New care delivery models: The vital signs for healthcare in 2025

Singapore's healthcare industry is evolving rapidly – ageing populations, healthcare reform, and increasing costs are forcing us to do things differently. The global healthcare industry faces renewed pressure to find new and innovative ways with which to extend healthcare services that are patient-centric and cost-effective.

According to the recent iN2015 Healthcare and Biomedical Sciences Report by Infocomm Development Authority of Singapore, infocomm is poised to play a bigger role in the healthcare landscape in Singapore in the near future.

Healthcare organisations face a perennial struggle with three main areas:
1) How to keep patients' information updated
2) How to keep people healthy, and
3) How to keep chronic disease from quickly turning into an acute episode thereby increasing hospitalisation counts and treatment costs.

Distance technology for healthcare – particularly the growth of telemedicine or telehealth – has offered opportunities to conquer these challenges. Telehealth or telemedicine, broadly speaking, is the electronic exchange of medical information – this could mean something as simple as sharing a photo of a lesion, to viewing a patient's blood pressure status, to accessing a patient's complete medical history, to specialists discussing a clinical study.

Statistics show that three million patients worldwide are already receiving professional care by being connected to home medical monitoring devices; this number is expected to grow to 19.1 million patients around the world by 2018ⁱ.

Video-enabled care delivery
In addition to traditional doctor-patient consultations, video technology enables face-to-face collaboration across the whole spectrum of stakeholders – between doctors and hospitals, patients and consultants, and other supporting professionals – independent of physical barriers.

We have seen some incredible instances of video-enabled care delivery in practice and the resulting benefits to patients and care providers in Singapore. For example:

• Eastern Health Alliance, the regional health system for eastern Singapore, collaborated with Changi General Hospital (CGH) and has in place a telecare system where nurses work out of an office equipped with computers and phones to care for chronic disease patients after they leave CGH. These nurses monitor patients' data in real-time, and can intervene when they detect signs of deterioration.
• Eye specialists at the National Healthcare Group Eye Institute at Tan Tock Seng Hospital diagnose patients with chronic blurred vision at Hougang Polyclinic through scan results and video conferencing. With this new service, the waiting time for patients to see an eye specialist is reduced significantly. This not only saves time, but also allows patients to receive the appropriate treatment faster.
• Doctors specialising in geriatric medicine at Khoo Teck Puat Hospital (KTPH) follow up on their elderly patient through video conferencing. They consult patients who are wheelchair-bound but are disposed to stroke, diabetes, heart disease, and hypertension. With such technology, doctors are able to view the patients' behaviours at their own homes, where this information may not be privy to them previously.
• Videoconferencing has also enabled stroke specialists at National Neuroscience Institute to collaborate with CGH and KTPH to make assessments on stroke patients who may need a 'clot-busting drug' named tPA. The real-time authorisation of this drug within three to four hours of the stroke can actually help save the patient’s life.
• More recently, NUH is also testing a specialised application called Home Rehab that is able to monitor the recovery activity of patients, who are able to video conference with their therapists to review their health condition. Using video conferencing can help better coordinate care between the home and the healthcare professionals, which betters health outcomes and decreases the likelihood of medication errors.

For a healthcare organisation, video-enabled care delivery makes strategic and financial sense. Singapore General Hospital (SGH) opened a Virtual Monitoring Clinic that helps observe patients with stable rheumatoid arthritis, and SGH in return was able to free up more than 500 slots for patients who genuinely required intensive medical care. Given that the bed crunch in hospitals is severe, a greater take-up of such technology can help ease the crunch in Singapore.

Likewise, for patients, video-enabled care delivery puts management of their health back into their own hands and reduces unnecessary travel time and associated costs. 40% of heart-failure patients in Changi General Hospital gets rehospitalised within a short 12 months. The amount spent can well be channelled into medication and the like.

The healthcare industry in Singapore strongly embraces technology in order to better provide the patients. The highly developed infocomm ecosystem should encourage the healthcare industry to implement a nation-wide telehealth network and bring the delivery of healthcare services to the next level.

There are resources to be unlocked and benefits to be gained when hospital caregivers, administrators, and patients embrace technology better. Innovation has enabled customised solutions for the industry and a multidisciplinary approach to healthcare delivery.

Moving into the next generation, the healthcare industry in Singapore is primed to accomplish a lot more to keep up with citizens' changing needs and demands.

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ⁱInfocomm Development Authority of Singapore (Nov 2013) – iN2015 Healthcare and Biomedical Sciences Report