Dr. WU, April Yushan
(HK, China)

Post-doctoral fellow

Centre for Health Systems and Policy Research,
Faculty of Medicine,
The Chinese University of Hong Kong

Dr. WU, April Yushan Photo


April WU (1)

Other Author:

Colman SHUM (1), William CHEUNG (2), Yi Chung CHEUNG (3), Wesker LAM (4), Fung HONG (1), Vincent CH CHUNG (1)

Author Affiliation:

1. Jockey Club School of Public Health and Primary Care
2. HKU BCM (FT) Alumni Association
3. Chinese Medicine Alumni Association of CUHK
4. HKBU Chinese Medicine (FT) Alumni Association


Telemedicine, COVID, Regulation, Cross Sectional, Survey


Introduction: Telemedicine has been widely recognized as having potential benefits for improving healthcare delivery in the last decade, but adoption of telemedicine had been slow until the COVID-19 pandemic. The surge of telemedicine services during COVID-19 offers a great opportunity to explore telemedicine services provision patterns. This cross-sectional study examined telemedicine services provision patterns by Chinese Medicine Practitioners (CMPs) in Hong Kong before and since COVID-19.

Method: We conducted a cross-sectional, web-based online survey from April 26 to May 16, 2022. Respondents were invited from 3 major traditional Chinese medicine (TCM) alumni societies, CMP groups on WhatApps and WeChat, and various social media platforms. We used a structured questionnaire to collect data on CMPs’ patterns of telemedicine provision. Respondents were also invited to assess telemedicine services via the Telehealth Usability Questionnaire (TUQ). We conducted univariate and multivariate logistic regressions for factors associated with the provision of telemedicine services.

Results: A total of 195 CMPs responded. Among them, 161 CMPs provided telemedicine services, of which 81 (50.3%) started before COVID-19, and 80 (49.7%) provided telemedicine services only since COVID-19. Both telemedicine providers and non-providers perceived the inability of conducting examinations on patients as their biggest barrier to telemedicine service delivery, followed by the legal and ethical concerns over medical negligence. We found a substantial increase in telemedicine service provision, as well as the use of telemedicine services for new patient consultations. Multivariate regression analyses showed that telemedicine providers were more likely to be males, being solo practitioners (compared to working in tripartite or NGO clinics), and more likely to perceive patients’ lack of technical competence as a barrier to telemedicine services. Multivariate regression showed that giving a higher TUQ score for ease of use (OR=4.266, p=0.025) or reliability (OR=3.490, p-value=0.053) were statistically significantly associated with higher odds to continue the provision of telemedicine services after the pandemic.

Discussion: Consistent with the trend worldwide, telemedicine service provision increased substantially among CMPs in Hong Kong. However, various barriers, especially in the lack of physical examination and clear regulatory guidance, were observed. In light of the positive association between ease of use, reliability, and the intention to continue the provision of telemedicine services after the pandemic, it is imperative that further policy actions be taken to improve the performance and security of telemedicine platforms, and to develop a detailed best practice of guideline for TCM telemedicine care by regulatory bodies.




Funding Source:

Conflict of Interest:The authors report no conflicts of interest related to this study.

Conflict of Interests:


Dr. April WU is a post-doctoral fellow in the Centre for Health Systems and Policy Research at the Faculty of Medicine, CUHK. She is a health economist with specialization in quantitative policy analysis. Her research focuses on the economics of health care, healthcare innovation, health financing, and inequity issue in health system. Her mission is to promote strategic purchasing to achieve a person-centered integrated care system and combat health system inefficiencies.