Getting a potential heart problem checked out at the National Heart Centre Singapore (NHCS) used to be a time-consuming process and, for most, the hassle would hardly be worth it.
NHCS found that seven in 10 people referred to it by the nine SingHealth polyclinics did not actually need to see a specialist.
Still, the tests must be done – if only to give patients peace of mind, said Professor Terrance Chua, the centre’s medical director.
What he and his team have done over the past two years is to work with polyclinics to streamline the process – making it such that patients need make only two visits rather than three, and get their results much more quickly.
“This allows us to cut one visit, and patients won’t be so anxious, wondering, ‘Do I have something serious?’ ” Prof Chua said.
Previously, patients would go to NHCS to see a specialist after getting a polyclinic referral.
They would make a second trip to get tested, and a third to get the results and see a doctor again if necessary.
Now, Prof Chua and his team at the centre first review the referral forms sent in by the polyclinic to decide if the patient needs certain diagnostic tests.
This has resulted in one-third of patients now going directly for the tests without first having to consult a specialist, and returning a month or so later to talk to a doctor and pick up their results.
Apart from saving them the time needed for that extra visit, it also saves most people about $38, the cost of a specialist outpatient clinic consultation for subsidised patients.
As of November last year, around 2,200 patients had come under this new initiative, freeing up about 94 doctors’ consultation slots each month.
One of these patients, Madam Koh Swee Ee, 70, has had high blood pressure for the past 10 years and experienced intermittent chest pains recently.
She went to a doctor at Pasir Ris Polyclinic in November last year and was referred to NHCS.
A month later, she underwent a test to check the function and blood flow of her heart, and received the results on Jan 7.
Everything was normal.
“It was not troublesome at all; everything was very convenient,” said Madam Koh, who works as a cleaner.
“They told me that if nothing else happens, I don’t need to go back.”
As part of a broader Health Ministry initiative, NHCS is working with four SingHealth polyclinics on a similar pilot scheme, in which polyclinic doctors are the ones ordering the tests, instead of a specialist, for patients to undergo at the heart centre.
Some 327 tests had been carried out under this scheme as of November, three-quarters of which turned out normal.
This means patients can be followed up at their regular polyclinics, without having to go for more specialist check-ups.
“I think in Singapore, we’re very worried about our rapidly ageing population,” Prof Chua said.
“We have got to learn to provide better care with the resources we have.”
linettel@sph.com.sg
This article was first published on Jan 26, 2017.
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