Page 92 - HA Convention 2015

Special Topics

ST3.3 Technology Advancement 14:30 Theatre 1

Monday, 18 May Singapore’s Tele-rehabilitation Experience: Its Basis and How It Works
Koh GCH
Saw Swee Hock School of Public Health, National University of Singapore, Singapore

Tele-rehabilitation was developed to provide equal access to rehabilitation services for clients in remote rural geographic
locations. However, in country and city like Singapore and Hong Kong which are densely populated, is tele-rehabilitation
relevant? Although participation in rehabilitation after hospital discharge results in significantly better functional recovery
after stroke, only a quarter of stroke patients recommended to continue with rehabilitation post-discharge actually do so.

The barriers of continuing with post-discharge rehabilitation include functional (unable to ambulate in the community),
social (caregivers need to accompany the patient to rehabilitation centre), financial (high cumulative cost of rehabilitation),
medical (co-morbidity reducing effort tolerance) and perceptual (unawareness of value of rehabilitation or ageist attitudes).
Home rehabilitation is a possible solution as it reduces physical barriers (therapists come to the patient’s home instead) and
social barriers (caregivers do not need to take time off to accompany the patient to rehabilitation centre). However, home
rehabilitation is three times more expensive than centre-based rehabilitation. Tele-rehabilitation also does not require the
therapist to visit patients at their homes, and patients and their caregivers do not need to travel to day rehabilitation centres.
However, it is still two times more expensive than centre-based rehabilitation. Current published studies on tele-rehabilitation
have used a combination of home visits, in-home messaging devices, telephony and store-and-forward video recording by
therapy assistants during home visits. These systems do not leverage on real-time video-conferencing which is more cost-
effective and efficient, and do not collect physical data which is important in tele-rehabilitation (unlike tele-psychiatry and
tele-dermatology).

The tele-rehabilitation system will be discussed in this session, which includes the use of video-conferencing, sensors to
capture physical data to help therapists assess recovery process and prescribe next level of exercises; and customisable
training videos which are pushed to patients’ end-user system when therapists prescribe an exercise programme to their
patients.

HOSPITAL AUTHORITY CONVENTION 2015

90