Scripts

I present 3 scripts: 2 of them written for actual presentations, by me and the newest coauthor of this blog, and one by the not-so-new coauthor (RMS), for fun. Challenge yourself, and see how fast you can identify the 2 scripts which were painstakingly worked on (actually only 1, but 2 were actually used!).

The 3 scripts are shown below. Enjoy.


Script 1: Remedies at a distance
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Telemedicine can form a key component of our everyday lives. Imagine going to the doctor's, queuing up to take a number, and waiting for hours on end, every second of agony in illness, multiplying the chance to contract another bug from your fellow sufferers.

We offer you another way out.

With the benefits of telemedicine, anybody - but in particular those who apply to receive its benefits - can enjoy the luxuries of treatment at home. Diagnosis is easily done by a mere description of symptoms, no reason to require a face-to-face interview with a practitioner; a simple videoconference (facilities not provided) will suffice. This stands to offer a whole host of benefits to the users, namely:

- Convenience
- Time-saving due to lack of travel and waiting times
- Psychological comfort of a readily-accessible treatment
- Lower chance of being infected by a TV screen than a flu-ridden sleepwalker

Long-distance monitoring also gifts the ability to divine physiological data of the user anytime, at any convenient location; it also offers conveniently a means to tag one's location such that medication can be delivered, or aid be sent to, should the need arise.

There may be a few non-believing heret- sorry, skeptics, who might view telemedicine from a rather more pessimistic, non-agreeable fashion, choosing to illuminate and expound its drawbacks while cheerfully discarding its guaranteed salvations. Allow me to elucidate sequentially and systematically refute each incorrect accusation:

1. There may be insufficient people to staff the system.
- Telemedicine's focus is on the use of IT to bring the patient-doctor interaction into a new medium, through new windows and adds depth and colour to the otherwise transactional meeting. A lack of doctors is the least of the concerns of the system; nonetheless, a friendly non-Turing compliant "AI" virtual receptionist will be made available to stall patients' otherwise incessant and - pardon me - downright puerile demands for instant consultations.

2. Medication in the physical form is absent.
- Telemedicine, despite the name, does not encourage drug abuse nor pill-taking in any way. It is simply a medium through which patients can talk to their doctors, and for doctors to check on their patients remotely. Any requirements for antibiotics or their ilk may be sent via e-mail or, more slowly, snail-mail. In urgent cases, patients are advised to have a ground-floor window open. Under no circumstances do we wish to precipitate illegal substance usage.

3. The elderly/non-tech-savvy individuals may not be able to utilise the system.
- Much like its cousins CCTV cameras and endoscopes, telemedicine provides a modicum of independence, allowing medical professionals full coverage and operational control of the relevant systems. Little to no technical ability is required on the part of the end-user, save the ability to use, debug and troubleshoot teleconferencing equipment and to conduct self-maintenance of the observation systems.

Having thus addressed surely the most pertinent concerns, we would now like to turn your attention to the future expandability of our project. We have taken Changi Prison as our first case study, and hope to expand the scope of our project to a similar extent, noting the first-rate observation coverage and response times of personnel manning the 'eye in the sky' systems there. Given more resources, a national telemedicine framework could be adopted, perhaps even living up to the pervasion envisaged groundbreakingly in George Orwell's 1984. With such a comprehensive system in place, nobody ever need be afraid of falling ill, for aid is always on the lookout, and help always around the corner. Thank you.

Script 2: Norway -- A Case Study
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I will now proceed to talk about our case study: Norway.

A question springs to mind: what makes Norway an ideal case study?

The reasons are many. The first is that Norway has a long history of telemedicine, giving sufficient time for its impact to be detailed.

Also, Norway has not only successfully implemented telemedicine, but also has had positive outcomes as a result of telemedicine. This makes it a good model for telemedicine in Singapore.

Having seen why we chose Norway as a case study, I shall now briefly talk about telemedicine in Norway.

Norway has an extremely low population density. This leads to problems such as unwillingness to work in rural areas and the economic unviability of setting up clinics in rural areas. Coupled with a rapidly ageing population, which brings along with it a host of problems, as previously mentioned, this makes it hard to offer quality healthcare to all Norwegians.

However, with robust communication technologies already in place, telemedicine was a logical choice to solve these problems.

Norway has implemented the Norwegian Health Net, which spans over more than 700 doctors and 25 hospitals. All GPs and private specialists use EHR, containing information of 80% of patients. Also, applications supplementing EHR such as the Picture Archiving and Communications System, an application to transfer medical pictures, come packaged with the EHR. We can thus say that EHR is highly developed in Norway.

Telemonitoring in Norway is also highly developed, and widely adopted. The pictures shown here depict a telemonitoring suite for the elderly, and even has specialised telemonitoring functions built into appliances like the television.

