12 October 2021, Singapore — More than 1,000 attendees gathered virtually on 12 October 2021 at the opening of the inaugural HealthTech X organised by the Integrated Health Information Systems (IHiS) to eXplore technologies to deliver better health and better care. Graced by Second Minister for Health, Mr Masagos Zulkifli, the virtual event will see more than 20 speakers from Singapore, Europe, Japan, and USA share insights over two half-days on advancing population health to more effectively address critical challenges posed by an increasing ageing population and rising chronic disease burden in Singapore.

2. In his address, Guest-of-Honour, Mr Masagos recognised the important role that HealthTech plays in supporting Singapore to combat the coronavirus. He said: “While COVID-19 has put our healthcare sector to the test, I am glad that we have managed to develop new technology and data capabilities within a short period, to support key pillars of our national strategy against COVID-19 – in contact tracing, testing, vaccinations and running our community care facilities. Our HealthTech teams leveraged existing solutions and capabilities, quickly adapting them to meet new demands.” (Refer to Annex A below for factsheet on HealthTech against COVID-19)

3. During the event, Minister Masagos appreciated more than 150 partner organisations that supported the public healthcare sector in delivering HealthTech initiatives, including augmenting the tech workforce, accelerating IT equipment delivery, expediting network services and offering innovative solutions. The partners were also appreciated in a video screened at the virtual event.

4. On ongoing efforts to improve population health, Minister Masagos shared: “We have made some inroads through the National Diabetes Dashboard. Through a consolidated database, the dashboard supports data-driven planning at the national and regional health system level. There has also been ongoing work by MOH and IHiS in using this to develop AI predictive models that can identify diabetic patients at risk of kidney failure. So that we can intervene early. We will also make this information available to our primary care practitioners through our National Electronic Health Record system, enabling them to deliver more personalised care to diabetic patients.”

Highlights of HealthTech X

5. Themed “Tech for Population Health”, the virtual event is attended by diverse experts from fields such as academia, healthcare, medicine, and IT to learn and exchange ideas on harnessing technology in preventive health, behavioral science, value-based care, precision medicine,telemedicine, new models of care such as home hospital, and more. 

6. Highlights of HealthTech X include keynote presentations by Mr Bruce Liang, Chief Executive Officer of IHiS, and Dr John Halamka, President of Mayo Clinic Platform, as well as a panel discussion titled Let’s C.H.A.T. (Conversations on Health and Technology). Panellists include:

• Mr Chan Yeng Kit, Permanent Secretary for Health 
• Prof Tan Chorh Chuan, Chief Health Scientist of MOH, Executive Director of MOH Office for Healthcare Transformation, and Chair for the Population Health Workstream on Transformation
• Ms Ngiam Siew Ying, DS (Policy), IHiS CEO-Designate, and Co-Lead for Population Health Workstream on Technology & Collaborative Platforms
• Dr Tham Tat Yean, CEO of Frontier Medical Group, Fellow at MOHT and Senior Consultant at MOH Primary and Community Care Division
• Moderator: Mr Ong Leong Seng, Chief Technology Officer, MOH
  

7. At the event, Mr Liang shared insights on how the HealthTech solutions put in place over the last decade provide for a strong HealthTech foundation for population health initiatives. He shared: “Healthcare institutions and IHiS have been progressively digitalising care, building up inter-systems integration capability, applying patient profiling data analytics and establishing digital engagement channels. These efforts have paid off in the current pandemic as information flows across systems from PCR tests and vaccinations to the population through apps such as HealthHub and TraceTogether, and to healthcare providers through the National Electronic Health Record and Patient Risk Profile Portal. We are probably one of the most connected healthcare systems in the world. But there is still a lot more to be done for Population Health. This includes digitally enabling and connecting more community care partners, and scaling population segmentation and targeted intervention programs.”

