Telehealth program by Changi General Hospital and Philips empowers heart failure patients to be more confident and involved in managing their heart condition

As a result of the telehealth program, patients had improved knowledge, improved confidence and ability to maintain their heart failure condition. In addition to the timely detection of changes in their clinical condition, the average length of stay for heart failure-related readmission over 12 months was reduced by 67 % for heart failure patients under telemonitoring support compared to the group that only received support via phone calls (2.2 days vs 6.6 days). 

With reduced heart failure related readmission, this translated to cost savings for both patients and hospitals. The bill size for heart failure related admissions in a year for heart failure patients in the telemonitoring group was 42% (S$ 2,514) lower compared to patients that received support via telephone calls.

 

“It is important for patients with chronic conditions to feel that they are empowered and in control of their own health as it increases their capacity to take action,” said Dr. Sheldon Lee, Program Director and Consultant, Cardiology, CGH. Patients with greater knowledge of their conditions are more confident about self-care, and are more likely to comply with treatment plans. This naturally leads to reduced risk of complications that may necessitate readmission to CGH. We are delighted to see these encouraging results in the pilot and will continue to look into enhancing the program further so as to provide sustainable benefits for our patients in the long run.”

Patients in the telemonitoring group were highly engaged in taking care of their own health. 93% of the respondents in the telemonitoring group felt that they were more involved in their own care. After going through the program, 68% of the patients were more confident and able to maintain their condition versus 34% and 32% respectively before the program.

Results also suggest that patients on the program felt more empowered to engage with their healthcare providers. 94% of respondents reported that submitting their weight and blood pressure readings helped them to talk more about their condition during their doctor’s visit.

 

“This program has helped me understand how to take better care of my health,” shared Mr. Gan Hwee Sun, 76, who was enrolled in the program. “I am now more conscientious about healthy eating and being active. I am also very grateful to my telecarer for her concern and regular follow-ups with me. She has shared useful knowledge about heart failure, which has given me more confidence to manage my condition at home. I have been following her advice and now have more energy and am able to walk more without feeling breathless easily.”

The Heart Failure Telehealth pilot program was launched in November 2014 by CGH and Philips to help heart failure patients learn how to better manage their heart condition at home; reduce the risk of readmission and premature death. The program integrated three elements of care: tele-monitoring, tele-education and tele-care support via tele-nurses from Changi General Hospital Health Management Unit.

Heart failure patients in the telemonitoring group were provided a weighing scale and blood pressure monitor to assist them in the daily measurement of their weight, pulse and blood pressure upon discharge from CGH. They also received a personal tablet to wirelessly capture these key vital parameters and to upload it to a central system for monitoring. Tele-nurses then remotely monitored participants’ vital readings and intervened when signs of deterioration were detected. To teach patients how to manage their diseases and ensure care compliance, there were also educational videos, e-quizzes and follow-up calls from tele-nurses.

 

“To meet the long-term demand for chronic care, we need to start shifting chronic disease management beyond hospital walls and into our patients’ home,” said Mr. Diederik Zeven, General Manager, Health Systems, Philips ASEAN Pacific. “Telehealth, where patients are remotely monitored at home, is a sustainable and scalable model that bridges the care delivery gap. At the same time, this care model also shows positive impact in treatment compliance which results in better quality of life for patients. Staying connected with patients in between their check-ups, ensuring that they remain healthy, thereby reducing hospital readmission rates and healthcare costs are the optimal goals in patient care.”

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