International Healthcare Facilities Exhibition and Conference 2006

31 Aug 2006

By Dr Balaji Sadasivan, Senior Minister of State

Venue: Singapore Expo

Distinguished Guests

Ladies and Gentlemen

Good Morning

Introduction

When I saw that the theme of this conference is "To be an International Healthcare Provider of Choice" with the tagline "Integrating New Knowledge, Enabling New Technologies", I thought of the many ways knowledge and IT can interact to determine the success of a hospital aspiring to be an International healthcare provider of choice.

To be a successful international healthcare provider, you need to be a hospital of international repute. Even the reputation and standing of your hospital among taxi-drivers is important. As most of you know, Singapore taxi-drivers are friendly and when you strike a conversation with them, they often will give you their opinion on many issues - including health advice and opinions on hospitals, doctors and healthcare cost. Even if you don't go around repeating the taxi-drivers opinion on hospitals and doctors, they are important opinion multipliers, because in the course of their working day, they may ferry 20-50 people around. These 20 to 50 persons are a captive audience to the taxi-driver's opinions.

Earlier this year, out of the blue, a surgeon in Los Angeles received an invitation from the Singapore Surgical Society to give a talk at its annual meeting. This was his first trip and the flight attendants on Singapore airlines made a positive impression on him. From the airport, he hopped into a taxi to get to his hotel. When the taxi-driver found out that he was a surgeon, the taxi-driver gave his opinion on surgical matters. When the taxi passed by a hospital, he told the surgeon "You can have a great hernia operation in there for $600." Curious, the surgeon asked "What makes a hernia repair great?" The taxi-driver replied "They don't have many infections and the hernia does not come back like in the other hospital. Six hundred dollars is not the lowest price but it is fair for what you get. You get charged extra if you stay overnight and anesthesia is extra." The taxi-driver also gave the surgeon an over-view of the healthcare system in Singapore.

I have not met the surgeon or the taxi driver. How did I know about the conversation between the two? Well, the surgeon, Dr Crossman wrote about it in July on the website -  www.generalsurgerynews.com. I and thousands of others are now aware about the taxi-drivers advice on hernia operations in Singapore hospitals. This is of how knowledge and technology interact today. Where previously a taxi-driver was only a limited opinion multiplier, the technology of the internet era is able to multiply its effect a thousand fold

Dr Crossman was not sure if the taxidriver's information was accurate. The movement he left the taxi and got to his hotel, he checked the internet about Singapore healthcare. He found that the information the taxi-driver provided was indeed accurate. This is another example of how knowledge and information technology converge. When anyone needs information or needs to check the veracity of a particular piece of knowledge, it is now the norm to turn to the internet and google the topic. Hospitals can expect international patients to come armed with knowledge acquired by googling their disease on the internet.

Around the world, governments and healthcare providers are awakening to the vast possibilities that advancements in IT can bring to the advancement of healthcare. So are the software companies. Attracted by the yet untapped potential of fully exploiting IT in an expanding healthcare services pie, many major software companies have taken the plunge to strike collaborations with hospitals and healthcare service providers in the hope of fusing the art of medicine with the science of IT.

Healthcare IT and Clinical Quality

Many US hospitals have already taken the lead to invest and discover how IT can transform their service delivery and create better value for their patients. Last year, the Hospitals and Health Networks magazine published its benchmarking study on the "100 Most Wired" list of US hospitals. The study found that the "100 Most Wired" hospitals have on average, risk-justed mortality rates that are 7.2% lower than other hospitals.

The indisputable conclusion from this study was that hospitals which recognised and took steps to exploit IT usually score better on clinical quality. In drawing the connection, the CIOs and Chief Medical Officers reckoned that, "to be effective, the adoption of information technology must be combined with clinical process improvements and a culture of safety". In short, technology is an integral component of any drive to improve clinical quality.

The Promise of Untapped Potential

IT investments have delivered much value in many other industries and sectors, including very information-rich sectors such as the Finance and Banking sector. The healthcare sector is also another information-rich sector which holds out similar promise, where much potential is just waiting to be unleashed.