8. In his keynote presentation, Dr John Halamka shared Mayo Clinic’s approach to population health including gathering varieties of health-related data, building new algorithms, validating that the algorithms are fit for purpose, and how they support patients in receiving the right care, in the right place, at the right time.

9. Mr Chua Chee Yong, Organising Chairman of HealthTech X and Director (Strategy & Planning), IHiS, said: “We are moving towards new models of care – a more proactive and upstream preventive approach with greater participation from our citizens. This is needed to reduce the reliance on hospital services and enable greater access and continuity of care in the community. Enhanced use of technologies such as telehealth, AI predictive insights and two-way engagement apps will change the way we care for our citizens. We hope that the insights shared at HealthTech X will inspire meaningful innovations that will improve the health of our nation.”

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Annex A

HealthTech Against COVID-19

Over 50 initiatives implemented by IHiS to support the healthcare family in the fight against COVID-19

When COVID-19 landed on our shores in January 2020, a Whole-of-Society approach was adopted to combat and contain the COVID-19 spread. As Singapore’s HealthTech agency, IHiS stepped up to deliver technology solutions and services in the fight against the pandemic to support cross-ministry operations, patient care delivery, tech-enable Community Care Facilities, Community Treatment Facilities (CCFs), and vaccination operations.

2. Over the last two years, IHiS has undertaken over 50 initiatives in supporting the healthcare family in the fight against COVID-19. The range of initiatives include:


• Supporting the expansion of care capacity. IHiS worked closely with the PHIs to tech-enable new areas within existing their premises such as the Fever/Flu Screening Areas (FSAs) and Isolation Zones, allowing the providers to have added capacity to care for COVID-19 patients safely.
  
  In 2020, IHiS was also deeply involved in tech-enabling six Community Care Facilities (CCFs), including 2 reserved sites,that added more than 15,000 beds for Singapore at the peak of their operations. Given the speed CCFs had to be operationalised when the outbreak escalated during mid-2020, IHiS adopted a lift-drop-evolve approach to operations technology (OpsTech) – leverage and iteratively enhance existing tech solutions to support CCF workflows. One technology that was adapted and deployed to support care delivery and administration at CCFs was GPConnect. It became the core clinical and administration system at these CCFs. A web based version, GPCLite, was subsequently developed to better support the needs of healthcare staff in challenging environments such as Tuas South CCF and dormitories.
  
  IHiS also custom-built a remote vital signs monitoring (VSM) solution termed the Health Discovery to allow the lean, on-site medical team to provide round-the-clock care for close to half the total COVID-19 cases in Singapore in 2020. Health Discovery provided a dashboard that allowed them to track patients’ compliance and flag patients who may need more medical attention. It not only significantly reduces the workload on clinicians, it also alerts them on any interventions required based on the input.
  
  With the rise in the number of community transmission cases in May 2021, IHiS also deployed GPConnect as part of the enablement efforts of 2 additional reserve sites at Civil Service Club @ Loyang and former Ang Mo Kio Institute of Technical Education to provide added buffer for contingencies should there be a need to further expand the existing CCF capacities.
  
  In September 2021, new Community Treatment Facilities (CTFs) started operations to care for COVID-19 patients who have mild symptoms or no symptoms but have underlying conditions that require close monitoring. With the experience of setting up CCFs, IHiS tech-enabled the new CTFs with the necessary suite of solutions rapidly including telehealth solutions that enabled remote vital signs monitoring and video consultation. Besides using GPConnect as the EMR for patient care, new GPC tags were developed to help users identify patients with fall risk, and patients who bring their own medication, to enable medication reconciliation for patient safety.


• Supporting Cross-Ministry operations, containment and deterrence efforts. In collaboration with MOH and the laboratories (private and public), IHiS conceptualised and developed the COVID-19 Test Repository (CTR) in April 2020, a one stop repository and single source of truth for COVID-19 test results. CTR automatically aggregates test results from many sources, minimising the need for manual compilation and removing bottlenecks in the workflow. CTR also includes a dashboard of composite COVID-19 test result data to support operations planning, management reporting and analytics.
  
