NUHS' remote monitoring service first in Singapore
SINGAPORE: Former stroke patient Elisabet Ramadihardja takes a
blood thinning drug. If she takes an overdose, it can cause internal
bleeding.
To have her blood tested, she used to take a taxi to and from her
Lorong Ah Soo home to the National University Hospital every two weeks.
The tests cost about $15, and transport cost her $30 each time.
"The blood test was fast, but I wasted time going to and from the
hospital," she said.
The frequent trips to the hospital ended last year after Ms
Ramadihardja, 40, bought a portable kit costing around $1,000 that
enables her to check her blood coagulation rates at home.
Now, she informs the hospital of her results via SMS or the
Internet. In turn, she is reminded to do the blood checks and is
informed of changes in dosage via SMS.
Such remote monitoring is a first in Singapore, made possible by
the portable kit developed by pharmaceutical company Roche and the
National University Health System's (NUHS) customised software called
Healthcare Messaging Systems.
Patients without a test kit can still be monitored remotely - they
can have their blood checks at polyclinics, give NUHS a call, and be
informed of the results via the phone, SMS, or Internet.
NUHS hopes to get general practitioners to adopt the software for their patients on the blood thinning drug warfarin.
A talk has been scheduled on Saturday for them, and 30 general practitioners have signed up.
The remote monitoring service's benefits are clear.
During a year-long trial that ended last year, patients using the
service consulted doctors only thrice - one-third the frequency of
other patients.
Launched in 2007, remote monitoring is already benefiting three in five - or 600 - of NUHS' patients on warfarin.
Used to treat conditions like deep vein thrombosis and irregular
heart rhythm to ward off stroke, warfarin dosage requires monitoring at
least once every three months, said cardiologist Dr James Yip of the
National University Heart Centre.
This is because simple dietary changes can cause blood coagulation
rates to fluctuate, necessitating an increase or decrease in the dosage
of the drug. Too much of it can cause internal bleeding in the joints,
brain or bladder; too little of it can lead to fatal clots.
The service is the result of NUHS' efforts to tap technology to
solve "administrative problems ... how to check blood more often
without inconveniencing patients more, and without taxing the
healthcare system more", said Dr Yip.
"And in my own work as a clinician, the problem is always how to tell patients what dose of warfarin to take," he said.
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