Authors (including presenting author) :
Yu AYC(1), Chan OL(1), Chan CK(1), Lee ATY(1), Liu T(1), Cheung PCK(1), Li OCA(1), Kwok KY(1), Lee YS(1)
Affiliation :
(1)Department of Radiology, Tuen Mun Hospital
Keyword 2: :
fees and charges reform
Keyword 3: :
operations research
Keyword 4: :
change management
Keyword 5: :
patient engagement
Keyword 6: :
staff engagement
Introduction :
The Hong Kong government provides one of the world’s most generous public healthcare subsidies, covering up to 97.6% of service costs. To maintain a sustainable and equitable healthcare system, the Hospital Authority (HA) launched a comprehensive Fees and Charges Reform effective January 1, 2026, introducing a new copayment model for non-emergency radiology services. This marks a major shift in patient experience and operational workflow across departments. In anticipation of the increased need for clear communication and consistent front-line guidance, the Tuen Mun Hospital radiology department developed Chargebot — an innovative and interactive chatbot platform designed to support staff during this system-wide change.
Objectives :
Our objectives are to standardize staff responses to patient enquiries, ensure accurate and digestible information dissemination, enhance staff confidence and efficiency in communicating new policy details, and reduce training burden by embedding reform knowledge directly into daily workflows, minimizing the need for extensive onboarding sessions.
Methodology :
Near the end of Dec 2025, we implemented a web-based chatbot interface composed of: (1) a server-side API for input interpretation and answer response, and (2) a frontend chat interface for capturing user messages and displaying bot output. Both relied on open-source frameworks for efficient software development. Chargebot launched in January, 2026. We then collected utilization data and user feedback for reporting purposes.
Result & Outcome :
We collaborated closely with our users (NTWC radiology staff) from the start of development, iterating on both the software interface and question-answer content based on their feedback. From a design perspective, users quickly understood and enjoyed the chatbot design pattern, i.e. a linear question-answer paradigm through a mobile interface. They preferred this mode of communication as it felt familiar to how they would ask and receive responses from a colleague or supervisor. However, users and administrators preferred a menu that presented common questions and situations to the users for selection, instead of a free-text input interface. Regarding content, we realized that our staff were overloaded with information from multiple official documents and slides that served as gold standard references, but did not deliver consumable information to help with patient communication. Chargebot's short and clear summaries that delivered key concepts were preferred in an operational setting. Not surprisingly, English and Chinese language support were essential. Finally, designing software that allowed easy modification of question/answers without extensive reprogramming allowed us to engage our front-line staff for user-led paired programming and editing. Chargebot had a total of 446 unique users over the past 3 months. We observed a downward trend of unique users over time, as users gained more experience and knowledge of the new Fees and Charges process, and as the number of process and administrative changes also decreased. On average, each unique user asked 0.72 questions (< 1 because some users visited Chargebot but did not ask any questions). The most common questions asked were: “how much / who needs to pay / when to pay” (19%), “cancel/move appointment” (14%), “financial assistance” (13%), “missed appointment” (11%), and “request refund” (9%). This reflects how Chargebot was able to help address both simple technical questions and more complex process/logistical issues. We believe that innovative tools, such as this chatbot platform, can support rollout of new and complex operational processes, such as the 2026 Fees and Charges Reform. We hope to increase patient satisfaction, standardize and simplify guidance during times of change, and empower our internal staff using such tools going forward.