Among the many exciting possibilities are:

• e-enabled patient services at the business office,

• electronic patient and medical records,

• clinician and physician order entry systems,

• clinical decision-support systems,

• telemedicine and teleradiology,

• and logistics and inventory management systems.

• No Shortcuts for Technology Trailblazers

For all the promise that using IT in healthcare holds, there are currently no shortcuts to reap easy rewards. Nevertheless, an exciting journey of discovery, learning and change awaits those who would take the first step to bring IT into their healthcare settings.

Win-Win Collaboration between Technology and Healthcare Providers

It is in this spirit that IDA issued a Call for Collaboration on the theme of "Enabling a Patient-Centred and Hassle-Free Healthcare Delivery System" earlier this year. The purpose is to bring together healthcare providers and technology providers to integrate their knowledge so as to develop and launch innovative solutions and products that would improve healthcare quality and create efficiencies in operations and processes. A total of 12 projects were awarded. One of the projects was a pilot targeted at improving patient care and safety through the use of wireless measurement of critical vital signs and wireless fall detection devices. In another pilot project, nursing workflow and patient identification are automated through RFID technology. Another project will have high-risk cardiac patients monitored continually for abnormal signs at home after discharge from hospital via a portable wireless heart monitoring patch.

Other pilot projects seek to improve nursing effectiveness and productivity through automated wireless monitoring of patients' vital signs in the wards, and better operating theatre scheduling to improve facilities utilisation and patient waiting times.

The Healthcare Ecosystem - Global and Local

Technology has globalised the knowledge industry and removed the traditional barriers put up by nations. In this new eco-system,it is possible now to overcome shortages in expertise and put the lid on rising costs through outsourcing. For eg: the National Healthcare Group has successfully launched teleradiology with radiologists in India reading X-rays.

General Practitioners - The Next Frontier

Within Singapore, the drive to develop a patient-centric healthcare system and the emphasis on preventive primary care has created the need to draw family physicians closer and closer into the healthcare ecosystem. GPs serve 80% of the primary healthcare market. They have a pivotal role in preventive care as well as in the management of chronic diseases. The extension of Medisave use at GP clinics for selected chronic diseases will require the exchange of data and information between GPs and other partners in the healthcare ecosystem - such as the public hospitals, Central Provident Fund (CPF) Board, and Ministry of Health. It will be practically impossible to manage without the support of IT linkages and systems. As key members of the healthcare system, GPs must to be plugged into Healthcare IT networks.

For GPs to participate more effectively in the care of patients within the healthcare ecosystem, it will be necessary to accelerate IT adoption among GPs. IDA is working with leading Application Service Providers to provide Clinic Management Systems (CMS) to GPs on a subscription basis, and therefore allow GPs to plug into IT networks without having to make heavy capital investments. This is part of an IT programme announced by IDA today to enable GPs to go electronic.

The CMS promises to allow GPs to work seamlessly in an integrated and coordinated manner with other hospitals and step-down care providers. Aligned to MOH's Chronic Disease Management programme, the CMS will help GPs to capture clinical indicators required for the monitoring of the patients' progress, improve treatment efficacy, and make Medisave claims. The CMS will also create value for GPs through various eServices facilitating mandatory reporting to MOH of cases of infectious diseases, immunisation reporting to the Health Promotion Board, and access to patients' allergies and medical alerts. The aim is to have more than 1000 clinics using the CMS.

Closing Remarks

Whether it is on the global stage or in the small office of the independent GP, all healthcare providers should aspire to provide better patient care at greater convenience, greater patient safety, better clinical outcomes, lower operating costs, greater operating efficiencies and greater productivity.

The forging of a more closely knitted healthcare ecosystem calls for the integration of knowledge - foremost about the patient, but not least also about other units in our healthcare work settings and other partners in healthcare - wherever they may be - to ensure better coordination and shared benefits. There are no shortcuts to enabling new technologies. Instead, it is an exciting journey of courtship to marry technology and healthcare delivery services in order to bring out the best in both of them. Finally, when it comes to being an International Healthcare Provider of Choice - we must remember always that it is the patient who makes the choice.