Speech by Mr Chee Hong Tat, Minister of State for Health at the Opening of the Singapore Health and Biomedical Congress 2016, 23 September 2016

Professor Philip Choo, Group CEO, National Healthcare Group
Adjunct Assistant Professor Pua Uei, Chairman, Organising Committee, Singapore Health & Biomedical Congress 2016 

Ladies and gentlemen. 

           Good morning and welcome to this conference. I’m very happy to be here at the 14^th Singapore Health and Biomedical Congress (SHBC) 2016. I would first like to extend a warm welcome to our international speakers and our friends from overseas. Welcome to Singapore. The fact that over 2,500 delegates have congregated from all over the world is testament to the relevance and timeliness of this Congress.

2.        Earlier, Professor Philip Choo mentioned some of the challenges we face, including an ageing population and diabetes. There is a link between the two because as our population ages, the prevalence of diabetes, all else being equal, is expected to go up. We currently have more than 400,000 Singaporeans suffering from diabetes and studies predicted that by 2050, we would hit one million. But I am hoping very much that we will be able to do something together, as a society, with different partners working together, to be able to lower that number so that by 2050, we will not have so many people suffering from diabetes.

3.        But we have to accept that with an ageing population, our healthcare needs will go up because the elderly are more likely to have multiple chronic conditions. They are also more likely to be hospitalised, and more likely to require healthcare services. At the same time, factors such as our lifestyles, diets, exercise regime, whether you get enough sleep and rest, can contribute to a rise in chronic diseases such as hypertension and diabetes. Chronic diseases require lifelong management as opposed to dealing with episodic, acute treatments. These challenges of an ageing population will pose an increasing strain on our healthcare system. And with a finite amount of resources, we certainly cannot continue with business as usual.

4.        So we need to change our paradigms, we need to change the way we operate, and have a look at new ways of tackling these challenges. In addition to addressing practical day-to-day demands, we must also plan ahead to prepare ourselves, bearing in mind our longer-term goals that we want to have a sustainable and cost-effective healthcare system. It is important that if you want to have strong partnerships, these partnerships will have to be built on strong relationships. So I’m glad that the focus on this congress is on building a sustainable, relationship-based healthcare system.

Beyond Healthcare 2020

5.        Professor Choo also mentioned that MOH has announced plans for “Beyond Healthcare 2020” earlier this year. We want to be able to develop a healthcare system that provides accessible, affordable, and high quality care for all Singaporeans; and to be able to do so in a sustainable manner that will enable us to make the most of our healthcare resources, while achieving good health outcomes for our people.

6.        One of the things that we want to achieve is to be able to move beyond the hospital setting into the community. Earlier Professor Choo mentioned that we want to start looking after Singaporeans before they become our patients. I think that is important because prevention is better than cure. If we can help people stay healthy, if we can help people to avoid falling ill and coming to the hospital, that will be a good outcome for everyone.

7.        We also need to move beyond quality to focus on value-driven care so that we can have a sustainable system for all Singaporeans. We will need to place greater emphasis on establishing the cost-effectiveness of new drugs and treatment modalities and providing guidance to health professionals on the drugs and treatment which will provide greater value for the outcomes achieved. We want to assure our patients that they are getting treatment which is right for them and to treat the diseases and circumstances that they are facing. Very importantly, we want to move beyond healthcare to health, helping Singaporeans to stay healthy and reduce the downstream complications, including tackling chronic diseases like diabetes.

8.        Diabetes is a classic example of a chronic disease with modifiable risk factors that we can target for upstream prevention. At present, over 400,000 Singaporeans have diabetes. One in three amongst us is at risk of getting diabetes during our lifetimes. Diabetes is a serious issue because it is associated with an increased risk of potentially debilitating complications such as stroke, kidney disease and lower limb amputations. For these reasons, the Ministry of Health declared a ‘War on Diabetes’ earlier this year. In the coming days and months, we will be sharing more about our plans for the War on Diabetes.

9.        Today, I want to focus on two enablers that I believe will help support our War on Diabetes. The initiatives that I am going to talk about are not comprehensive solutions to the diabetes problem. But they represent two aspects of what we hope will contribute to the War on Diabetes. MOH, together with our healthcare clusters and healthcare professionals, will be rolling out further initiatives and announcing them over time. Today we will focus on two areas – Data and Research.

