SHM Converge Scientific Abstract ePoster Gallery-The Business Model of Teleconsultation With Point-of-Care Ultrasound at Home

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This article describes the business model and implementation of a teleconsultation-at-home (TAH) program in rural Taitung, Taiwan, centered on point-of-care ultrasound (POCUS) and doctor-to-doctor-to-patient (D2D2P) communication. The program emerged in response to increased demand during the COVID-19 Omicron surge, especially for patients in remote areas with limited access to hospital care.<br /><br />The TAH model enables local primary care physicians at Home Clinic Dulan to consult specialists at remote medical centers using information and communications technology while seeing patients in their familiar home environment. The service is flexible across time, place, and medical specialty, and can support multiple clinical needs through telemedicine equipment and a shared platform.<br /><br />From March 2021 to October 2023, 70 patients were enrolled. Services were delivered mainly through roving medical visits (57%), home care (34%), and outpatient clinic visits (9%). Specialist consultations included cardiology, rehabilitation, nephrology/hospital medicine, neurology, swallowing training, and traditional Chinese medicine. Multi-target POCUS was used in 10% of patients, particularly for fluid overload in advanced chronic kidney disease. Flexible nasopharyngoscopy was used in 7% of patients with dysphagia, and renal supportive care was introduced for one fully dependent end-stage renal disease patient.<br /><br />The model emphasized customer value through improved access, rapid 24-hour response, and affordable, high-value care. The study also evaluated financial break-even points across 24 teleconsultation scenarios and recommended six priority strategies. Overall, the authors conclude that Home Clinic Dulan’s digital transformation, staff training, regulatory adaptation, and regional collaboration created a comprehensive, innovative home POCUS and teleconsultation network that helps fill gaps in rural healthcare.

Asset Subtitle

Hung-Bin Tsai

Meta Tag

Author List Hung-Bin Tsai, Lin-Hua Tseng, Nin-Chieh Hsu, Sang-Ru Yu

Category Innovations

Concept Teleconsultation-at-Home Model

Concept Point-of-Care Ultrasound

Concept Home Care

Concept Rural Care

Concept Multimorbidity

Distinguished Non-Finalist

Presenter Organization Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

Presenting Author Hung-Bin Tsai

Track Consultative Medicine

Keywords

teleconsultation-at-home

rural healthcare

point-of-care ultrasound

POCUS

telemedicine

Taitung Taiwan

doctor-to-doctor-to-patient

home clinic

COVID-19 Omicron surge

digital transformation

Teleconsultation-at-Home Model

Point-of-Care Ultrasound

Home Care

Rural Care

Multimorbidity