Remote care push proves prophetic

Remote care push proves prophetic

Pandemic sees investment in local health services pay off

Wichian Kanthiya, 43, a patient in Chiang Mai works with his physical therapist from Nakornping Hospital via a tele-medicine app on a mobile phone. The tele-medicine app was developed by the National Health Security Office (NHSO) to assist bed-ridden patients and now touted as solution for helping patients avoid hospitals during Covid-19 period. Onnucha Hutasingh
Wichian Kanthiya, 43, a patient in Chiang Mai works with his physical therapist from Nakornping Hospital via a tele-medicine app on a mobile phone. The tele-medicine app was developed by the National Health Security Office (NHSO) to assist bed-ridden patients and now touted as solution for helping patients avoid hospitals during Covid-19 period. Onnucha Hutasingh

For years, the National Health Security Office -- the state body that oversees the 30-baht universal healthcare scheme -- has invested in telemedicine, visits to distant areas by healthcare workers and delivery networks for prescription medications for those unable to leave their homes, with little take-up.

However, after a slow start, Rattaphon Triemwichanon, assistant to the secretary-general of the NHSO, said these three steps have played an invaluable role in the healthcare system's widely-praised efforts to contain the domestic spread of Covid-19.

During the early period of the pandemic, there were fears health issues would go untreated as many patients were advised to stay away from state hospitals if possible to avoid crowding that might further spread the virus.

"During the Covid-19 pandemic, these three services enabled patients to receive medical treatment without having to travel to state hospitals, and maintain social distancing. These three services help to maintain the connection between patients and hospitals," Dr Rattaphon told the Bangkok Post.

Wichian Kanthiya, 43, a Chaing Mai resident, is among those to have benefited from these services.

Mr Wichian, a villager of Ban Pong Krai in tambon Pong Yaeng of Mae Rim district fractured his skull and fell into a coma after a motorcycle accident in April.

After over a month in Nakornping Hospital in Chiang Mai's Mae Rim district, doctors made the decision to send him home and continue his care remotely.

Mr Wichian's house is 35 kilometres from the hospital in an isolated mountain area of the province and he admits that, at the time, he was worried about how he would manage as he was still unable to walk.

Despite his concerns, the threat of the emerging pandemic saw doctors insist that homecare was the best option.

Mr Wichian was provided with all the equipment necessary for his recovery, including an oxygen tank, and staff at the hospital also installed a telemedicine app on his phone so they could remain in direct contact with him and monitor his progress.

Family members, and his mother in particular, told the Bangkok Post they initially feared they would not be able to operate the equipment but were reassured after being given thorough instructions and receiving supervision from medical staff who drove to visit Mr Wichan at home twice a week.

These measures are all part of the NHSO's "Long Term Care" service which was launched in 2016 to assist 1.3 million bed-ridden patients who could not travel to state hospitals.

The NHSO estimates the number of patients needing to make use of this service could go to over 20 million by 2040. "Without this service, it would be impossible for patients like me in remote areas to visit the hospital regularly," said Mr Wichian.

With his recuperation currently going well, he now uses the app to work with his physiotherapists to regain full mobility.

Another elderly woman in the same village, Peng Panthiya, who is over 100 years old, is also benefiting from the delivery of prescription medications to local pharmacies where her family members can collect it for her.

Previously, some medicines could only be collected directly from hospitals which meant long journeys and hours wasted.

Every month, a medical team from Nakornping Hospital comes to visit her and check on her health.

These services form part of an initiative to reduce the average number of hospital visits per patient from six a year to just two.

The medicine pick-up service began in October last year and covers medication for conditions such as diabetes, high blood pressure, asthma, psychological illness and non-communicable diseases.

According to a report on April 1, 108 nationwide hospitals and 1,033 drugstores are participating in the project. Somsak Kampang, 63, a patient at Lamphun Hospital said that being able to collect his medicine locally is a real time-saver.

In the past, after spending hours waiting for treatment at the hospital, he usually also had to spend hours waiting to receive his prescribed medicines.

Lamphun Hospital has 1,200 daily patients and an average waiting time of 160 minutes for the collection of prescriptions for its pharmacy.

"Now I can get my medicines near where I live and I can go back home immediately after my consultation with the doctor," he said, adding that hospital pharmacy communicates with him using the same app to make sure he is taking the correct dose and that there are no side effects.

"The pharmacists now have more time to explain how the drugs work and what signs and symptoms to look out for," he said.

"I feel like I've learned a lot more about how to manage my health since the service began."

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