Speech by Dr Amy Khor at the Opening Ceremony of the Asia-Pacific Congress of Cardiovascular and Interventional Radiology (APCCVIR) 2014, 15 May 2014

Prof Shozo Hirota, President, Asia Pacific Society of Cardiovascular and Interventional Radiology

Prof Tan Bien Soo – Chairman, Organising Committee

Dr Chua Eu Tiong  – Vice-President, College of Radiologist Singapore

Dr Pua Uei – President, Singapore Radiological Society

Our Radiologists colleagues and friends from Singapore and around the world

1.            Good morning. It is indeed my pleasure to welcome you to the 11th Asia-Pacific Congress of Cardiovascular and Interventional Radiology Singapore (APCCVIR), held in conjunction with the 23rd Annual Scientific Meeting of the Singapore Radiological Society and College of Radiologists Singapore. I am pleased to join you in your academic activities today.

History and development of Radiology and Interventional Radiology

2.            X-rays were discovered almost 120 years ago. Together with ultrasonography and magnetic resonance, radiology is integral to our diagnostic capabilities to accurately diagnose disease conditions.

3.            In 1964, Dr Charles Dotter performed the first interventional radiology procedure for the dilation of a narrowed lower limb artery under x-ray guidance, now commonly known as angioplasty or “ballooning”. This pioneered a whole new modality of treatment for diseases.

4.            Since that ground-breaking procedure, the development of interventional radiology has expanded greatly. Many conditions, once done by open surgery, can now be managed using minimally invasive techniques. This has meant lower complication rates and shorter hospital stays, since many procedures could now be performed on an outpatient basis. This is particularly important for efficient use of healthcare services with better patient comfort.

Role of Interventional Radiology in Ageing Population

5.            Ageing is a global issue and the way we deliver healthcare needs to change.  Interventional radiology may have a greater role as it is a less invasive treatment for the elderly. I note that interventional radiology techniques are already being utilised to treat many conditions associated with ageing, such as opening up blocked blood vessels for patients with stroke and treating tumours of the lungs and liver. New treatment strategies, such as using balloon angioplasty or the injection of radioactive drugs directly into liver cancers are being studied, and I understand some of these developments and advances will be discussed in this conference. However, we should still be careful to select candidate patients wisely.

Controlling Healthcare Costs

6.            As Singapore’s population and that of the world age, healthcare costs would inevitably increase in part because of increasing prevalence of chronic diseases. It may also be attributed to partly improvements in technology. New technologies treat diseases that were once considered fatal, thus prolonging lives. Improvements in imaging studies and investigations allow doctors and patients to know beforehand what could possibly be wrong with their body, regardless of whether something can be done subsequent to detecting the abnormality. Also, increasingly more treatment might be instituted regardless of the necessity and evidence.

7.            My ministry has in place several measures to ensure that healthcare remains affordable to Singaporeans. The 3Ms are currently being reviewed with Medishield Life, amongst others, being proposed to protect patients against large bills for life. To ensure that the public has access to medications, rigorous reviews are conducted to ensure that those medications that are cost effective and essential for treatment are subsidised. For technologies such as medical devices and implants, MOH is also introducing health technology assessment to ensure they are cost-effective. MOH has in place a framework to assess new costly technologies, based on their track record in terms of treatment outcome and cost-effectiveness. Since 1 January this year, my Ministry has included interventional radiology procedures in the Table of Surgical Procedures, allowing for Medisave claims by patients undergoing these procedures.

8.            An article published last year in the Journal of the American College of Radiology^[1] described ways to improve efficiency without affecting patient care. This improves cost-effectiveness, ensuring optimised resource utilization while maintaining or improving clinical outcomes and quality of life.  As interventional radiologists continue to develop new treatment strategies there is a need to be responsible in ensuring that the most appropriate and cost effective diagnostic and interventional technologies are used to improve care and outcomes.

Our Radiologists

9.            I am most happy to learn that Singapore is internationally recognised in the field of Radiology. I note that Professor Lenny Tan from the National University Health System (NUHS) is the second Asian to be awarded the prestigious award of the Society of Interventional Radiology Gold Medal. Professor Lenny Tan, who was a former Dean of the Yong Loo Lin School of Medicine in National University of Singapore is a well-known interventional radiologist and teacher who has taught many medical students, doctors and radiologists.

10.         Professor Tan Bien Soo, from the Singapore General Hospital (SGH), who is also the Chairman of the Radiology Residency Advisory Committee, was honoured with the Cardiovascular and Interventional Radiology Society of Europe (CIRSE) Distinguished Fellowship Award. This award is a very high honour indeed and bestowed to Distinguished Fellows who have made exceptional contributions to the practice and science of Interventional Radiology. Dr Tan is the 3rd Asian radiologist to receive this award. I congratulate both “Professor Tans” who have achieved much in their specialty of Radiology.

11.         I am encouraged to see this spirit of excellence amongst our radiologists as they continue to share their experience to advance the field of Radiology as well as take part in the training of our next generation of specialists.

Conclusion

12.         Radiology is a rapidly evolving and exciting field of medicine. I am truly glad to see many of you come together to collaborate at this Congress, and to present and share your experiences in Interventional Radiology from the Asia-Pacific region and around the world. I note the numerous scientific papers and voluminous work and research presented over the next few days. I note that the organisers of this congress have chosen the theme ‘Inspiration’ for this event and know that you will be inspired to hone your skills and further develop your knowledge in such gatherings.

13.         Let me wish you all an enriching, knowledgeable, learning experience and for our overseas guests, don’t forget to enjoy this city and the sights and food of Singapore.

14.         Thank you.

[1] Prabhakar AM, Harvey HB, Wicky S, Hirsch JA, Thrall JH, Oklu R.What's brewing: how interventional radiologists can learn from the reinvention of Starbucks.J Am Coll Radiol. 2013 Aug;10(8):559-61.