Stroke patients in Singapore are using iPads for remote rehabilitation — removing the need to visit their clinic.
The new treatment is part of a tele-rehabilitation programme currently being trialled by the National University of Singapore (NUS) to get patients back on their feet sooner.
It uses tablets to guide patients through exercises on videos, whilst motion sensors capture data about their progress.
“With telerehab, patients do not need to face physical barriers, their caregivers do not need to accompany them to the rehabilitation center and their therapists do not need to visit them at home to provide rehabilitation,” said Associate Professor Gerald Koh from the NUS Saw Swee Hock School of Public Health.
Koh is leading the work, which also addresses the challenge of keeping Singapore’s aging population healthy.
Getting older
Declining birth rates combined with a longer-living population has led to Singapore into an age-shift, with the median age expected to reach 47 in 2030.
Life expectancy is already amongst the highest in the world — 83 years in 2013, according to the 2015 World Health Statistics.
By 2030, the number of Singaporeans aged 65 or older is expected to be one in five.
As the population ages, the need to tailor health services towards them is a priority and whilst telerehab won’t work as a universal option, for some patients it can save time and money by reducing the number of visits to the doctor.
Its effectiveness in Singapore could be unique as the small scale of the country makes this both an efficient and cost-effective option.
“We are looking at 70 dollars per month, as opposed to 1000 euros per month in Europe,” says James Yip, cardiologist at the National University Heart Center.
Yip is leading his own tele-health programme, targeting the elderly population with the goal of keeping them away from hospitals and clinics.
Patients with conditions such as chronic hypertension, diabetes or heart failure can use sensors for remote monitoring of their vital signs — in real-time.
Yip’s devices can measure and transmit information including blood pressure and one day indicators such as weight and blood sugar.
However, this 24-hour technology could result in more, rather than less, pressure on staff.
Demand on health services
“There will be more stress for healthcare providers to be present in this telehealth space,” says Yip, which has resulted in some resistance from health providers.
“[This is opposed to] you only seeing patients with an appointment,” he says.
The removal of human contact may also not be the preferred option for elderly patients.
“I like hospital,” says 63-year old NG Kim Chu who recently suffered a stroke leaving the left side of her body weakened significantly.
After five months in hospital, NG was able to take her rehabilitation programme home and complete her exercises remotely but instead missed the company she’d had in hospital — leaving the question of whether technology can replace the advantage of human touch.
