新加坡卫生部：远程医疗服务或可减轻急诊的压力并节省成本

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2024年4月3日，新加坡卫生部兼通讯及新闻部高级政务部长普杰立医生在国会上回复议员关于远程医疗服务提供商的数量及其服务的接受率的问题

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以下内容为新加坡眼根据国会英文资料翻译整理：

叶汉荣先生问卫生部长：

（a）迄今为止，新加坡有多少家远程医疗服务提供商正在运营；

（b）这些服务的接受程度如何，包括进行的咨询次数或服务的患者人数；

（c）远程医疗服务是否导致急诊科非急诊病例的减少；

（d）是否有计划增加公众意识并促进远程医疗服务在非急诊情况下的使用。

卫生部长 普杰立医生（卫生部长的代表）：先生，根据《医疗服务法》（HCSA），许多门诊医疗服务提供商已获批提供远程医疗服务，其中有19家是没有实体场所的独立远程医疗提供商。

卫生部并不追踪远程医疗服务的接受程度。目前也没有确切的数据表明远程医疗是否减少了非急诊部门的就诊人数，尤其是考虑到人口老龄化和对医疗保健需求增加的情况。

远程医疗服务在慢性疾病管理的初级保健，和特定条件的专科门诊环境中得到了卫生部的支持。卫生部将继续在适当的环境中推动远程医疗服务的应用。

议长先生：叶汉荣先生。

叶汉荣先生（杨厝港议员）：谢谢，议长先生。我感谢高级卫生部长的回答。从系统的角度来看，将远程医疗整合到现有的医疗系统中，而不是将其作为可选的附加选项，对于优化患者护理交付至关重要。这种平衡的方法使医疗保健专业人员能够评估最适合每个患者需求的模式，避免不必要的远程医疗使用。有鉴于此，我有两个问题。

首先，对于开展远程医疗试点的新医院，能否将其纳入常规临床实践的标准部分？其次，在公众意识宣传之外，是否有计划激励初级保健医生利用远程医疗进行适当的咨询？这可能会减轻急诊服务的压力并节省成本。

普杰立医生：先生，我感谢叶汉荣先生先生的提问。远程医疗是一种工具。该技术和平台可能非常有用，他已经描述了它如何改变行为模式。这是一个需要两方选择的工具：临床提供者和潜在患者。

我们的方法是将其视为一种选项。在临床提供者选择它是因为它是安全的、有效的，它提供了更好的护理质量；或者对于患者来说，因为它方便并提供了更好的接入，那么我们希望消除临床提供者或患者选择该项服务的障碍。因此，我们正在努力在法规上实现标准化，并减少一些与患者选择相关的成本和财务方面的障碍。

因此，对于两个问题的简短回答是，我们希望医院和初级保健在适当的情况下使用远程医疗服务，当其对临床护理有所改善，当它变得更加方便和更受患者欢迎。

以下是英文质询内容：

Mr Yip Hon Weng asked the Minister for Health (a) to date, how many telemedicine service providers are operating in Singapore; (b) what has been the take-up rate of these services, including the number of consultations conducted or patients served; (c) whether telemedicine services have contributed to a drop in non-emergency cases at the emergency departments; and (d) whether there are plans to increase public awareness and promote the use of telemedicine services for non-emergency conditions.

The Senior Minister of State for Health (Dr Janil Puthucheary) (for the Minister for Health): Sir, many outpatient medical service providers are approved to provide telemedicine services under the Healthcare Services Act (HCSA), of which 19 are standalone telemedicine providers without physical premises.

The Ministry of Health (MOH) does not track the take-up rate of telemedicine services. There is also no definitive data on whether telemedicine has reduced non-emergency attendances at Emergency Departments, especially given an ageing population with rising demand for healthcare.

Telemedicine services have been facilitated by MOH in primary care for chronic disease management and in specialist outpatient settings for specific conditions. MOH will continue to facilitate the application of telemedicine service in appropriate settings.

Mr Speaker: Mr Yip.

Mr Yip Hon Weng (Yio Chu Kang): Thank you, Mr Speaker. I thank the Senior Minister of State for his response. From a systems perspective, integrating telemedicine into existing care protocols rather than offering them as an optional add-on, is critical for optimising patient care delivery. This balanced approach empowers healthcare professionals to assess the most suitable modality for each patient's needs, avoiding unnecessary telemedicine use. With this in mind, I have two questions.

First, for new hospitals opened to piloting telemedicine, can it be incorporated as a standard part of routine clinical practice? Second, beyond public awareness campaigns, are there plans to incentivise primary care physicians to utilise telemedicine for appropriate consultations? This could potentially reduce strain on emergency services and generate cost savings.

Dr Janil Puthucheary: Sir, I thank Mr Yip for his questions. Telemedicine is a tool. The technology and the platform are potentially quite useful – and he has illustrated and described some of the ways in which it can change patterns of behaviour. It is a tool that needs to be chosen by two parties: the clinical provider and the potential patient.

Our approach to say it is an option. And where it is a suitable option for the clinical providers because is safe, efficacious, it provides better quality of care; or for the patient because it is convenient and provides better access, then, we want to remove the obstacles for the clinician or the patient from choosing this. So, we are working on standardising the regulatory approach across, as well as reducing some of the barriers in terms of cost and financials associated in terms of the choice that a patient might make.

So, the short answer to both questions is that we would like to see progress for hospitals as well as primary care using telemedicine services appropriately, where it makes a difference to the clinical care, where it becomes more convenient and more acceptable to the patients.

HQ丨编辑

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