  Together with MOH, IHiS also designed, built and deployed the Patient Risk Profile Portal (PRPP) to help GP clinics identify patients with increased risks of COVID-19 exposure based on pre-arrival declarations from patients as well as data from MOH systems. It was piloted within 2 weeks and rolled out to more than 1600 GP Clinics. PRPP has the capability of capturing and contributing Acute Respiratory Illness (ARI) diagnosis for reporting purposes to MOH, as well as trigger SMS reminders to patients who have missed their swab referrals.
  
  Since its deployment in April 2020, PRPP has gone through around 35 deployments to improve on its offerings. The solution has been expanded to include swabs for travelers and swabs for persons under quarantine. One of the most critical updates was the expansion of PRPP’s role to a COVID-19 related electronic record system for GPs. For example, from being a pre-visit declaration form, PRPP progressively became the platform which GPs used to enter a patient’s information after swabbing them, as well as channel for GPs to submit COVID-19 adverse event / allergy reporting for patients suffering from severe side effects after vaccination. This system was also integrated with the CTR so that GPs could use PRPP to view the results of patients that they had sent for swabs. In addition, PRPP has also been expanded to include Antigen Rapid Test (ART) to be used, for example, for pre-event testing.
  
  
• Supporting vaccination operations (VacOps). Since January 2021, IHiS has been extensively involved in supporting the rollout of the nation-wide COVID-19 vaccination.
  
  IHiS pivoted GPConnect as the key system to support the clinical and administration needs at more than 140 vaccination sites, including polyclinics, vaccination centres (VCs), public health preparedness clinics (PHPCs), in-situ vaccination sites at PHIs and mobile vaccination teams (MVTs). To-date, approximately 50 enhancements have been made to better serve the evolving protocols and workflows at the various vaccination sites. For example, the system was enhanced to enable the printing of auto-populated patient information, second appointment and vaccination records on an A5 vaccination card, eliminating the need to hand-write the information. To help staff keep track of the required 30 minutes observation time after vaccination, the system was modified to allow each patient’s observation end time to be displayed on screen, making it easier for staff at the Observation Station to keep track and identify patients ready for discharge. With tech, operations were made more efficient and safety of the patients are enhanced through the system checks which were put in place. Developments and enhancements were also made to existing software products, including the Staff Surveillance System (S3) and HealthHub. The technology stack was also extended beyond the healthcare family, to support the Ministry of Manpower in vaccinating migrant workers at 5 of their on-site medical centres (OMCs), as well as the Ministry of Trade & Industry in vaccinating the Malaysian truck drivers at 2 of their vaccination sites.
  
  
• Protecting care settings and enhancing operational effectiveness. IHiS supported the PHIs in accelerating various digitisation initiatives in response to the rapidly evolving COVID-19 situation. Efforts in this space included the Digital Visitors’ Declaration Form (VDF) which had configurable predisposition logic that directs visitors to different queues based on their risk profiles, iConnect.COVID that enabled automatic SMS notification to patients who were tested for COVID-19 at polyclinics, as well as the ALPS Business Intelligence (BI) dashboard which sought to enhance operational productivity and support better demand forecast for COVID-19 related supplies (e.g. PPEs).
  
  In the case of Tan Tock Seng Hospital (TTSH) and National Centre of Infectious Disease (NCID), they had to handle patient volume increase, strain on essential medical supplies, and tackle issues like crowd management and contact tracing. The Command, Control and Communication (C3) system launched in December 2019 enabled TTSH to leverage artificial intelligence (AI) to gain real-time visibility of its operations, predict potential choke points and make informed decisions. In the first five months of the outbreak, the C3 team completed 19 rapid development releases and implemented over 55 disease outbreak widgets and over 90 widget enhancements. These would typically take 1 year to complete. When changes in COVID-19 case definition criteria caused a three-fold patient increase in the Screening Centre in the initial weeks, C3 helped TTSH identify the escalating situation and open five more wards at NCID. This was made possible through the data pooled from CCTV footage and RTLS enabled the C3 System to pre-empt the mobilisation of manpower, equipment and resources to meet the increased demand.
  
