How Singapore used telemedicine to tide over the pandemic

By Jaz Low

Interview with Dr Walter Lim, Group Managing Director of Clinical Services and Singapore Deputy Managing Director, Fullerton Health.

Not all heroes wear capes. Wonder Woman doesn’t, Aquaman doesn’t, and telemedicine certainly doesn’t. Telemedicine is the practice of using technology to deliver care at a distance, and it has been heroically holding the health industry together over the past two years.

Fullerton Health Singapore has set up a telemedicine kiosk to remotely support migrant worker dormitories. Patients can also access telephysiotherapy sessions and Covid-related teleconsultations via an app.

Dr Walter Lim, Group Managing Director of Clinical Services and Singapore Deputy Managing Director of Fullerton Health, shares how the organisation is using telemedicine to relieve the strain on the healthcare system and help patients receive the care they need in time.

Leave no migrant worker behind

Fullerton Health launched a telemedicine kiosk to remotely serve migrant worker dormitories that were badly hit by a series of Covid-19 outbreaks in 2020. Initially, the organisation stationed on-site doctors and nurses to treat patients. But when the outbreaks grew in scale, they turned to this tool to overcome manpower constraints.

The kiosk resembles a vending machine and has an in-built teleconsultation function. Migrant workers scan their work pass to register, then stand in front of the machine for their consultation.

A migrant worker using the telemedicine kiosk. 

During the consultation, doctors diagnose health problems and prescribe medication, which the kiosk dispenses accordingly. It stores medicine that can treat common conditions among migrant workers such as muscle injuries, stomach aches, and other minor ailments.

At the end of the session, the kiosk will print out any medical certificates, receipts, and referral letters if necessary.

“According to our statistics, more than two-thirds of migrant worker clinic visits could be resolved with medication,” Dr Lim says. The kiosk has helped to “alleviate the burden on primary care facilities,” he adds.

Lowering the barriers to healthcare for migrant workers 

So far, the kiosk has benefitted several thousand migrant workers who live in a dormitory located in the North of Singapore. Fullerton Health is working closely with the Ministry of Health to bring the kiosk to other regions, Dr Lim shares.

One such region houses around 70,000 to 80,000 residents. The first phase of the project took off in April 2022 and has already enrolled a few thousand workers.

The kiosk is only one of the initiatives under a larger project to provide migrant workers with quality and affordable healthcare. Other initiatives include scheduled transportation of migrant workers to and from medical centres and annual in-person health screenings.

The pandemic has raised concerns over the disparities that migrant workers face in accessing healthcare. “We hope that the kiosk will be able to cater to their needs even beyond the pandemic,” Dr Lim says.

Bringing healthcare closer to patients

Fullerton Health has also explored other uses of telemedicine on its app, where users can access telemedicine services, locate nearby clinics, and manage medical claims.

First, patients can arrange telephysiotherapy sessions via the app. Patients will first meet with physiotherapists online, who will prescribe them a certain set of exercises. Post-consultation, patients can refer to the app’s instructions to complete them in their own time.

For example, the app guides patients who are recovering from a knee injury on how to perform knee extensions correctly. This involves sitting on a chair and slowly moving one’s lower legs upwards until the knees are nearly straight, before slowly returning to the starting position.

“Telephysiotherapy was especially helpful during lockdown when patients were unsure if they needed to cancel their appointments,” Dr Lim explains. “But the app walks them through the exercises so they can continue rehabilitating in the comfort of their homes,” he adds.

Second, the app allows patients to book virtually supervised ART tests. This means that individuals who are required to produce negative pre-event or pre-departure tests do not need to make unnecessary trips to a clinic for testing.

Users simply have to hop on a video call and a doctor will oversee this process. They can expect to receive their results within four hours, according to Fullerton Health’s website.

Third, patients who are concerned about their post-jab symptoms can opt for Covid-19 vaccination teleconsultations. This gives doctors the opportunity to address commonly asked questions such as the signs of a severe allergic reaction and how long vaccine-induced immunity will last.

Prevention is the best cure

Fullerton Health is making use of wearable devices to help individuals take greater charge of their healthcare journey. Dr Lim shares that he is heartened to see that there has been an increased awareness of the importance of preventive care amongst his patients.

One wrist-worn wearable device can monitor if users are at risk of developing any sleep disorders, such as sleep apnea where a person’s breathing repeatedly stops and starts. One of the potential red flags is when a person’s blood oxygen level decreases over prolonged periods, he notes.

“Users may also find home sleep studies more comfortable than going to the hospital and having sleep specialists evaluate their sleep cycle,” Dr Lim says.

Another wrist-worn wearable device can help patients to track their blood pressure seamlessly. This eliminates the need for bulky monitors and is a “great way to encourage consistent monitoring and increase compliance,” he elaborates.

A central dashboard links up blood pressure data from all wearable devices. This gives nurses an overview of patients’ conditions and allows them to flag any abnormalities to healthcare staff.

It also helps “maintain a reasonable nurse-to-patient ratio as you can tell when one nurse is handling way too many cases,” Dr Lim shares. This allows the organisation to maximise labour resources.

Telemedicine greatly minimises any interruptions to treatment. In a time when many people are falling ill, it might just be the hero we all need.

Pictures courtesy of Fullerton Health’s website.