Hospital Authority Ultrasound Wa...
Introduction: Ultrasound waiting time has become a social problem
In recent years, the waiting time for ultrasound examinations in public hospitals under the Hong Kong Hospital Authority has been increasing and has gradually developed into a high-profile public health problem. According to the latest statistics released by HA, the median waiting time for routine ultrasound examinations in non-urgent cases is over 16 weeks, and the waiting time for some specialties (such as gastroenterology and hepatology) is as high as 28 weeks. This phenomenon not only directly affects the timeliness of patients' diagnosis, but may also delay the golden opportunity for early disease intervention. It is worth noting that the ultrasound waiting dilemma does not exist alone, but is related to itCTscan referenced by HAAndand other imaging services together constitute a bottleneck phenomenon in Hong Kong's public healthcare system. Many patients report that they have to go through a waiting period of several months between referral from their primary care physician and when the ultrasound is actually completed, during which time their condition can change unpredictably. This situation has raised deep public concerns about the efficiency and fairness of healthcare resource allocation, and has also prompted an in-depth analysis of the root causes of problems at the system level to explore feasible solutions.
Analysis of Demand and Supply of HA Ultrasound Services
Hong Kong's healthcare system faces an unprecedented supply-demand imbalance. On the demand side, the proportion of people aged 65 and above in Hong Kong rose from 13% in 2011 to 21% in 2023. At the same time, the prevalence of chronic diseases such as diabetes and hypertension continues to rise, and these patients require regular abdominal ultrasound and vascular ultrasound monitoring. According to HA's 2022 annual report, the compound annual growth rate of ultrasound demand reached 6.8%, far outpacing the expansion rate of healthcare resources.醫管局轉介mri
On the supply side, there are multiple structural problems.
- There are only about 380 ultrasound machines in public hospitals in Hong Kong, of which less than 30% of the high-end equipment can perform special tests (cardiac ultrasound, vascular Doppler, etc.)
- There is a severe shortage of radiologists and sonographers, with fewer than 50 newly qualified professionals each year, but the wave of retirement has resulted in an average annual turnover rate of 4.2%
- Equipment usage time is concentrated during the daytime on weekdays, and in the evening and weekends, the equipment usage rate is only 35%, so idle resources and overuse coexist
This supply and demand discrepancy is particularly pronounced in the referral system. When issued by a family doctorAfter applying, patients are often assigned to hospitals with the most stringent equipment and personnel, and the resource allocation mechanism between regions is inflexible. The ultrasound latency in the New Territories East cluster is on average 40% longer than in the Hong Kong West cluster, indicating significant geographic differences in resource allocation.
Underlying reasons that affect latency
The issue of long waiting times for ultrasounds is rooted in the multi-layered structural factors of Hong Kong's healthcare system. First, there are obvious bottlenecks in the efficiency of medical processes. The current referral system still relies heavily on paper-based assignments issued by physiciansCTscan referenced by HAor ultrasound forms, file collection, appointment assignment, and report delivery take an average of 11 business days. Information systems between different networks are not fully interoperable, so patients need to repeat tests frequently when they visit the hospital across hospitals.
The issue of fairness in resource allocation is also worth noting. According to the 2023 report of the Audit Committee, the number of ultrasound machines per 100,000 people in the Kowloon Central Cluster is 2.3 times that of the New Territories West Cluster, but the aging of the population is relatively low. This discrepancy between resource allocation and actual demand is partly due to historical development trajectories and differences in hospital size, but also reflects the lack of demand-oriented accurate allocation capabilities in the current resource allocation mechanism.
Patient medical behavior is also an important influencing factor. Although private medical institutions provide ultrasound services (the average waiting time is only 3-7 days), about 75% of non-urgent cases still insist on choosing a public hospital, mainly due to the difference in cost (public hospitals charge about HK$300-500 for ultrasound, while private institutions charge HK$1500-HK$4000). This over-reliance on public health care has led toUltrasound and other services are constantly overloaded. At the same time, some patients have a "specialist myth" and insist on undergoing an ultrasound even if their family doctor thinks their symptoms are mild, further exacerbating resource constraints.醫管局轉介超聲波
International Experience Reference: How Can Other Countries Solve the Problem of Ultrasonic Standby?
In the face of similar challenges, several countries have implemented innovative measures with remarkable results. In 2019, the National Health Service (NHS) launched the "Diagnostic Centre Scheme" to establish specialist testing centres in the region that are independent of hospitals, specializing in routine imaging tests such as ultrasound, CT, and MRI. These centers have reduced the waiting time for ultrasound examinations from an average of 18 weeks to less than 6 weeks by extending service hours 7 days a week and adopting a standardized booking system. Importantly, these centers can be led by radiologists and conduct routine examinations without the presence of doctors, significantly improving the efficiency of human resource utilization.
Ontario, Canada, has implemented a "regional centralized booking system" to incorporate provincial ultrasound equipment into a unified management platform. When the doctor issues a referral for medical examination, the system will automatically display the real-time waiting status of each facility, and patients can choose a facility with a short waiting time according to their situation. The system also features an intelligent priority rating algorithm that automatically adjusts the schedule order based on clinical urgency. After 3 years of implementation, the average waiting time for ultrasound examinations in the province has decreased by 42%.
