AMI-HOPE: Pharmacists Leading Person-Centred Digitally-Enabled Care

Updated: Aug 5



"Match-making Digital Health and Pharmacist Clinicians in the delivery of Post AMI Care"


Did our previous multi-disciplinary features result in all your hearts yearning for more? We guarantee you that this week's feature will definitely capture your attention! ❤️

This week, we would like to showcase our pharmacists playing leading roles in promoting better post-acute myocardial infarction (AMI) care through the use of technology!

 

Why is Post AMI Care important?



More commonly known as heart attack, AMI (acute myocardial infarction) is a phenomenon where the coronary artery is obstructed, resulting in insufficient blood supply to the heart muscles. This is a medical emergency and often require rapid interventions.


AMI afflicts 10,000 Singaporeans annually, and the incidence is expected to increase by 59% by 2030. Among the high-income OECD countries, Singapore has also one of the highest 30-day AMI all-cause mortality rates. Hence, there is great importance for quality care after an episode of AMI.


Some of the key gaps in the current AMI care model include:


What is the AMI-HOPE programme about?


With the gaps identified, several healthcare professionals in Singapore gathered to form the AMI-HOPE (Acute Myocardial Infarction allied Health-Oriented Patient-centred digitally-Enabled care) team, which aims to cultivate a learning healthcare system that:

  1. empowers allied health professionals (pharmacist clinicians) to delivery high quality care using digital interfaces,

  2. values quality of patient care and patient outcomes over the quantity of service delivery, and

  3. delivers the above at an affordable price.




AMI-HOPE is a step-wedge pragmatic study in partnership with the Ministry of Health (MOH), MOH Office for Healthcare Transformation (MOHT), Health Promotion Board (HPB), and Integrated Health Information System (IHiS), to deliver a remote care model for AMI patients across Singapore’s healthcare clusters (NUHS, SingHealth & NHG). It aims to improve post AMI quality of care, person-centred outcomes and reduced cost through a greater involvement of pharmacist clinicians in patient care.


Overview of a patient journey under the AMI-HOPE program



Let us hear some inspiration from the AMI-HOPE team!


"The team was very honoured when Health Discovery+ was chosen by MOHT and NUHS as the platform to build the AMI-HOPE protocols with the intent to care for AMI patients. The objective is really about harnessing technology to empower these post-MI patients in healthy living, and facilitating timely interventions by clinicians. The big picture of the project is about saving more lives in this space. Working with MOHT and NUHS team has been gratifying and hopefully vital sign monitoring (VSM) can path the way of future healthcare in Singapore.”

– Mr Torres Oey, Deputy Director, IHIS –


AMI HOPE has indeed been an eye opening! It was humbling to witness and participate in the partnerships between MOHT health technologists and fellow pharmacist clinicians across the island. It is exciting to see how these partnerships have birthed novel remote health monitoring and education technologies to better care provision for our post AMI patients!”

– Mr Samuel Ho, Lead, Educational Strategy, AMI-HOPE & Cardiac Pharmacist Clinic, Khoo Teck Puat Hospital



"As a technologist, I found that being involved in this project was fascinating, I learned a lot about cardiology and the role of pharmacists. As we exchanged with other teams around the world, it became clear that, for patients, just the idea that “someone is looking out for you”, and in a non-intrusive way, is quite a valuable lifeline and an encouragement for adherence and healthy living. As we get more experience, and introduce new gentle nudges this idea could become even more transformative."

– Prof Robert Morris, Chief Technology Strategist, MOHT



How do Pharmacist Clinicians contribute in AMI-HOPE?


The AMI-HOPE care model is divided into 3 phases:


Phase 1:

Prior to discharge from the hospital, pharmacist clinicians will have a meet-and-greet session with patients to build rapport so that the patient is acquainted with the pharmacist who will walk with him in his journey of care. Medication review will also be performed to ensure all the medications are evidence-based and initiated appropriately.


Phase 2:

To ensure early post discharge care, all patients will receive a phone call within 5 days of discharge. Our pharmacist clinicians will then assess the patient’s general condition, and manage any complaints which could be related to the condition, adverse reactions or otherwise. Furthermore, the pharmacist will determine the patient's adherence to prescribed medicines, assess the level of physical activity, offer smoking cessation and dietary advice. Naturally, the pharmacist may also adjust or add important medications, and address the patient's queries on the disease or prescribed medications.