Patient care does not start with and end with doctors. From the Health Monitoring Station staff to the nurses and doctors of SHP, they work as a team to provide holistic care to chronic patients.
Selected staff have undergone structured in-house training to provide basic clinical service such as measuring patients ’blood pressure, taking smoking history and other health readings at the Health Monitoring Station (HMS). The figures are then automatically entered to the SHP Chronic Care Module (a patient management system) where doctors can access from their computer terminals remotely. Since May 2008, the HMS staff also assist in asking questions pertaining to patients' asthma control level. The asthma scores are tabulated and automatically entered into the SHP Chronic Care Module together with other health readings.
With inputs from the HMS coupled with laboratory test and other investigation results, SHP polyclinic doctors are able to advise patients on their risk of having a heart attack in the next 10 years. This is because SingHealth Polyclinics has incorporated a Cardiovascular Disease Risk Calculator (CVD Risk Calculator) in the Chronic Care Module. The calculator takes into account a range of patients' health indicators, such as those taken at the HMS as well as cholesterol and glucose readings etc to tabulate a score and classify patients’ risk into “low”, “medium” or “high”level.
In addition to the CVD Risk Calculator, SHP also launched an Asthma/COPD IT Module in May 2008 that is able to recommend a list of WAAP (Written Asthma Action Plan) instructions, based on patient's asthma control level. These instructions support the doctors in their clinical judgement and are useful in determing the treatment plan for patients.
Refer to news articles:
The Straits Times - Mind Your Body, pg 7, 16 July
LianHe ZaoBao, pg 13, 1 July
ShinMin, pg 14, 9 July
Berita Harian, pg 10, 9 July