10.       First, on data. At the moment, we have a lot of data on diabetes, but they reside in multiple repositories within MOH and in individual healthcare institutions. The data is not well connected and it is difficult to make good use of it. Because the data is not well connected, it is difficult to get a full picture, and the value that we can extract from the data is limited. The National Electronic Health Records (NEHR) system allows our clinicians to view patients’ records across different institutions, but this can only be seen at the individual patient level. We need to move beyond this and allow the data to be collected and analysed so that we are able to use the information at an aggregate level to do planning and research. For example, the data could give us a geographic view of where different groups among our patients are, and where they seek care and treatment. With data, we can be more proactive in prevention and prediction. Data is therefore an important enabler. As part of the War on Diabetes, we want to work together with different institutions to bring together our databases and tap on the tremendous potential offered by big data to derive new insights and gain a more in-depth understanding of the diabetes situation.

11.       I am happy to announce that MOH will be developing a National Diabetes Database. This Database will consolidate data from multiple different sources, including existing databases in our healthcare institutions, so that we can make the best possible use of our data. We will layer on data analytics capabilities to ensure that users are able to carry out analysis that will suit their needs. This can be for planning, prevention or research purposes. Data from the National Diabetes Database will also be extracted into different dashboards, which will allow users to visualise the data in a user-friendly way.

12.       For example, our Regional Health Systems (RHSs) may use aggregated data for larger scale planning of outreach programmes. A lot of people have diabetes but are unaware of their condition. Screening and outreach therefore are an important part of the War on Diabetes. With data, we are better able to reach out to our targeted audience. Clinicians may have a dashboard that shows more specific information about their patients, such as risk profile for developing diabetes-related complications. We will work closely with our healthcare professionals and institutions to see how we can best design these systems.

13.       Going forward, I think it is also important for us to make good use of the data by making it available to our researchers and other parties conducting research studies on diabetes because we want to foster greater collaboration and partnership. Through the use of appropriate controls and safeguards, we can preserve data confidentiality while allowing the data to be shared and used in a manner that will extract maximum value. Through this, we hope to engender shared ownership by multiple stakeholders in the War on Diabetes.

Building up Research Capabilities and Collaborations

14.       A second important area is research. We have many clinicians and researchers in the audience and we would like to work together with you to be able to explore better ways to do things and come up with new innovations, and try out new technologies and methods so that we can assess whether these methods are effective. 

15.       To do this, we need to support and encourage collaboration between academia and healthcare providers.  I am glad to see that the collaborative relationship between NHG and the Nanyang Technological University (NTU) Lee Kong Chian (LKC) School of Medicine has strengthened over the years. NHG has been the primary clinical training partner for LKC School of Medicine since 2010. Since then, the partnership has grown beyond undergraduate medical training to support various areas of research and development. I am therefore happy to announce that NHG and LKC Medicine are entering into two Memoranda of Understanding (MOUs) in the area of research. 

16.       The first MOU covers the formation of the Centre for Primary Health Care Research and Innovation. Our polyclinics, family medicine clinics and GPs are the first line of care for our population.  We need to also establish a strong relationship between our primary care providers and their patients, so that they can help their patients to achieve better health outcomes.  It is timely that the Centre will undertake research in the important areas of chronic disease management, including the evaluation of new technologies, and how to empower patients.

17.       The second MOU marks the establishment of the Games for Health Innovations Centre or ALIVE. Games are used in many industries, including education or defence for training and skills enhancement. In healthcare, games can motivate users to take greater ownership of their health by making the pursuit of wellness fun. I have visited nursing homes and community hospitals, and I had a chat with some of the patients who are doing rehab exercises using games. It is a way of making the exercises more fun while allowing them to achieve good health outcomes. Games are also a way to empower patients to be active participants in their care, and help them to make lifestyle changes such as diet modification, or follow an exercise regime. ALIVE will be a translational research centre within Singapore’s serious games eco-system that will enable stakeholders to harness game science, technology and gamification to solve real world problems. 

18.       These two platforms bring together healthcare, technology and engineering experts to help us create workable solutions for better care at all levels.  Beyond these examples, I am sure there are many more ideas in the pipeline. I would like to urge our healthcare leaders and providers to design and develop these ideas, and implement them well. We need to look at not just what is happening within our own healthcare system but to also look at other sectors, which can offer interesting perspectives and ideas that can help us. We can also learn from our friends and partners from overseas because there are many good ideas that are being implemented in other countries and we don’t have to reinvent the wheel. I am very happy that we have many overseas experts here to share with us their best practices, and we can also share with them what we have already done in Singapore so that the learning can benefit everyone.

Conclusion

19.       To conclude, we know that change takes time. To make these changes to the healthcare system, we need to do it in a manner that is sustainable and beneficial to our patients. This is topmost priority for MOH and all our healthcare workers, something which we think about day in day out, to look for better ways of doing things so that we can deliver a sustainable healthcare system for all Singaporeans.

20.       I wish you a successful conference and hope that all of you will make the best of these opportunities to meet, share, and learn from one another to shape the future of healthcare. 

Thank you.