June 3, 2021 by Philips

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Case Study: Changi General Hospital extends better care to more heart failure patients

Changi General Hospital
The number of heart failure patients at Changi General Hospital (CGH) was increasing and the hospital needed an efficient way to extend better care to more people. CGH called on Philips to help them define their need and customize a solution for their cardiac patient population and care providers. Together, CGH and Philips designed a telehealth program that delivered results, such as reduced length of stay and cost, and engaged patients more deeply in their own care. Due to the program’s success, it was also used as a model for a national initiative by the Singapore Ministry of Health.
Results
At a glance
 
Changi General Hospital,
Singapore
 
Challenge
  • Heart failure is on the rise globally, including Asia1
  • Heart failure has significant mortality, readmissions morbidity, and high health costs
  • The adoption of comprehensive cardiac rehabilitation programs in Asia is limited1
Solution
Heart Failure Telehealth program
Results
  • Length of stay for heart failure-related readmissions shortened by 67 percent3
  • Total cost of heart failure-related care for each patient dropped by 42 percent3

Challenge

Chronic illnesses, including heart failure (HF) are rising along with an aging population in Asia.1 In the region, HF contributes to high mortality, readmissions and health costs.1 Patient participation in care management can contribute to successful HF treatment and significantly impact symptoms, functional capacity, well-being, morbidity, and prognosis.2 However, the adoption of comprehensive cardiac rehabilitation programs is limited in Asia.1
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.” 

Dr. Sheldon Lee

Program Director and Consultant, Cardiology, CGH

Solution

The Heart Failure Telehealth 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; and 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 Eastern Health Alliance Health Management Unit.

 

Pilot program details:
 

  • 150 heart failure patients from CGH were enrolled in the telehealth program
  • Pilot ran from November 2014 and March 2016
  • Patients received telemonitoring support for one year

 

Heart failure patients in the telemonitoring group were provided a weight 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 support ongoing disease management education and ensure compliance, patients also received educational videos, e-quizzes and follow-up calls from tele-nurses. 

Results*

Patients enrolled in the Heart Failure Telehealth program increased their heart failure knowledge, improved self-care abilities, and experienced greater self-confidence in managing their heart condition, while receiving a better quality of care.  
This program has helped me understand how to take better care of my health. 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.” 

Gan Hwee Sun, 76

CGH Telehealth Program Participant

High patient compliance and timely detection of changes in clinical condition yielded a reduced cost of healthcare utilization and an overall reduction in length of hospital stay due to heart failure-related readmissions.

 

  • 67% reduction in length of hospital stay for heart failure-related readmissions
  • 42% reduction in cost of care

 

In addition, the results from the CGH Heart Failure Telehealth program pilot contributed to the design and development of a national telehealth vital signs monitoring (VSM) project initiated by the Singapore Ministry of Health. 

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.” 

Dr. Sheldon Lee

Program Director and Consultant, Cardiology, CGH

*Results from case studies are not predictive of results in other cases. Results in other cases may vary.
At a glance
 
Changi General Hospital,
Singapore
 
Challenge
  • Heart failure is on the rise globally, including Asia1
  • Heart failure has significant mortality, readmissions morbidity, and high health costs
  • The adoption of comprehensive cardiac rehabilitation programs in Asia is limited1
Solution
Heart Failure Telehealth program
Results
  • Length of stay for heart failure-related readmissions shortened by 67 percent3
  • Total cost of heart failure-related care for each patient dropped by 42 percent3
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