that senior people in Hong Kong prefer to age at their homes and familiar communities. Ev...

Technology is a common element in our everyday lives. The goal of occupational therapy is to enhance or enable meaningful participation in the occupations (activities) important to the clients served. Occupational Therapist prescribes assistive technology device to increase, maintain, or improve th...

Radioactive iodine therapy (RAI) using a high dose of I-131 (3 or 5.5 GBq) is an effective regime to eradicate or ablate any remnant cancerous thyroid tissues after surgery or thyroid cancer which has metastasized. Hong Kong radiation regulations mandate that a patient with radioactivity of higher t...

In Hong Kong, blunt trauma prevails. Carotid artery is vulnerable to be injured in different common mechanisms like hyperextension in neck whiplash, stretching of the carotid by mandibular or LeFort’s fractures occurred in fall or motorcycle accidents. Blunt carotid artery injuries account for 3 t...

With service commencement of Hong Kong Children’s Hospital in 2018, five paediatric oncology centres will be merged into one tertiary centre. In order to cope with the service needs, I had attached to Great Ormond Street Hospital for Children in London, aiming to find out good clinical pharmacy pr...

  A knee joint is composed of three compartments – medial tibiofemoral, lateral tibiofemoral and patellofemoral joint. When end-stage degeneration affects either one of the compartments, the traditional surgical treatment is total knee replacement with a prosthesis which sacrifices the normal...

Most of the wrist pain following injuries are actually related to injuries to ligament rather than fractures. So most of them may not be revealed on conventional plain x ray. Careful history taking about mechanism of injury and physical examination is he clue to diagnosis and interpretation of MRI n...

Inborn errors of metabolism (IEM) comprise a large group of both clinically and etiologically heterogeneous disorders involving in human metabolism. There are more than 1000 different IEM disorders ranging from organic acidemias, amino acid metabolism, urea cycle defects, fatty acid oxidation, mitoc...

The increase in prevalence of obesity among children is a worldwide problem. Obesity in childhood is associated with long term morbidity and mortality. A sustainable and effective program for treatment of childhood obesity is important. Prevention is always better than cure, promotion of healthy lif...

Despite all the great work that has taken place around the world to improve the safety of care, harm continues to happen at an alarming rate! In Canada, patient safety incidents are the third leading cause of death behind cancer and heart disease. And a recent national survey showed that very few Ca...

The steady increase in the incidence of geriatric hip fracture places an increasing burden on health care service in Hong Kong. Post fracture limitations are prominent and restrain many of the elderly from returning to community, rehabilitation is therefore important for reducing their long-term dis...

Background: Fasciotomy is essential for the prevention and management of compartment syndrome on limbs. The traditional method is to wet to dry dressing to the wide laid open wound to well prepare the wound bed for closure. Most fasciotomy wounds will require delayed primary closure and there may...

Use of dried blood spots (DBS) to screen newborns for inborn errors of metabolism (IEM) began as a pilot study in Hong Kong (HK) in 2015. Results from the pilot study showed the collective incidence of the 24 screened conditions to be 1 in 1,682. The pilot study demonstrated feasible logistics and a...

E-cigarette was created in 2003, and gained popularity over the past decade. It has been perceived to be good in term of a harm reduction product for chronic smoker, environmental friendly, or even “fashionable”. Although user of e-cigarette may expose to less known toxic substances such as nitr...

Incidence of incorrect annotation of radiological images is common in radiology  department and can lead to grave consequence of patient. At radiology department, image annotation about the laterality (e.g. Left, Right) or view position (e.g. AP, PA) is required for every image. As the annotati...

In the past decade, 3D printing technologies were widely applied to the medical services by the medical service providers. The technologies provide more details and accurate information to the surgical team in order to prepare the pre-operative planning before surgery. In addition, 3D printing techn...

Based on ancient techniques, mindfulness is a powerful psychological intervention/coping skill that has been shown to improve mood and reduce stress. Mindfulness involves bringing one’s attention into the present moment; bringing full awareness into present experiences on purpose and nonjudgmental...

Healthcare professionals abide by codes of conduct built around respect of life and human dignity, respect for autonomy of the patient, minimizing harm and doing good, justice, respect for colleagues and other professional etiquette.  Some of these elements are as ancient as Hippocrates (c. 370...

Diseases affecting the brain is the commonest reason for preventing aging in place. Commonest brain diseases associated with institutionalization are Alzheimer’s and cerebrovascular diseases (stroke, small vessel disease), degenerative (idiopathic Parkinson’s disease) and vascular (small vessel ...

Modern health systems remain built around acute care in hospitals. These miracle factories have delivered dramatic improvements in life expectancy, but they were ill adapted to cope with the consequences of their success – an ageing population with a complex mix of chronic health conditions and so...

The demonstrated capacity of immune cells to kill tumor cells suggests that they could be used to treat cancer. Conceivably, immune cells could overcome the resistance of cancer cells to standard treatment modalities while sparing normal tissues. Results of recent clinical trials with autologous T c...

Each year, influenza viruses circulate worldwide and are responsible for a considerable burden of medical visits, hospitalizations and deaths, especially at the extremes of age, among the very young and the very old. Older adults are more vulnerable to influenza illness and less likely to benefit fr...

The term FinTech, a portmanteau of "financial technology", is used to describe new digital technology which has the potential to improve the delivery of financial services. FinTech helps companies, business owners, and consumers to better manage their financial operations, processes, and daily lives...

Electrophysiological recording (IONM) during neurosurgical, orthopedic, and vascular surgery are gradually becoming part of standard medical practice, mainly because it provides information regarding the functional integrity of the nervous system. The merits of IONM have been extensively reported in...

In order to tackle with the growing pressure on the healthcare system in Hong Kong, it is important for all nurse leaders to develop leadership competencies and build up high performing teams regardless of their level of responsibilities and working background. From 9th to 20th October 2017, a group...

Knee osteoarthritis (OA) is one of the most common degenerative diseases that cause disability in elderly people. An epidemiological study by Felson et al showed that about 30% of all adults have radiological signs of OA; 8.9% of the adult population has clinically significant OA of the knee or hip,...

Medical professionalism is the belief system that formulates and upholds the values and standards of medical practice. It underpins our social contract with society that allows us to self-regulate and maintain autonomy. Changing expectations from patients and doctors as well as the introduction of d...

Introduction With the advancement in surgical techniques and arthroscopic instrumentations, minimally invasive hand surgery has become the most popular treatment options for most common hand diseases. It has proven to have faster patient recovery and lower morbidity. These can be divided into arthro...

Myopia is in epidemic proportion in China and many Asian cities. The prevalence of myopia is well beyond 80% in these cities. Since high myopia increases the risk of sight-threatening diseases such as glaucoma, retinal degeneration and detachments, it is important to decrease the prevalence of myopi...

•       This talk sets out the English National Health Service (NHS) approach to improving outcomes through greater personalisation of care underpinned by developments in genomics. •       It reviews how the world-leading 100,000 Genomes Project provided a proof of concept for the ...