
Introduction: iConnect.COVID
The COVID-19 pandemic, while disrupting work and life in many ways, presented unique conditions that allow the innovator in us to think about the problem at hand, consider the resources we have, and put them together in a way that creates rapid, impactful change.
In HealthTech, an existing digital platform originally designed to facilitate care conversations across providers, has been repurposed in innovative ways to help frontline healthcare staff in the management of information flow and communication with patients.
iConnect.COVID was developed by MOH Office for Healthcare Transformation (MOHT) together with Integrated Health Information Systems (IHiS), to manage COVID-19 swab tests done at polyclinics. The tool seeks to significantly improve patient and clinician experience in swab-related registration, results management, and results notification.
iConnect.COVID At a Glance
iConnect.COVID automates care processes, freeing up healthcare staff from having to do them manually. When a patient arrives, clinicians register them seamlessly with automated population of administrative data at the point of care. Swab test results are updated once they are available from the testing labs, and the application then notifies patients with negative results via SMS. All of these were previously done manually; it is estimated that this automation saves staff around 30 minutes per patient.
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The Opportunity
A patient developed COVID-19 symptoms and went to a polyclinic for a consult. Suspecting COVID-19, a polyclinic nurse performed a swab test.
For documentation, she keyed data into two places – the clinical management system (CMS) which sent the data to the laboratories for testing, and an internal tracking sheet. The next day, the nurse logged in to the CMS to check on the patient's test results and manually updated the internal tracking sheet. The nurse used a separate system to send an SMS to notify the patient of his negative result.
Polyclinic staff across the 20 different polyclinics in Singapore spend a sizeable amount of time manually tracking and updating thousands of patients.
How did iConnect Covid help to streamline this process?
iConnect is an application set up in 2019 for a different purpose. It connected care teams from different settings so that patients could receive better care coordination and continuity.
For example, when a patient discharges from a hospital to a community provider facility, iConnect facilitates care transition by sharing a base set of patient information, focused around their medical, functional, social, and activation needs.
With iConnect, care continuity is improved, and the patient experiences a continuous care conversation. In early April, an opportunity presented itself when the National University Polyclinics shared with MOHT that their manual processes with swab tests, involving manually tracking and updating the tests results, had become time-consuming. MOHT quickly initiated a discussion with IHiS on the re-purposing of iConnect to help with the automation of administrative processes. The original intention was to develop a form in iConnect, which could be integrated with the lab test results and tracked by relevant parties such as MOH, instead of updating manually using Microsoft Excel.
With this goal in mind, the core team of staff from MOHT and IHiS developed, tested, and deployed this form in iConnect– now termed iConnect.COVID – within five days using the "Scrum" methodology. Scrum is where a small team delivers a new or improved product within a set period of time known as a sprint, before embarking on further sprints to improve the product after receiving feedback. Throughout the process, they also diligently applied the "two in a box" model, whereby the product owners (MOHT) and the development team (IHiS) stayed in very close touch to ensure aligned priorities and adaptability in scope changes.
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"We were thinking about making the administrative processes of point-of-care testing easier, so that we could test more people more efficiently. After we talked to staff on the ground and had discussions with members of the team, we arrived at a possible design which leverages on re-purposing iConnect to suit the current needs. Re-purposing it also meant that more could be done faster, as we did not have to develop from scratch."
Mr Ong Pang Hao, Manager, MOHT
In the six weeks since the first release on 13 April, iConnect.COVID has had new features added to improve productivity in the polyclinics. For example, an upgrade integrated the application with the NEHR, which helped to automatically populate patient admin data. iConnect.COVID also integrated with laboratory information systems to auto-pull laboratory test results. Further upgrades saw the addition of the SMS notification – if patients tested negative, iConnect.COVID would immediately send an SMS to inform them, instead of having to wait for a staff to check the system and do it manually. This not only reduced staff's workload, it also meant that patients received their negative test results sooner, relieving them of their anxiety.
"Before we had iConnect.COVID, the process of updating patients' details, tracking their test results, and then notifying them was tedious and time-consuming. Given that we average about 60-100 swabs a day, the automated flow of data in and out of iConnect.COVID allowed us to send information more securely, accurately and quickly to the relevant stakeholders."
Ms Teo Lay Sze, Nurse Manager, National University Polyclinics
"iConnect.COVID was purposefully built to cater to needs on the ground. As staff began to use it, they gave us regular feedback on how the application could be even more helpful. So we constantly improved it iteratively based on the priority of needs. It is gratifying to see how it helps frontline staff save precious time, so that they could focus on patient care. Our team is grateful to be able to contribute to the COVID fight, and also for all the support that we had received from the rest of the IHIS family."
Mr James Ng, Assistant Director, Emerging Services-Health Marketplace, IHiS
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As of 29 May 2020, iConnect.COVID has been implemented at all National University Polyclinics and National Healthcare Group Polyclinics, and there are approximately 750 users. It is expected to be implemented at SingHealth Polyclinics by mid-June.