Aim: We adopted an implementation perspective to conduct a pilot to assess the feasibility, acceptability and satisfaction with conducting self-administered HbA1c test by patients with type 2 diabetes coupled with telemonitoring and teleconsultations (i.e., the Primary Technology Enhanced Care (PTEC) Home HbA1c Testing (HAT) Programme) in the primary care setting in Singapore. The secondary objective was to compare the HbA1c and primary care visits at the end or during the intervention, vs. 6 months before.

Methods: Adopting one-group pre- and post-study design, data was collected via patient self-reports and electronic medical records extraction. While summary statistics and paired t-test were computed for quantitative data, open-ended feedback was analysed using content analysis.

Results: A total of 33 participants completed the intervention out of 37 (33/37=89%) recruited from 73 eligible (37/73=51%). Most were either 51 to 60 years old (46.9%) or more than 60 years (37.5%), with more males (53.1%) and majority Chinese (93.8%). Majority (81.3%) felt that home HbA1c testing was beneficial with most commonly reported benefit of not having a clinic visit. The most commonly reported challenge was using Bluetooth to transmit the reading (43.7%), followed by having too many steps to remember (28.1%). While participants reported being overall satisfied with the intervention, only 22% were willing to pay for it in future. While average of all visits and HbA1c values were comparable pre- and post-intervention, the average of diabetes-related visits was significantly lower post-intervention.

Conclusion: These feasibility pilot findings will inform the implementation scaling phase in future. Following are practical recommendations for this implementation scaling phase: offering PTEC HAT Programme to suitable patients who are self-motivated and have adequate digital literacy, provision of adequate educational and training support, sending reminders and exploring enabling manual submission of HbA1c readings considering Bluetooth-related challenges.

The advance of digital medicine over two decades has been as transformative as the introduction of the scientific method in the 1800’s or the rise of science in the 1950’s. Digital healthcare now pervades every aspect of medicine -- starting with the patient-physician relationship - and encompassing all diagnostics, procedures, and patient data. Computers and electronic health records (EHRs) offer instant access to patient records, decision support, and informatics and increasingly facilitate remote communication and care, all advanced by the pandemic.

This technological explosion has shifted many relationship paradigms. The former patient-physician dyad is now the patient-physician-EHR triad, and Artificial Intelligence may well be similarly transformative. Data itself has a life beyond the patient. Team-based care, shared decision making, patients accessing clinical data and other information, and privacy concerns are all changing patient-practitioner power dynamics. Modalities like telehealth, remote monitoring, smartphone applications, SMS texting, and robots are redefining trust to include not only humans but also Health Information Technology (HIT).

These changes are redefining relationship aspects of care. What have we gained and lost in this rapid transformation? How can we prepare current and future physicians for this evolving landscape? Training methods based on old models are no longer adequate.

The presenters have spent many years conceptualizing, researching, and teaching about these changes, including participation in three international conferences on the subject. In this session they will share their experience and ideas about educating current and future generations to balance human relationships and HIT, maximising the benefits of both while minimising adverse effects of rapid change. They will summarise the current state of research and present practical methods to prioritize human relationships while integrating the best of HIT.

1. Describe elements of an updated professional and personal identity integrating human relationships and health information technology.
2. Emphasize that education must include both mastering digital technologies AND their effective use in clinical interactions.
3. Develop educational competencies that include building solid relationship skills, digital competence, and flexibility to adapt to a rapidly changing digital landscape (for example, patient-doctor-computer communication skills)