Editor’s note: The Patient Risk Profile Portal (PRPP) was first covered in the article: Patient Risk Profile Portal: Helping GPs Assess Patients’ COVID-19 Risk Before They Visit. In this article, we recap the HealthTech system, PRPP, and how its roles have significantly expanded, including Swab Referral System and Antigen Rapid Test functions.

When COVID-19 first broke out in early 2020s, General Practitioner (GP) clinics were among the first line of defence – all across the country, they saw patients who exhibited symptoms or who had just came back from countries with high rates of infection.

To manage COVID-19 effectively on a national scale, the authorities needed to be sent such information quickly and accurately. The healthcare sector, already saddled with the extra work load of COVID-19 testing and additional precautionary measures, suddenly found themselves loaded with even more administrative work. The authorities too, realised that compiling the data from hundreds of clinics in varying formats was very time consuming.

It soon became apparent that a more efficient way of capturing and reporting this data was necessary. To meet that need, the Ministry of Health tasked IHiS to develop a web-based healthcare portal called the Patient Risk Profile Portal (PRPP) to help general practitioners digitise the pre-visit declaration process for visiting patients.

Besides eliminating tedious manual processes such as the submission of patients’ answers, the Patient Risk Profile Portal (PRPP) also facilitated clinics’ assessment for COVID-19 risk, as well as triaged patients into high-risk and low-risk categories. The IHiS team worked quickly with the primary care team from MOH to develop and deploy the portal within two weeks. Its usefulness was evident as more than 500 Primary Care Network clinics began the process of onboarding almost as soon as PRPP was ready. One year later, more than 1,400 clinics, or almost all Public Health Preparedness Clinics have onboarded the system.

Improving the Patient Risk Profile Portal (PRPP) Week After Week

Since its deployment in April 2020, the Patient Risk Profile Portal (PRPP) has gone through numerous improvements, with an estimate of around 35 deployments. The requirements evolved so quickly on the ground that the team had to deploy a weekly release for 11 consecutive weeks, working through many evenings and weekends to do so.

“In the initial few months, we were pushing out updates almost every week. The improvements were in response to what was necessary on the ground as the situation evolved. We had to actively gather requirements and feedback from MOH users to continuously enhance PRPP so as to improve the GPs’ operational effectiveness.”
Jimmy Li Say Kiang, Patient Risk Profile Portal (PRPP) Project Manager, IHiS

One of the most critical updates was the role expansion of the Patient Risk Profile Portal (PRPP). In a nutshell, it evolved from being a simple e-questionnaire into a mini COVID-19 related Electronic Record system for GPs. For example, from being a pre-visit declaration form, PRPP progressively became the healthcare portal which GP doctors used to enter a patient’s information after swabbing them. PRPP then seamlessly sends the swab orders to those laboratories that are ready to receive it electronically, for preregistration before the physical specimen arrives, giving them more time to prepare.

The Patient Risk Profile Portal (PRPP) team also worked quickly to integrate it with the COVID-19 Test Repository (CTR) system, so that GPs could use PRPP to view the results of patients that they had sent for swabs. As HealthHub is integrated with CTR, patients can also log on there to check their swab results.

Introducing the Swab Referral System in Patient Risk Profile Portal (PRPP)

Another major update was the swab referral system, which was made possible after developers had integrated the Patient Risk Profile Portal (PRPP) with the systems used by the polyclinics and Regional Screening Centres (RSC). With the swab referral system, in cases where patients visit a Non-Swab and Send Home (Non-SASH) clinic, doctors can use PRPP to refer them to a nearby swab testing facility, such as a polyclinic, RSCs or even a SASH GP clinic.

For patients that had been referred via the swab referral system for a swab visit but yet to do so, they would receive an SMS notifications on the 3rd and 5th day to remind them to go for their swab tests. The referring GP will also receive a daily email on the list of patients who have received these SMS reminders so that they can follow-up with the patient.

Once the swab specimens are processed, patients with negative swab results will receive an SMS notification. For patients with positive or inconclusive results, the GPs would receive both email and SMS notifications, which they are required to acknowledge by viewing the patients’ swab result in the Patient Risk Profile Portal (PRPP). This is crucial as swabbed positive patients need to be informed of the results in a timely manner to ensure early isolation and to contain any potential spread.

Patient Risk Profile Portal (PRPP) expanded to include Antigen Rapid Test (ART)

The Patient Risk Profile Portal (PRPP) has also been expanded to include Antigen Rapid Test (ART) to be used, for example, for pre-event testing. The Antigen Rapid Test (ART) typically takes around 30 minutes, and patients with negative ART test results will receive an SMS notification, which they can show to event organisers for admission.

The Patient Risk Profile Portal (PRPP) has also been enhanced to provide another channel for GPs to submit COVID-19 adverse event/allergy reporting for patients suffering from severe side effect after vaccination. This will enable downstream systems to cancel or defer the 2nd vaccination appointment or to do a referral to an allergy doctor for the affected patient. It also helps relevant authorities in using data analytics to look into the relationship between COVID-19 vaccination and serious adverse events.

“As the Patient Risk Profile Portal (PRPP) is a bespoke application, we built multiple integrations with various systems such as iConnect, COVID-19 Management Backbone and the Swab Referral from scratch. This type of integration work usually takes a few months for each system, but for COVID-19, everyone worked extremely hard to get it up within two weeks. We are proud that we are an active part of the national fight against the pandemic, and will continue doing our best to help.”
Ramil Diongco, Development Team Lead of Software Engineering and Development, IHiS

“Working on the Patient Risk Profile Portal (PRPP) required not just a multi-team effort within IHiS, but we also had the privilege of working with other stakeholders, such as the Ministry of Health, GovTech, Health Promotion Board, and of course, the healthcare professionals and more. It was a holistic effort and despite the very tight timelines, we helped each other overcome the odds. We all want to do our part to help our front liners fight COVID-19, and to eventually open up our country once more.”
Jimmy Li Say Kiang, Patient Risk Profile Portal (PRPP) Project Manager, IHiS

With the recent increase in COVID-19 cases in May, the Patient Risk Profile Portal (PRPP) team had ramped up their operations in anticipation of heightened caseloads. We thank everyone involved in PRPP for their dedication and hard work.