Speech by Dr Amy Khor, Senior Minister of State (Health), at the Healthcare Infrastructure Technology & Engineering Conference (HI•TEC), 28 Oct 2014

Distinguished Guests

Ladies and Gentlemen

Good morning. I am delighted to join you today at the third Healthcare Infrastructure Technology & Engineering Conference (HI.TEC).

2.            Many countries, including Singapore, are facing a rapid increase in healthcare demand brought about by the emergence of chronic diseases and ageing populations. In Singapore, we expect to have over 900,000 seniors by 2030. This translates to about one in five residents over the age of 65 – a two fold increase from today’s numbers.

3.            Maintaining a sustainable healthcare ecosystem that balances affordability, accessibility and good quality healthcare in the face of increasing demand is not a simple undertaking. Singapore has been steadily implementing a series of measures to ensure that the healthcare needs of our residents are well taken care of. Earlier this year, we accepted all recommendations of the Medishield Life Review Committee on the design of the Medishield Life scheme. The introduction of Medishield Life in 2015 will be a major step in our efforts to build a strong and sustainable social safety net.  We continue to build on our Healthy Living Masterplan so that we can live healthy lives in the workplace, schools, and in our communities. A few years ago, we also embarked upon the Healthcare 2020 plan to build up the capacity of the health care sector so that there are sufficient healthcare services to meet needs. 

Developing capacity in different care sectors

4.            Under Healthcare 2020, we are strengthening healthcare service capacity not just at the acute hospital setting but in the intermediate, long-term care and primary care sectors, to complement services in the acute sector.This is meant to facilitate the placement of patients in the right care setting, so that they can receive appropriate care.

5.            Each of the three new public general hospitals in the pipeline - Ng Teng Fong General Hospital, Sengkang General Hospital and Woodlands General Hospital - will be flanked by a community hospital to facilitate the transition of care from acute to sub-acute settings. We are ramping up our nursing home capacity, and expanding the number of day care centres and home care places. On primary care, we are building more publicly run polyclinics and expanding existing ones to meet the growing needs of our population. The government is also collaborating with the private sector to tap on the capacity there. In particular, the Community Health Assist Scheme (CHAS) and the Pioneer Generation Package (PGP) will ensure that our needy and our elderly continue to receive support for their healthcare bills even when they seek care from private General Practitioners, Family Medicine Clinics (FMCs) and Community Health Centres.

Future of Healthcare Infrastructure Excellence

6.            But with changing healthcare demands and priorities, the delivery of infrastructure projects has become increasingly complex.  As we plan and develop our new healthcare facilities, our challenge is two-fold – how do we build better and smarter facilities, but in a cost effective and sustainable manner? 

7.            We need to draw upon and analyse the learning and experience acquired after each project, and use this as a basis for further innovation. The Ministry of Health and MOH Holdings have already embarked on the innovation journey for all our upcoming healthcare projects. This will be shaped by three main thrusts:

a) Remodelling Design

b) Remaking Knowledge Sharing; and

c) Capitalising on Technology

Remodelling Design

(The use of Implementation Science Methodologies in Design Process)

8.            Firstly, healthcare facility design. Healthcare facilities must be designed so that they cater to changing patient profiles and needs.  They must also be able to support evolving models of care and not just current clinical practices, norms and guidelines. Lastly, they must facilitate smooth and efficient operations for healthcare staff – both frontline staff as well as the backroom support and administrative staff. Designing infrastructural “hardware” that is able to adapt to changes in the “software” of care models and the needs of patients and healthcare staff will help to ensure that facilities remain effective and relevant for a longer period of time. 

9.             I am therefore glad to note that MOHH will be incorporating an Implementation Science (IS) design approach to projects, by using ‘design thinking’ methodologies during the project conceptualisation phase to develop future space and design requirements.

10.         Some of the public healthcare clusters planning new facilities have already started to make use of such methodologies in the design process,   and have benefited considerably from the insights gained. For example, NHG Polyclinics has engaged Singapore Polytechnic to conduct a series of Envisioning Workshops to create a more holistic, patient-centred healthcare experience for patients. These workshops saw stakeholders involved in ‘design thinking’ activities such as role-plays, creation of mock-ups and models in order to simulate the journey of different patients so as to meet their specific needs in the new polyclinic. 

11.         From these early experiments, I am confident that as MOH systematically builds up capabilities and incorporates this approach for our forthcoming projects, our new healthcare facilities will be developed to be both patient-centric as well as staff-centric. 

Remaking Knowledge Sharing

(The use of C.A.S.E portal to enhance the project delivery process)

12.         Secondly, to promote knowledge sharing in local healthcare facilities designing, MOH and MOHH will be launching an integrated construction, information and asset management (namely Construction, Asset, Standard and Engineering Management System - C.A.S.E) portal to manage healthcare infrastructure projects.

13.         The web-based portal will enable our cluster teams and partners in project development to obtain information, carry out analysis and exchange ideas for both local and international healthcare facilities through an integrated system.  For example one of the key functions of C.A.S.E is to serve as a centralised document repository for tender and technical specifications, allowing project teams to have reference to reliable and updated specifications of past healthcare infrastructure projects.  This in turn will help project teams to define the project scope and expedite the preparation of tender documents. I have been informed that C.A.S.E will be launched in 2015 so do keep an eye out for it.

Capitalising on Technology

(The use of technology to increase productivity)

14.          Thirdly, technology is key to increasing productivity in healthcare infrastructure development.  Given the volume of healthcare projects in our pipeline, we can play a part in helping the industry build up its capabilities to deploy new construction technologies which will, in the end, help us build better and faster in a sustainable manner.  As such, we will be applying the use of productive technologies such as piloting the prefabricated prefinished volumetric construction (PPVC) system in a new nursing home project at Woodlands Crescent and multi-trade prefabrication of modularised assembled components like bathrooms, patient rooms, and exterior elements for some of the upcoming healthcare projects.

15.           We will also be accelerating our adoption and test bedding of new research and development ideas.  One of these is the adoption of the next generation of Building Information Modelling (BIM) system for healthcare developments through the use of cloud computing. BIM’s benefit lies not only in being able to allow predictive planning at very early stages of a project and management of as-built data for facilities, but also provides web services for integrating with other tools as well as links to GIS applications such as Google Earth. I understand that this is also a topic that will be further discussed at the conference.

Concluding Remarks

16.           At the heart of healthcare is the patient.  Executing our key priorities of accessibility, quality and affordability has always been done with the patient in mind. Hence, healthcare infrastructure needs to be constructed with consideration for functionality and flexibility. For long-term sustainability, we also have to ensure that facilities are practical and cost efficient. 

17.         I hope that this year’s HI.TEC will nurture cross fertilisation of ideas, facilitate learning to share best practices and encourage collaboration to bring the entire sector forward.

18.         I wish you a productive conference and hope to see you again next year.

19.         Thank you.