By Trina Priscilla Ng, Commentary Editor
In view of the Wuhan virus, it is ever more pertinent that the Nation utilises its smart nation capabilities to tackle the crisis, such as the use of Telemedicine.
While telemedicine can potentially help amidst the public health challenge, it is not without its drawbacks if the technology is to be misused.
Nonetheless, considering that Singapore has been working towards realising the Smart Nation Vision, ranking second in the IMD (International Institute for Management Development) World Digital Competitiveness Ranking, telemedicine remains a huge potential for the society.
Telemedicine as a Smart Nation Initiative
Telemedicine allows the traditional doctor consultation to take place via a video call, a phone call, or through text messages. In the event that the telemedicine consultation is insufficient for the doctor to come up with an accurate diagnosis, the person seeking medical help will be directed to seek a face-to-face meeting.
The telemedicine initiative is one holding massive potential.
Firstly, telemedicine could increase productivity and efficiency. By reducing the number of unnecessary clinic visits, time is saved for both the healthcare providers and those seeking medical help. In cases where a face-to-face meeting is not required, such as in follow-up consultations, this also removes the need for long and dreary travel and wait times.
Additionally, telemedicine could be beneficial for seniors who are less mobile. Telemedicine would tie in well with the “Ageing in Place” initiative by the Ministry of Health by making the community more senior-friendly.
Telemedicine is also an initiative that seems to have a large potential to scale, considering that there is the potential for any available doctor around Singapore to be contacted when necessary, even if the patient is not within the vicinity of the hospital or the clinic.
The Wuhan virus: Telemedicine as a means
The current Wuhan coronavirus outbreak is a force that has the potential of causing strain to the healthcare system should its spread be insufficiently contained. Especially so, that the virus has hit our shores and triggered various public health response from officials.
Increasing number of confirmed cases meant that patient numbers may outstrip the abilities for hospitals to respond, and the frequent movement of large volumes of people in and out of medical centres could exacerbate the spread of an infectious disease.
Telemedicine could act as a possible way to alleviate both of the above mentioned problems. While virtual consultations cannot replace face-to-face consultations, it could possibly reduce hospital load by filtering out those who are unlikely to have contracted the disease.
Such technology serves the function of freeing up time, manpower and resources for patients who actually need medical attention and supervision.
At the same time, this also prevents those who were otherwise uninfected from possibly coming into contact with the virus in a crowded hospital, especially if they already feel unwell, and would as such be likely to have a weakened immune system.
Doing so would ensure that those who do end up at the hospital, suspected for the virus, would be given sufficient medical attention, tests and treatments which would boost the ability of our hospitals to both isolate and medicate the sick.
While telemedicine might seem like a feasible and sustainable solution to tackle public health crisis and healthcare problems, it certainly is not a panacea. Telemedicine would also bring with it a range of challenges.
Legitimacy of Medical Certificates
The first of such challenges would be that virtual consultations could also make it easier for people to “fake an illness” in the hopes of being granted a Medical Certificate (MC).
With a reduced ability to confirm if a patient’s reported signs truly exist, the ability to come up with an accurate diagnosis is also reduced. Similarly, since telemedicine companies work privately, users might choose to virtually consult multiple doctors until a favourable diagnosis is received. This might have further problems in terms of ensuring accountability.
A solution to such an issue is to get users with symptoms serious enough to warrant an MC to come to the clinic for a face-to-face consultation. This solution ensures that diagnoses are more accurate for more serious cases, while maintaining the reputation and legitimacy of telehealth service providers.
Yet, undeniably the best bet out of such ambiguity is to ensure social responsibility and ethics on both the medical professionals and patients.
Data Protection and Fragmentation
Since telemedicine services are offered by a variety of companies, patient data would be stored on the databases of these companies separately, and this could work against Singapore’s move to store healthcare data on a common platform. Without proper data sharing, aberrant users might also be able to hop from doctor to doctor until they receive a favourable diagnosis, undetected.
Singapore has, in previous years, made data sharing a key aim of our healthcare system. This sharing of medical information helps to make the treatment process a more seamless one, as patients commonly visit multiple doctors.
To prevent this from happening, telemedicine companies can be made to store their information on a shared platform. This is not unlike the move made by the MOH to have all private healthcare providers store their information on the National Electronic Health Record (NEHR).
Telemedicine in Singapore
The launch of the MOH Regulatory Sandbox in 2018, as well as the formation of organisations like the Ministry of Healthcare Transformation has helped light the way for telehealth to take its first steps into nationwide implementation.
Telemedicine providers like MyDoc, Doctor Anywhere, Speedoc and MaNaDr will work in the MOH regulatory sandbox until telemedicine services are formally licensed under the Healthcare Services Act.
Such initiatives have demonstrated a willingness for innovation and change in the current healthcare system, and are positive indicators of improvement and adaptation.
Moving forward, telemedicine can become significant and long-lasting while working through its teething problems for it to become a permanent fixture in our healthcare system.
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Trina Priscilla Ng is a Commentary Editor for The Convergence. She believes in the value of encouraging discourse about pertinent issues and feels most strongly about healthcare and about inequality. At other times, she is a medical student at the NUS Yong Loo Lin School of Medicine.