The experience of Singapore is especially worthy of reference in Hong Kong. Public hospitals divide ultrasound examination into three levels. The second level is performed by a radiologist to perform diagnostic tests. Only at level 3, radiologists perform complex case examinations. This tiered service model allows doctors to focus on the cases that require the most specialized judgment, increasing the overall service volume by 30%. At the same time, Singapore is actively promoting public-private partnerships, with the government subsidizing part of the private sector's testing costs and diverting about 25% of non-urgent cases.
These international cases show that systemic reforms such as service model innovation, technology application, and system adjustment are necessary to solve the latency problem. Of particular note is that these countries have established integrated digital referral platforms.Or other imaging inspections, all electronic circulation and intelligent scheduling can be realized.
Policy recommendations
In response to the dilemma of ultrasonic standby in Hong Kong, we propose the following multi-dimensional solutions:
First, it is necessary to increase investment in medical resources and optimize allocation efficiency. Specific measures include:
- Over the next five years, we plan to procure an additional 150 ultrasound machines, focusing on the New Territories region with the longest waiting time
- Set up a "mobile ultrasound inspection vehicle" team to provide regular services in remote areas
- Expand the training locations of radiologists, increase the number of training positions by 30% each year, and introduce fast track for overseas specialists
There is an urgent need to reform the resource allocation mechanism. In order to realize the resource provisioning function between networks, it is proposed to establish a "territory-wide image inspection resource sharing platform". When the hospital receivesCTscan referenced by HAAutomatically display real-time booking availability for each organization at the time of application, improving resource utilization by more than 25%. At the same time, a demand-oriented resource allocation formula is introduced, which comprehensively considers factors such as population structure, disease spectrum, and existing resource density to ensure accurate allocation.
Promoting hierarchical care is a key strategy to reduce pressure on public hospitals. Referring to international experience, training nurses and medical assistants to perform basic ultrasound screening, and establishing a "sonographer-led service" model for routine examinations, allow qualified radiologists to issue reports independently, and only complex cases should be considered by doctors. At the same time, it is expected to improve the public-private partnership mechanism, provide fixed subsidies (e.g., HK$800 per test) to patients who choose to undergo private testing, and divert 20% of non-urgent cases.
Strengthening public health education is equally important. Many patients have misconceptions about the indications for ultrasound, and even mild symptoms require testing. Educational activities should be carried out through community health centers to explain applicable scenarios for various imaging studies and to help patients establish reasonable expectations. At the same time, promote the concept of "self-health care", reduce unnecessary demand for medical services. For passingor provide clear instructions to patients who have undergone ultrasound about expected wait times and alternatives, increasing transparency in services.
Technology Applications: The Potential of Artificial Intelligence in Ultrasound Diagnostics
AI technology is revolutionizing the field of medical imaging. As for ultrasound, AI algorithms can now automatically identify and measure the size of organs (liver volume, thyroid nodule size, etc.). Flag abnormal areas and provide initial diagnostic recommendations. It also guides the operator to obtain a standardized image section. According to a study by the Faculty of Medicine of the Chinese University of Hong Kong, AI-assisted ultrasound diagnostic systems can reduce examination time by 40% and improve the detection rate of small lesions by 15%.
For HA, AI technology can improve service in three ways: First, AI preprocessing systems can automatically match servicesInitial triage and priority assessment requests are made to ensure urgent cases are handled quickly. Secondly, AI-assisted image acquisition reduces reliance on operator experience, allowing trained technicians to obtain diagnostic-quality images. Finally, the AI report generation system automatically generates a structured preliminary report, allowing radiologists to review and correct it, reducing the report issuance time from an average of 3 days to 24 hours.
It's important to note that AI applications are not limited to the field of ultrasound. The same technical principles can be applied toCTscan referenced by HAMRI image analysis provides a synergistic effect. HA should accelerate the establishment of a framework for the approval and application of medical AI, and introduce mature AI technologies into clinical workflows as soon as possible, on the premise of ensuring safety. After the full-scale implementation of AI-assisted diagnostics, the total capacity of ultrasound services is expected to increase by more than 35%, significantly reducing the pressure of waiting time.
Overview: Multi-party collaboration to improve healthcare delivery
Addressing long wait times for ultrasound examinations requires a concerted effort from the healthcare system, government, and society. In the short term, the focus should be on optimizing the efficiency of existing resources, increasing equipment uptime, and improving the intelligence of the booking system. In the medium term, it is necessary to expand the scale of specialized training and implement innovative service models such as regional diagnostic centers and mobile testing services. In the long term, the structure of the health care system needs to be fundamentally adjusted to establish a more effective hierarchical care system and public-private partnership mechanism.
Technological innovation plays a crucial role in this process. From e-referral platforms to AI-assisted diagnostics, digital transformation significantly improves the efficiency and capacity of services. At the same time, it is necessary to strengthen public education and cultivate rational medical concepts so that medical resources can be exploited by patients who need it most.
Ultrasound, as a fundamental tool in modern medical diagnostics, has a direct impact on people's health. Through systematic reform and innovation, we are confident that we can establish a more efficient and equitable healthcare service system that everyone needsAlternatively, other imaging tests can provide timely and high-quality diagnostic services. This requires ongoing collaboration and joint efforts from various sectors of pharmacy, healthcare professionals, academia, and society to build a better healthcare future for the people of Hong Kong.