More polyclinics to have telehealth programme for hypertension patients

Patients on the programme will be given a Bluetooth-enabled device and asked to download a Vital Signs Monitoring app. ST PHOTO: ONG WEE JIN

SINGAPORE - A telehealth programme for patients with high blood pressure is being rolled out by all three polyclinic clusters, enabling patients to monitor their blood pressure at home with the aid of a Bluetooth-enabled device that automatically transmits the readings to a polyclinic care team as well as reduce their polyclinic visits.

The home blood pressure or BP monitoring programme was rolled out at Ang Mo Kio Polyclinic about two months ago and at Bedok Polyclinic last month. It will be available in Clementi Polyclinic in the first half of next year.

Thereafter, each cluster will push it out to the polyclinics under their care, as well as new polyclinics that are coming up.

The roll-out will be completed in three years, Professor Tan Chorh Chuan, executive director of the Ministry of Health Office for Healthcare Transformation (MOHT), told a media briefing at Ang Mo Kio Polyclinic on Tuesday (Nov 03).

Patients on the programme will be given a Bluetooth-enabled device and asked to download a Vital Signs Monitoring app by the Integrated Health Information Systems (IHiS). They are to take their readings at least once a week with the device, which automatically transmits their BP readings to their polyclinic care team through the app. If their BP levels are not well-controlled, they will receive Chatbot alerts and tips on BP control. The app can also remind them to take their readings.

If needed, additional teleconsultation advice is provided by their nurse and their medication may be adjusted. The app is in English, though the chatbot alerts are also available in Mandarin.

The home BP monitoring programme costs $6.30 a month for the first two years, inclusive of the device and the subscription to an app, and $7 a month for subsequent years.

A six-month pilot project, which was launched in September 2018 at Ang Mo Kio polyclinic, showed that about 60 per cent of the 120 patients with uncontrolled blood pressure and had used the telemonitoring service to monitor their BP levels at least once a week achieved BP control. This is compared with 52.6 per cent of the 120 patients in the group receiving the usual care, which involved making two to four physical visits a year to see the doctor.

Patients who sign up for this BP telemonitoring service will get to see the polyclinic doctor at their first appointment, and a phone consultation with a nurse in six month's time, said Dr Valerie Teo, a family physician, consultant and the deputy head of Ang Mo Kio Polyclinic. Thereafter, they will see the doctor once a year when they go to the polyclinic for their blood tests, unless there's a need for more frequent consults, she said.

Only suitable patients will be enrolled, as those with diabetes and/or complex conditions, who require closer monitoring, are not suitable, she said.

Madam Tham Siew Yee, 65, a retiree, is one of 250 patients who have enrolled in the programme since it was launched at Ang Mo Kio Polyclinic about two months ago. She said it is convenient as it removed the need for manual recordings of her BP levels, which she used to do three times a day. Now, she checks her BP about two to three times a week and the readings get transmitted to a care team at the polyclinic.

A telehealth pilot for patients with high blood pressure has shown positive clinical outcomes, improved adherence to home monitoring and enhanced patient experience. ST PHOTO: ONG WEE JIN

"The thing I find useful and comforting is that the reading is immediately uploaded and checked by a healthcare team behind the scenes on a regular basis. This means they don't need to review it only in three months, or six months or at my next appointment," she said.

The cost is not a problem as it includes the monitoring device, she said.

Hypertension affects one in four Singaporeans aged 30 or older, and up to half have uncontrolled BP, which can lead to serious problems such as stroke and heart failure.

The home BP management programme was the result of Primary Tech-Enhanced Care (PTEC), a partnership between MOHT, National Healthcare Group Polyclinics, SingHealth Polyclinics, National University Polyclinics and IHiS.

Going forward, the plan is to roll out telehealth services for other chronic conditions, said Prof Tan. Next up will be a telemonitoring service for diabetes patients. Sengkang polyclinic is now in the midst of recruiting suitable patients for a pilot. It started on this project early this year, but was delayed for several months by the Covid-19 pandemic. Patients on this pilot will be followed up for 18 months after the pilot.

The pandemic has accelerated the use of telehealth and video consultations in healthcare.


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