Saturday, April 16, 2016

Singapore - More programmes leverage tech for treatment beyond the hospital

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This is part of ongoing efforts by institutions to spare patients the hassle of travelling unnecessarily, and move care back into the community.

Integrating technology into patient treatment is not new, but in the push to bring care closer to the community, healthcare institutions here have been coming up with new programmes and fine-tuning existing ones to get more patients to use technology at home.

Their goal is also to spare patients the hassle of travelling unnecessarily.

Mr Bob Sayers has been suffering from facial nerve attacks for more than a decade. The 71-year-old said the pain is "agonising" and he has turned to a programme called iACT-CEL, which enables patients to do therapy exercises at home instead of the clinic.

The programme was invented by Ms Yang Su-Yin, chronic pain psychologist from Tan Tock Seng Hospital (TTSH).

"I was able to do the first sections of this programme while I was overseas," said Mr Sayers. "It didn't detract from any information or conversations I needed to have with the psychologist, which is a wonderful thing."

The programme is both audiovisual and interactive, and has a whole range of pain management exercises. It also has a portal where patients can communicate with the psychologist if they have any questions.

The trial programme is open to patients in TTSH's pain management clinic, who are assessed to be suitable for it. The next step is to make it more user-friendly so it can better serve the community.

"It's also part of the general healthcare initiatives to move healthcare back into the community," said Ms Yang. "(This is so that) people who feel they may not need tertiary care can still have that support ... they are able to function well, but can come in when it's necessary and appropriate."

Moving care back into the community has also been the crux of the Telecare Programme, which has been implemented under the National Healthcare Group Polyclinics (NHGP) for the past three years.

Nurses and care managers conduct tele-consultations with patients who have well-controlled chronic diseases like diabetes or hyper tension. As part of the programme, patients submit their readings regularly from home.

There are now 259 patients in the programme, compared to 180 patients in December 2014. However, NHGP said that recruiting patients for this programme has been a challenge, so it is refining its selection criteria to recruit moderately-controlled patients with chronic conditions.

"Well-controlled patients usually have been well-controlled for a certain period of time," said Dr Simon Lee, Chief Medical Informatics Officer at the NHGP Office of Clinical Informatics. "As such, they may not see value in doing an additional step of keying the readings into the portal.

"But with the the moderately-controlled patients, by doing so, they would save themselves a physical visit through a tele-consultation. Secondly, the moderately-controlled patients would benefit more from frequent monitoring of their conditions."

NHGP has saved S$10,000 in manpower and productivity costs in the past three years, because its doctors do not need to spend as much time seeing patients who are on the Telecare programme, it said.

By Nadia Jansen Hassan


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