More patients in Singapore are willing to work with healthcare professionals in managing their own health when they realised they can also influence the outcome of their illnesses. At SingHealth, teams of doctors and nurses have been working closely with in-house iTAG (Innovative Technology Applications Group) team to put "thoughts" into "actions". Leveraging on each other’s expertise, both clinicians and IT professionals have developed several innovative and practical applications to empower patients with the ability and tools to manage their own health and immediate needs. Some of these ideas are completed and some are in their various trial stages.

An example of such an "innovation at work" is the "Telecare" pilot series that is designed to help chronically-ill patients to further improve their conditions and quality of life. Leveraging on technology, the SingHealth iTAG team developed an in-house system that allows patients to safely and remotely transmit their current medical results and data to their respective doctors at anytime from anywhere, via the web and SMS. The Telecare system will update the patients’ individual data and trigger appropriate alerts to the respective doctors for necessary action should the situation warrant intervention. The patient will receive an alert message from the Telecare system via the channel he/she has sent the data.

Depending on their medical status, chronically-ill patients are advised to monitor their condition and see their clinicians at regular intervals to ascertain their progress. Starting in October, SingHealth doctors will be working with several groups of outpatients in a 6-month pilot Telecare project. These outpatients are:-

1. Pregnant mothers with gestational diabetes
2. Pregnant mothers with pregnancy-induced hypertension
3. Chronic heart failure & post heart transplant patients
4. Peritoneal dialysis patients

• By maintaining close contact and getting regular updates, SingHealth doctors can review the information and pick up any unusual data of their patients at an earlier stage so that medical advice and treatment can be rendered in the quickest possible time.
• By receiving current and regular data, doctors are able to pick up unusual readings and refine their patients’ medication dosage to better control their condition without having to wait for the next appointment.
• With better control of their chronic condition, patients could potentially reduce the number of outpatient visits.
• Patients continue to receive care and attention from a multi-disciplinary team of doctors and nurses.
• Doctors and nurses can focus more effort on patients with poor control of their condition.
• Significant time savings and convenience for patients as they can submit their data anytime, anywhere.
• Potential operational efficiency and time savings for SingHealth institutions.

Dr Chan Wing Kwong, Chairperson of SingHealth iTAG and Head of Refractive Surgery, Singapore National Eye Centre said, "SingHealth iTAG serves as a conduit for our doctors and nurses to develop innovative ideas to provide greater value and improve patient outcomes. It aims to change the landscape of how healthcare services will be delivered, for the benefit of our patients in the next five to ten years. The Telecare project is such an example of innovation at work - where the use of information and everyday communication technologies will enable our healthcare professionals to effectively improve patient care, and enable patients to proactively manage their own medical conditions. This is about providing the right care, at the right time, in the right siting."

The "Telecare" project is particularly user-friendly for patients who travel frequently for whom scheduling regular appointments is a challenge. Busy patients have the convenience and flexibility to enter via the web and/or SMS their medical updates within a 24-hour window period. In addition, they have the assurance that their doctors are able to render medical advice when needed.

Overseeing the Telecare project for pregnant mothers with gestational diabetes, Dr Devendra Kanagalingam, Consultant, Obstetrics & Gynaecology Department of Singapore General Hospital added, "Women with diabetes in pregnancy represent a unique group of patients. At SGH, we see about 100 of these patients. Many of them want to play an active role in managing their conditions to avoid any complications at birth and for their babies. Instead of taking six to eight weeks to adjust the insulin intake of our patients at their appointments, we hope to effectively stabilise their glucose profile and set them on the right course within the soonest time possible. The Telecare system deploys the use of internet and mobile phone to help our mothers monitor their own health more effective and efficiently."

The Telecare projects will be piloted at selected specialist outpatient clinics across SingHealth institutions. Patients on the pilot projects will be trained to use the various channels to send in the necessary data and information.

The SingHealth iTAG was first set up in late 2003 for staff to develop and realise their innovative ideas that would optimize the provision of clinical care and healthcare services through the deployment of information technology. Since its inception, more than 35 innovative ideas have been surfaced. Many patient-focused and innovative initiatives came into fruition and several are currently in pilot stages with the support of iTAG’s expertise and IT capabilities.