Telehealth helps spread medical Net wider

Prof James Yip started the telehealth programme at NUHS last February and some 1,300 chronically ill patients have benefited from being monitored online. The trial was concluded at the end of last year, and NUH is now the first public hospital to off
Prof James Yip started the telehealth programme at NUHS last February and some 1,300 chronically ill patients have benefited from being monitored online. The trial was concluded at the end of last year, and NUH is now the first public hospital to offer telehealth as a standard clinical treatment.ST PHOTO: ALICIA CHAN

Use of infocomm tech to deliver healthcare set to rise as public hospitals get on board

Madam Chan Ah Chan, 79, a hypertension patient, was recently put on a programme at the National University Health System (NUHS) that monitored her erratic blood pressure levels online.

Madam Chan uses a cuff at home to take her own blood pressure reading, which is then relayed through the Internet to the hospital, where the nurses check it.

"It is convenient as I don't have to make the trip down to the hospital," said the retiree in Mandarin.

She is among a growing group of chronically ill patients who are discovering telehealth, a new way of consuming and delivering healthcare by using infocomm technology that is set to grow here.

Associate Professor James Yip, the chief medical information officer at NUHS, started the telehealth programme there last February. Since then, some 1,300 patients with hypertension, diabetes and heart failure have benefited from being monitored online.

The trial was concluded at the end of last year, and the National University Hospital (NUH) is now the first and only public hospital to offer telehealth as a standard clinical treatment for its chronically ill patients.

NUHS has now moved on to the next phase of its telehealth service. It is studying the role of intensive long-term telehealth - with the help of an app called Heal My Heart - versus traditional care.

This six-month study started in June, and aims to recruit 300 heart- attack patients from NUH and other public hospitals. The app has informational material and reminds patients to take their medicine.

It also offers a line of communication for patients to send messages to healthcare professionals.

Changi General Hospital, too, has a tele-monitoring initiative. It is a pilot scheme targeting 160 heart-failure patients that started last June and will end next year.

Jurong Health Services, which manages Ng Teng Fong General Hospital and Jurong Community Hospital, is next in line. It started a pilot telehealth programme on Oct 10 at its Lakeside Family Medicine Clinic to evaluate if patients will take to having their blood pressure monitored remotely. It is expected to last up to six months. To enrol users, it lets patients try out the remote monitoring free for a week.

The Ministry of Health said in January that telemedicine or telehealth is increasingly recognised as a means to provide healthcare services more readily and in a timely manner. It can help bridge the constraints of distance and save time and costs, if done right.

"The telehealth market is still very much in its infancy, with no industry-dominant players and no single 'killer app'," said Mr William Chew, managing director of myHealth Sentinel, a healthcare tech firm that is partnering NUHS in its telehealth service.

Therefore, there is room for multiple players, both large and small, he said. He added that the home-grown company is "in active discussions with government health agencies" to explore opportunities to deploy telehealth in other hospitals.

The firm also works with Frontier Healthcare Group, a private general practitioner chain, to offer telehealth to monitor chronic care patients. It is also in talks with several nursing homes and home care providers, said Mr Chew.

While useful, telehealth has also brought about some unforeseen consequences.

Prof Yip said he and his colleagues initially thought telehealth could replace traditional face-to-face consultations in the long run.

"One of the things that we thought we would be saying was: 'Don't come to the clinics to see doctors anymore'. But, in doing telehealth, you may increase the utilisation of healthcare," said Prof Yip, who is also a cardiologist at the National University Heart Centre, Singapore.

Since patients are constantly being monitored, healthcare providers are receiving a steady stream of information. "So, we find out more things about them and we then have to increase our intervention points," said Prof Yip.

For instance, if a patient's blood pressure were to shoot up, a nurse may contact the doctor to find out what should be done. Services rendered at these intervention points are free of charge, said Prof Yip.

"Previously, out of sight is out of mind. With telehealth, everyone is online. That has led to some stress among healthcare providers."

Gradually, nurses will become more confident of taking care of patients and not overreact when they see a high reading as it takes a while for some drugs to take effect, for instance. Therefore, they will be better placed to know when they need to consult a doctor.

But not everyone is buying in yet, said Prof Yip.

"People who want to do this must believe that they are doing this for their patients. Telehealth increases stress among healthcare providers. There was a lot of resistance initially and even today."

A version of this article appeared in the print edition of The Straits Times on October 20, 2015, with the headline 'Telehealth helps spread medical Net wider'. Print Edition | Subscribe