Speech by Mr Gan Kim Yong, Minister for Health, at the National Health IT Summit 2017, 30 May 2017

Distinguished guests

Ladies and gentlemen,

Good morning.

1.           I am very happy to join you this morning.  The National Health IT Summit is a very useful platform for us to explore, share and discuss our IT strategy in healthcare.

2.           In the past, IT played a mostly supportive role in healthcare - in patient administration, diagnosis and treatment. This is changing rapidly. Many new innovations - from telemedicine to big data; from wearable sensors to personalised medicine; from robots to 3D printing; and many more – have come into the healthcare market in recent years.  IT can potentially change the landscape of the healthcare sector.

3.           We must harness technology in innovative and effective ways. To guide us in our journey, MOH developed a Health IT Master Plan, or HITMAP, in 2014.  As you can see, the HITMAP has seven transformation programmes.  Several initiatives have been rolled out including Smart Health Video Consultation, Smart Health TeleRehab, Care and Case Management System, Medical Device Integration and Outpatient Pharmacy Automation System.  The progress is encouraging, but we need to do more.

4.           As we continue to update the HITMAP, implement new initiatives and expand existing ones, it is important for us to be clear of our objectives and our principles.  I call this the 3 “D”s – Going Digital Intelligently; Using Data Effectively and Disrupting Meaningfully.  These 3 ‘D’s will in turn support our 3 ‘B’s in our care transformation – going beyond healthcare to health; beyond the hospital to the community and beyond quality to value.

Going Digital Intelligently

5.           First, going Digital intelligently.  We should go digital not for digital sake, but in ways that bring about real value for our patients, healthcare professionals or providers.  There are three areas in particular where we are putting emphasis on going digital. 

Going Digital in Health Records

6.           The first area is going digital in health records.  Late last year, a patient went to the A&E department of Changi General Hospital in a delirious state, showing shortness of breath and abnormal heart rhythm.  Associate Professor Mohan Tiru, a senior consultant, found that the patient had low levels of potassium.  The patient mentioned that he was taking asthma medication but could not recall its name. Through the National Electronic Health Record (NEHR), Prof Tiru found out that the patient had been prescribed Theophylline (thee-uh-fil-een) by another care provider. Prof Tiru diagnosed that the patient was likely to be suffering from Theophylline toxicity and administered the appropriate treatment.  

7.           This example illustrates one key value of having health and healthcare information in digital forms.  It enables the capturing and sharing of information systematically across providers and settings, leading to better decision making and more coordinated care.  In critical moments, it may even make a difference between life and death.  The usage of NEHR across both public and private care providers has been growing over the years. Today, over 760,000 patient record searches are made monthly. But I think we need to go further and faster.  I urge more private and VWO healthcare providers in particular to digitise their records and come on board the NEHR, as soon as possible. 

8.           Over the last few years, we have been digitising and connecting various segments of our healthcare system. We will continue to support public, private and VWO healthcare providers in this journey.  For VWOs for example, we have provided funding through the Centre-Based and Home-Care IT Enablement Programme Fund.  More than S$2million has been awarded over the last two years.  One beneficiary is St Luke’s Eldercare, which tapped on the fund to digitise their operations and connect to our national systems.  A winning project this year, St Luke’s system enables 100% of case summaries and 80% of their referrals to go digital.  As a result, they have seen a reduction in administrative work, duplications and manual transcription errors.  We welcome more VWOs to tap on this fund.

Going Digital for Informed and Active Patients

9.           Another promising area to go digital is that of enabling our patients to become more informed and active partners in their own health.  HPB has started the HealthHub platform. The vision for HealthHub is to empower citizens by providing them with the information required to better manage their health and healthcare.  Today, users of the HealthHub receive selected health articles based on their individual profiles.  They can also input their vital signs such as BMI, weight, or blood glucose to monitor their health. HPB is also making HealthHub more relevant to Singaporeans with different conditions and at different points of their life journey.  Those at risk of diabetes can now enrol in a digital-enabled diabetes prevention programme. Pregnant women can receive guidance during their pregnancy.  After delivery, they and their spouse can track their baby’s growth and developmental milestones through the eHealthbook.

Going Digital in TeleHealth

10.       A third area where we are going digital is enabling more productive telehealth service delivery models.  Under the umbrella of what we call Smart Health, we have rolled out national platforms for video consultation and tele-rehab solutions over the past 3 months.  The platforms enable patients to receive care in convenient locations of their choice, and improve the productivity of our healthcare professionals and providers.

