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Community resources for stroke clients are underdeveloped in Hong Kong and stroke survivors often face difficulties in community reintegration. We have examined the feasibility of using videoconferencing for community-based stroke rehabilitation. The sample comprised 21 stroke patients living at home. All the subjects participated in an eight-week intervention programme at a community centre for seniors. The intervention, which comprised educational talks, exercise and psychosocial support, was conducted by a physiotherapist via a videoconference link. The Berg Balance Scale (BBS), State Self-Esteem Scale (SSES), Medical Outcomes Study 36-item Short Form (SF-36) and a stroke knowledge test were administered at the start and end of the programme. In addition, at the start of the study the Geriatric Depression Scale 15-item Short Form, the Elderly Mobility Scale and the Lawton Instrumental Activities of Daily Living Scale were used to assess subjects' baseline status, and a focus group was also held at the end of the programme to gather qualitative findings. Nineteen subjects completed the eight-week intervention. The baseline functional status was high, although 52% had symptoms of depression. After the intervention, there were significant improvements in BBS, SSES and knowledge test scores and scores on all subscales of the SF-36. All the subjects accepted the use of videoconferencing for delivery of the intervention. The pilot study demonstrated the feasibility, efficacy and high level of acceptance of telerehabilitation for community-dwelling stroke clients.

Background: Telemedicine has been applied successfully in various fields of medicine. This mode of health care delivery may potentially be useful in supporting frail nursing home residents who require multidisciplinary geriatric services. Objective: To assess the feasibility of telemedicine in providing geriatric services to nursing home residents, and whether this mode of care resulted in increased productivity and savings. Methods: A local 200-bed nursing home supported by the Community Geriatric Assessment Team (CGAT) was recruited. Over a 1-year period, teleconferencing was used to replace conventional geriatric outreach services. The feasibility of telemedicine was evaluated by participating specialists. Productivity gains, consumption of hospital services and user satisfaction were measured. Results: Telemedicine was adequate for service delivery in up to 99% of cases, depending on the specialty. A greater number of clients were served and follow-up intervals were shortened. The service was cheaper than conventional outreach or clinic activities, and acceptable to users and clients. In particular, savings were made through a 9% reduction in visits to the Accidents and Emergency Department and in 11% fewer admissions to acute hospital wards. Conclusion: Telemedicine is a feasible means of delivering multidisciplinary care to frail nursing home residents, and may result in increased productivity and significant savings.