​New AI-assisted Physiotherapy System to Enable Home-based Rehabilitation

13 May 2024 – Patients may soon be able to seamlessly continue with physical rehabilitation exercises at home after their discharge from hospital. The AI-Assisted TelerehabiLitAtion System (ATLAS) programme, which enables patients' physical therapy to be remotely guided and monitored, will be piloted by several community hospitals in Singapore to help patients bridge care and continue working towards their optimal functional ability after their hospitalisation.

With Singapore's rapidly ageing population, more patients require continued rehabilitation to help them with their recovery after they are discharged home. However, patients may face delays and therefore, interruptions to their physical rehabilitation regime due to waiting times for day rehabilitation centres (DRC). Other factors such as travelling cost and caregivers' availability to bring patients to DRC also pose barriers to accessible post-discharge rehabilitation.

Noting the need for a post-discharge rehabilitation solution that is convenient, affordable, and works across multiple health conditions, SingHealth Community Hospitals (SCH) and Rebee Health co-developed ATLAS with feedback from patients and caregivers. The initial development of this solution was catalysed by Temasek Foundation in 2022.

ATLAS comprises a wearable sensor, a patient application and an application for the physiotherapy team. Both applications are AI-assisted. During the inpatient stay, ATLAS allows physiotherapists to work together with patients and jointly determine rehabilitation goals, customise exercises for them based on their individual needs, monitor patients' progress, and suggest changes to patients' prescribed rehabilitation programme based on their progress. The patient application guides patients through gamified exercises, provides feedback on the progress towards their rehabilitation goals, and encourages them to take charge of their own rehabilitation journey. Upon discharge, patients will continue with their post-discharge rehabilitation remotely with their physiotherapy team via the AI-assisted applications, while waiting for placement at a DRC.

"Patients who need continued, guided rehabilitation after hospitalisation will benefit most from what ATLAS can offer in terms of remote instruction, surveillance and AI-assisted customisation of exercises based on each patient's progress. However, to fully reap the benefits, time is needed to understand their rehabilitation goals, design customised exercise programmes, and to familiarise them with the use of ATLAS. The community hospital is the ideal place for this as patients typically stay for a longer period of time for rehabilitation and caregiver training. Through the ATLAS programme, we hope to mainstream telerehabilitation as part of the standard care in the minds of patients and caregivers, and contribute towards the national push towards community-based care", shared Mr Lincoln Dacy, Chief Executive Officer of Rebee Health.

SCH and Jurong Community Hospital (JCH), together with Rebee Health as a collaborator, has been shortlisted for the National Health Innovation Centre's I2Adopt Grant, which provides up to $1M in support for clinical adoption across local public healthcare institutions. This project aims to accelerate the implementation and adoption of ATLAS across SCH and JCH with the goal to make a wider impact across public healthcare to strengthen community-based care and to positively impact patients' health outcomes.  

Recognising the potential of ATLAS, and the capabilities and resources that each party possesses, SCH and Rebee Health also signed a Memorandum of Understanding today that will see both organisations strengthen their collaboration as preferred partners for the co-development and commercialisation of remote AI-assisted telerehabilitation.

"We saw promising outcomes from ATLAS' earlier trials, including better joint range and gait speed of patients who underwent the ATLAS programme compared to conventional telerehabilitation via only video consultation. The programme combines the best of two important determinants of rehabilitation outcomes – to allow patients to continue physical rehabilitation in their familiar home environment with close family support, and at the same time have the assurance that their progress and recovery is monitored remotely by healthcare professionals. SCH and Rebee Health share the same philosophy in person-centredness when designing health technology solutions and translating them into real life clinical applications. Through this partnership, we hope to co-develop more impactful health technology innovations that will advance population health in Singapore and beyond," shared Associate Professor Gan Wee Hoe, Chief Executive Officer of SCH.

Ms Heng Li Lang, Head, Climate & Liveability at Temasek Foundation, said "ATLAS plugs the gap in rehabilitation care and recovery by linking digital health with not just the acute hospitals, but also with community care providers. Through our catalytic funding, Temasek Foundation is committed to bringing together healthcare innovators like Rebee Health with practitioners and institutions to adopt and scale up solutions that address our health challenges."

Two hundred patients across Outram Community Hospital, Sengkang Community Hospital and Jurong Community Hospital will be enrolled into the ATLAS programme. Outcome measures will also be obtained from patients and their caregivers, to measure the impact of ATLAS' effectiveness in bridging rehabilitation between hospitals and DRCs through AI-assisted telerehabilitation. One of the key measures of success will be the ability for patients to maintain or improve on their physical strength and functional status over the interim period before they are enrolled in a DRC.

"As a physiotherapist working in the community hospital setting, our goal is always to help our patients transit smoothly back home and for them to continue to recover well in the community. With the ATLAS programme, we will be able to develop customised exercises for our patients to continue with after discharge and monitor their progress remotely. This can be done while patients await for their community rehabilitation to commence. It is heartening to know that we can do more to help our patients who face challenges with post-discharge rehabilitation, and I am excited to be part of this project to provide patients with a seamless rehabilitation journey from hospital to home," shared Ms Hozaidah Binte Hosain, Head of Physiotherapy at SCH, who is also part of the ATLAS project team.

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About SingHealth Community Hospitals
SingHealth Community Hospitals (SCH) comprises Sengkang Community Hospital, Outram Community Hospital and the future Eastern Community Hospital, where the focus goes beyond healthcare to health as patients are provided with a homely environment to recuperate and take part in well-paced personalised care. As part of the SingHealth Regional Health System, SCH believes in working closely with community partners to allow patients to receive holistic and continued care during admission and after discharge. 

About Rebee Health
Rebee Health is a Singapore based company powered by XCLR8 Technologies Pte Ltd. Rebee is here to support and address the increasing demand for physical rehabilitation faced by elderly patients and the healthcare system. Through Rebee's technology, we inspire to empower and uplift patients' recovery experiences to be better, safer and faster.