11.       Later this year, we will launch our third telehealth initiative - the Vital Signs Monitoring (VSM) system that brings care beyond the healthcare institution into the community and the home.  VSM will enable the remote monitoring of vital signs such as the blood pressure, blood glucose, or weight of patients with conditions such as hypertension, diabetes, and heart or pulmonary diseases. Patients can in turn receive more timely advice and intervention to manage their conditions without having to schedule an appointment to visit the hospital.  As a whole, the use of VSM can enable more regular monitoring, improve patient management and reduce hospital visits and readmissions.

Using Data Effectively

12.       A natural outcome of going digital is having richer and more comprehensive data.  This brings me to the second ‘D’ – that of ‘using Data effectively’.  There is immense potential in harnessing health data for research, more effective policy and programme development, better targeted care interventions and treatments, more productive practices and expanded outreach. 

Using Data for Value-Driven Care

13.       Using data to drive more value in our healthcare system will be one key priority. A good example is the NUHS’ ongoing Value Driven Outcome (VDO) project, which is also one of the winning projects today. By collecting, benchmarking and analysing various quality and cost indicators, and providing the data to healthcare professionals, it enabled them to identify cost-effective clinical practices, reduce unnecessary variations and improve both cost and quality outcomes.  Take total knee replacements for example, the number of patients requiring post-operative blood transfusion has fallen from 26% to just 3%, and the median savings of $955 per case was achieved with no drop in the clinical outcomes.  

Predictive Data Analytics

14.       Another area of data science where we will be putting attention on is predictive analytics.  Over the past year, IHiS, together with NHG, NUHS and SingHealth, have developed a predictive model that identifies discharged patients who are at risk of multiple readmissions and enables proactive early intervention to be provided to better support them.

15.       Mdm Kanni is one patient who benefited from the Hospital to Home programme. Last month, she met with a road accident and was admitted to SGH for stoma surgery. The predictive model identified that she was at risk of readmissions.  Nurse Clinician, Mdm Low Siew Woon, made a post-discharge follow-up visit to Mdm Kanni, and found her frustrated at being home-bound as her motorised wheelchair was damaged during the accident. Mdm Low worked with various organisations to arrange for home care services which will help Mdm Kanni with regular changes of her stoma dressing, loan of an interim wheelchair while hers was being repaired, and home food delivery services until she regains mobility.  With such support, I am sure Mdm Kanni will have a successful recovery. This Hospital to Home programme is targeted to serve some 19,000 patients in FY17.

16.       Looking ahead, MOH and IHIS will also be working with partners like GovTech and AI.SG to infuse more applications of data, and in some cases even artificial intelligence into healthcare.  

Disrupting Meaningfully

17.       The application of IT will not just improve our systems and delivery models, but has the potential to disrupt and fundamentally change our underlying models. 

18.       Disruption can sometimes and often be painful. The management needs to change, the workforce will have to adapt to new ways to carrying out their jobs.  But if the disruptions have the potential to bring about meaningful benefits to patients and their families, and to our healthcare system, we must not be afraid to allow them to take place.  Better still, we should disrupt ourselves proactively before we are forced to do so.

19.       This is the reason why we are developing the Health Marketplace, to aggregate demand and provide matching services in the home care space.  Late last year, nursing services was first offered on Health Marketplace via a “match-a-nurse” service. By the end of this year, Singaporeans can look forward to a healthcare consumables marketplace that AIC and IHiS will put together.  For those who qualify for the Seniors Mobility and Enabling Fund, they will be able to directly use the funds allocated to purchase home care supplies. Other home care services which we hope to add on progressively on the platform include personal care services, medical transportation, meals-on-wheels, and therapist services.

20.       With funding support from the National Robotics Programme, MOH will support the trial use of robotics in healthcare.  We intend to develop prototypes of smart wards integrated with smart logistics for what we hope will be hospitals of the future.  In line with the shift beyond hospitals to community, we will also look into robotics-assisted home care. To ensure strategic focus, MOH has designated the Centre for Healthcare Assistive & Robotics Technology (CHART) to take the lead in this area of work. IHiS will support CHART and institutions in the technology enablement. This includes the development of a standardised healthcare robotics framework.

Recognising Excellence in Healthcare IT

21.       Technology is now transforming healthcare in ways that were unimaginable as recently as a decade ago.  We must ride on this digital healthcare revolution by going digital intelligently, using data effectively and disrupting meaningfully.  In embarking on our journey, we will need to take on some coordinated large-scale initiatives as well as support ground-up efforts.  I am pleased to see both types of work among the winning projects. 

22.       I would like to congratulate all our award winners.  I hope to see many more next year, including worthy winners in the healthcare to health category.  Let me now conclude by thanking all of you for your contributions to our healthcare system, our digital health journey and the citizens that we serve. 

23.       Thank you.  And have an enjoyable morning.