Page 33 - ITU Indicators for Smart Sustainable Cities – Pilot project Singapore

ITU Indicators for Smart Sustainable Cities – Pilot project Singapore
I 4.2.4 Proportion of patients involved in telemedicine programs including services, such as e-consultation,
e-monitoring, online health care advice and guidance etc.

Singapore’s definition of telehealth/telemedicine, according to MOH’s published National Telemedicine
Guidelines (NTG), is quite different from ITU’s. In NTG, the terms “telehealth” and “telemedicine” are
synonymous, and are defined as the "systematic provision of healthcare services over physically separate
environments via Information and Communications Technology". Telehealth/telemedicine are further
defined according to 4 domains:

1. Tele-collaboration – between provider and provider
2. Tele-treatment – between provider and patient
3. Tele-monitoring – between provider and patient
4. Tele-support – between provider and patient/caregiver

The first 3 are for clinical care context, the last one is a "catch-all" term for all non-clinical care context (e.g.
educating a patient to manage his chronic disease).
As for ITU’s proposed metrics to measure how smart or sustainable a city is with regard to telehealth:

1) No. of patients that benefit from telemedicine
2) Percentage of (1) with reference to total no. of patients in the city

It seems the metrics measure the extent of adoption of telehealth/telemedicine rather than the smartness
or sustainability. Even if the assumption is that telehealth/telemedicine is by definition “smart”, it doesn’t
necessarily mean that the more widely adopted, the more sustainable it becomes. What if
telehealth/telemedicine costs more per “unit of care” per patient than “brick-and-mortar” healthcare? Then
the more widely adopted, the more difficult it becomes to sustain this system. In an urban city’s setting,
without the traditional telehealth drivers like large geographical distances and inaccessibility to “brick-and-
mortar” healthcare, one cannot assume that telehealth/telemedicine is by default more cost effective.

MOHH has an internal framework that assesses the viability and sustainability of any given telehealth service
(telehealth is not just about technology, but also the clinical care processes and manpower), based on:

1. Health business outcomes
2. Manpower/ resource optimisation outcome
3. Business sustainability

and taking into consideration the operational viability, scalability and business model of the telehealth
service.

A5.3.2 Online visits to cultural resources per capita.

The National Arts Council and its parent ministry, the Ministry of Culture, Community and Youth propose a
change in definition to Arts Consumption via Digital Media. The basis behind this is that digital consumption
occurs in many ways and not just online. Singapore conducts a National Population Survey on the Arts to
gather the information. Survey includes the following question:

Apart from physically attending any arts and cultural events and activities, which of the following have you
watched or listened through other electronic/virtual media (such as TV, DVDs, Radio, Media Portable Devices
such as Mobile phones, Ipod or Internet)? Any others? [MA]

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