Virtual care to increase military medical centre capacity in the primary health care setting: A prospective self-controlled pilot study of symptoms collection and telemedicine. (September 2022)

• Record Type: Journal Article
• Authors: Tan, Nan-Guang; Yang, Lily Wei-Yun; Tan, Mark Zhong-Wei; Chng, Jeremiah; Tan, Marcus Hong-Tat; Tan, Clive
• Is Part Of: Journal of telemedicine and telecare. Volume 28:Number 8(2022)
• Page Start: 603
• Page End: 612
• Publication Date: 2022-09
• Subjects: Telemedicine -- virtual care -- telehealth -- symptoms collection -- pandemic -- military medicine -- general practice -- COVID-19; Telecommunication in medicine -- Periodicals; 610
• DOI: 10.1177/1357633X20959579
• Languages: English
• ISSNs: 1357-633X

Abstract

Introduction: The Singapore Armed Forces (SAF) recognises the potential benefits and looks to harnessing telemedicine for primary health care services. In this prospective self-controlled pilot study, we aimed to evaluate the safety, efficiency and user satisfaction outcomes of virtual care (VC) at a military medical centre. Methods: Out of 320 patients seen during the study period, 28 were enrolled in this study and underwent on-premises VC, comprising digital symptoms collection and telemedicine in addition to the usual in-person physician consultation. Safety outcomes were measured based on the diagnostic concordance between physicians. Efficiency was measured based on consultation times, and user satisfaction was evaluated using a standard questionnaire. Results: There was a higher caseload of both upper respiratory infections and dermatological conditions in our population, in which telemedicine performed well. In terms of safety, telemedicine achieved a mean diagnostic concordance of 92.8% compared to in-person consultations. In terms of efficiency, consultation times were 26.2% – or 2 minutes and 15 seconds – shorter on average with telemedicine ( p = 0.0488). User satisfaction was favourable, with 85.5% of patients satisfied with the VC experience. Discussion: This study has been invaluable in showing that on-premises telemedicine is a safe, efficient and effective means to extend and increase our surge capacity for primary health care. Our results have given us reasonable confidence to explore a larger-scale implementation in our network of military medical centres in the future.