  
• Supporting patient care delivery and care continuity. Over 300 enhancements to the National Electronic Health Record (NEHR) and the three Electronic Medical Records (EMRs) used by the public healthcare institutions (PHIs) have been implemented to incorporate new and evolving COVID-19 requirements, including creating COVID-19 test reports, changes to SMS reminders and updating of laboratory codes for COVID-19 tests.
  
  
• Enabling sustained quality care virtually. The emergence of COVID-19 has provided an impetus for greater adoption of telehealth as physical contact is minimised. With video consultations (VC), patients save on transportation costs and travelling time, while being able to keep their appointments more private. They are also potentially more motivated to see a doctor in a timelier manner, without the risk of exposure to the COVID-19 virus if they were to travel out of their homes. About 11,000 public healthcare VC sessions are conducted monthly. Since 2019, the overall number of institutions using VC, including Intermediate and Long-Term Care Services and Community Care Partners, have grown by about 140%. Practically all specialties (60) are using video consultation currently. With VSM kiosks developed by IHIS playing a significant role in enabling round-the-clock remote monitoring of COVID-19 patients at the Community Care Facilities (CCFs), an enhanced version of the kiosk has also been deployed at multiple Community Nurse Posts (CNPs) in early 2021 for surveillance of hypertension among community residents and escalation of cases necessary for medical treatment. In parallel, the VSM home monitoring platform is being scaled up for monitoring of polyclinic hypertension patients across all clusters through the Primary Tech-Enhanced Care (PTEC) programme, which is a collaboration between IHIS, MOHT and the 3 clusters.
  
  
• Facilitating the implementation of new COVID-19 related subsidies and reporting requirements. Enhancements were made to the billing systems in PHIs as well as to GPConnect (for GP clinics) to effect new subsidies for eligible patients as announced by MOH in 2020.
  



HealthTech beyond COVID-19

3. COVID-19 has been a test of resilience. It has also presented new opportunities. Through building on solutions developed in these two years and pivoting, IHiS will continue to keep these systems relevant after the pandemic. Besides CTR, which was architected to support COVID-19 and future pandemics, IHiS will also enhance MWHealth – an AI-powered application developed with MOH Office or Healthcare Transformation (MOHT) which utilises optical character recognition to speed up patient registration – to integrate with systems supporting migrant workers’acute respiratory infection reporting.


4. The Community Acquired Pneumonia and COVID-19 AI Predictive Engine (CAPE) developed by Changi General Hospital and IHiS which generates risk scores for pneumonia patients will be useful in non-COVID-19 situations to enable timelier interventions and treatments.

5. Moving into the new normal, HealthTech will continue to play a part in helping clinicians fight diseases and deliver effective patient care.


About Integrated Health Information Systems (IHiS)

IHiS is a multi-award-winning healthcare IT leader that digitises, connects, and analyses Singapore’s health ecosystem. Its ultimate aim is to improve the Singapore population’s health and health administration by integrating intelligent, highly resilient, and cost effective technologies with process and people.

IHiS played a key role in helping all major public healthcare institutions become amongst the first in Asia Pacific to achieve HIMSS EMRAM Stage 6 and 7, international benchmarks for advanced technology used in patient care.

Transforming healthcare through smart technology, IHiS has garnered more than 150 awards for its innovations. It supports more than 50,000 healthcare users in Singapore’s health ecosystem through the application of clinical informatics, computer science, data science, mechatronics, standards based IT that enables information exchange and cross boundary workflows, analysis, statistical and machine learning techniques to discover insights.

For more information, visit us at www.ihis.com.sg, connect with us on Facebook and follow us on LinkedIn to learn more about the latest healthcare IT news.