Teleconsultation is also widely applied in Norway, and spans fields such as telepsychology and teleradiology, and includes both doctor-to-doctor and patient-to-doctor communications.

So how did Norway achieve all this?

After researching, we found that the key steps to implementing telemedicine in Norway includes developing a centralised communications network, which connects the nation's doctors, implementing reimbursement policies for telemedicine for patients, as well as developing educational opportunities for telemedicine. This includes offering telemedicine courses at the National University of Tromso. Also, the Norwegian government has developed a set of standards for EHR and information exchange, volven.

Having seen how Norway implemented telemedicine, I will proceed to describe the benefits and drawbacks of EHR and telehomecare.

The EHR reduces human errors by digitalising the recording process. It also increases the efficiency of treatment, since doctors no longer need to manually search through piles of paper records. Furthermore, the information is more complete and reliable, as it is corroborated across each clinic the patient has been to, and lastly, the EHR leads to cost savings derived in part from less paperwork.

Yet, EHR has its fair share of drawbacks, namely prohibitive startup costs and a steep learning curve of the technology, which leads to diminished efficiency in the short run as doctors struggle to use the program.

This diagram summarises the advantages and impacts of EHR.

Telehomecare has many benefits. It reduces clinical and hospital visits, as patients can now be treated at home instead of at the hospital. This is especially true for routine checkups and minor illnesses, and is a great blessing for sufferers of chronic diseases. The constant monitoring through remote devices also results in more responsive healthcare, leading to improved outcomes for patients. For elderly patients with chronic illnesses, telehomecare can improve their functional independence. Also, the reduction of visits to medical facilities can bring about time savings as well has the reduction of travelling costs.

Telehomecare also has its drawbacks, including high startup costs, issues associated with the open nature of the Internet through which information is sent, as well as the lack of a clear common standard for telehomecare devices, meaning some technologies may be mutually incompatible.

The following slide summarises the advantages and drawbacks of telehomecare.

Script 3: Telemedicine is coming to town
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To evaluate whether telemedicine is applicable locally, we need to answer the following questions about the plausibility of local implementation, and the applicability of Norway’s lessons.

Telemedicine is highly plausible in Singapore.

Firstly, there is strong funding and support from the government because the government is also actively seeking to improve the healthcare system and is seriously considering telemedicine as a solution.

Secondly, many telemedicine prerequisites are already implemented, such as a nationwide high-speed transmission network required by EHR, are already implemented.

Thirdly, Singapore implemented pilot telemedicine project in the past, and thus already has some prior knowledge in this area.

The above reasons show that successful local telemedicine implementation is highly plausible.

Telemedicine is highly relevant to Singapore. But exactly what kind of changes do we expect for both the doctors and patients. We want to share some of the more exciting implications here.

One immediate change doctors experience is the digitalization of patient records. This has immense implications. Gone are the days where finding patient records is a chore. Electronic records allows doctors to easily access, retrieve and update patient information without going through the tedious paperwork that is needed when keeping physical records. This saves a lot of time and frees up medical personnel to devote more time to the care of the patients.

Furthermore, the EHR connects all doctors under a single system, allowing doctor to share and discuss past records of the patient. In this case, the patient will not be treated by a single doctor anymore. He will be treated by the combined and collaborated efforts of all the doctors connected under the EHR. This allows better treatment to be administered to the patient.

The implications for patients are even more promising. With telehomecare, they will be able to receive treatment at the comfort of their home, under the care of their loved ones. Studies have shown that care in such home environments immensely benefit the patient’s condition. Regular trips to medical centres, especially for those with chronic illnesses, are waived, providing great convenience for the patients.

The development of new telemonitoring devices, from wristwatches that tracks your glucose level to shirts that tracks your heart rate, also allows easy and constant monitoring of the patient’s condition. This effectively allows doctors to keep track of the patient’s condition. They can also easily relate to patients changes in the treatment given, without troubling the patient to visit them in their medical centres.

Undeniably, telemedicine shows much promise and can bring a smile to the faces of both patients and doctors.

Now that we established the promise and viability of telemedicine in Singapore, we need to start implementing. Firstly, we drew some lessons that we learnt from Norway.

From the difficulties that Norway faced, we came up with some areas of improvement that needs to be worked upon. We need to set up common standards in telemedicine implementation to allow for the inter-operability of telemedicine in different medical centres. We also need to provide support to ensure long-term sustainability of telemedicine, and subsidies to attract more users. Measures to ensure the privacy and security of medical information should also be in place. As such measures are geared towards building the foundation of telemedicine, we derived from these our guiding principle of structural development.

Next, we noticed that telemedicine users need to be fairly proficient in telemedicine in order to get the most out of it. Therefore, we aim to provide educational opportunities for telemedicine. This is under our guiding principle Education.