Video consultations handy for patients

Clinical pharmacist Vanessa Cheong from KK Women’s and Children’s Hospital (KKH) conducting a video consultation with a mock patient at home with her caregiver and the patient’s “father” on 12 April 2017.
PHOTO: The Straits Times

A few months after her son's birth, administrative worker Liu Xin realised that he had a bad case of eczema - a skin condition which causes itchiness.

She took him to KK Women's and Children's Hospital (KKH), where doctors asked if she preferred that the next consultation be done through video call via a smartphone or computer. She said yes.

"It would have caused us some trouble to take the baby to the hospital," Ms Liu, who is in her 20s, told reporters yesterday, giving the thumbs up to telemedicine.

Her six-month-old baby is one of the first patients to use the new video call system, which is being rolled out nationwide, starting with six public healthcare institutions, including KKH.

Dr Mark Koh, who heads the hospital's dermatology service, said he sees around 200 eczema patients a week, 40 of whom would be suitable for video consultations with pharmacists, who check on a patient's skin and make sure the medication is suitable. "It replaces a follow-up appointment with the doctor and saves an extra visit, especially if the eczema is well controlled," he said.

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Pharmacists will help arrange for a face-to-face appointment with a doctor if they decide that the child needs one, he added.

Depending on the hospital, patients may pay for the video consultations upfront after their first face-to-face doctor's visit, and the costs could be lower than seeing a doctor face-to-face.

Mr Bruce Liang, who is chief executive of Integrated Health Information Systems and chief information officer at the Health Ministry, said that they will be monitoring patient feedback on these virtual consultations to make sure patients are comfortable with the technology.

Some, like housewife Catherine Ng, 59, have reservations. "An online consultation just won't have a human touch. In face-to-face consultations, the doctor and patient can communicate better," she said.

However, 19-year-old Lee Xin Min has no qualms about using video call technology for medical consultations, as long as the quality of care remains the same.

Said the student: "Telemedicine sounds incredibly convenient... I can arrange my time around the consultation and return immediately to what I was doing before."

Volunteer clowns bring joy to sick kids at KK Women's and Children Hospital

  • With their red noses and white face paint, rainbow-coloured outfits and oversized shoes, the Caring Clown Unit (CCU) has brought nothing but love and laughter to the sickest children at KK Women's and Children's Hospital.
  • Caring for a mother with dementia, she understands the challenges of a caregiver and being a clown reminds her to face each new day with humour and courage.
  • To hone their skills, seven of them are headed to Bangkok for an international clown convention organised by the World Clown Association at the end of the month.
  • For instance, they are not allowed to take up assignments if they are not feeling well or suspect they may have a virus.
  • It is the member's responsibility to attend all training conducted by CCU and be committed to practice.
  • Because the unit's work concerns mainly children, senior members take great care in running background checks on interested applicants, observing them for at least a year before they are allowed to become an official member.
  • They believe that care clowning is a form of diversion therapy that can help heal one's body and spirit, especially if a person feels trapped in a predicament and loses the joy and happiness of living.
  • "After more than a decade of walking the wards as a clown, I have come to realise it is not a one-way traffic of dispensing cheer," said Madam Toh.
  • With ages ranging from 26 to 62, the 11 active members are a motley crew, with different personalities and from various walks of life, counting among them a policeman, vehicle mechanic, handyman, polytechnic lecturer as well as two housewives, three retirees and two business and marketing executives.

Telemedicine is not a novel concept. Seven years ago, Khoo Teck Puat Hospital started a similar scheme with eight nursing homes. But in that case, a special video conferencing set was used as the technology on smartphones was not so readily available.

The success of the scheme was limited by the need for specialised hardware, said Dr James Low, a senior consultant in the hospital's geriatric medicine department. "Cabling in our hospital and the nursing homes was required when we started," he said.

But even with the constraints, he added, it helped save nursing home residents and their caregivers a trip to hospital.

Services provided and how they work

Q How will the new video consultation system work?

- Patients make appointments after their first face-to-face consultation with a doctor. They will be sent a virtual appointment invitation link.

- On the appointment day, they log in to the video call using a smartphone app or a Web browser.

- A check to verify their identity is then done.

Q What services are provided through video calls, and what is the timeline of their rollout?

 KK Women's and Children's Hospital

When: November last year.

What: Speech therapy, home care for children, breastfeeding consultations, pharmacy follow-up and consultation for young eczema patients.

Institute of Mental Health

When: November last year.

What: Psychiatric counselling and residential care nurse support.

Tan Tock Seng Hospital

When: January.

What: Post-stroke care, infectious diseases care, staff training at day care centres, medication counselling and refills.

Singapore General Hospital

When: This month.

What: Speech therapy.

National University Hospital and National University Cancer Institute, Singapore

When: June.

What: Post-stroke inpatient care at offsite wards, cancer patient care.

This article was first published on Apr 13, 2017.
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