SPEECH BY MR EDWIN TONG, SENIOR MINISTER OF STATE, MINISTRY OF HEALTH, AT THE 10TH KKH SCIENTIFIC MEETING 2019

Professor Ivy Ng, Group CEO of SingHealth

Professor Terrance Chua, Group Chairman, Medical Board, SingHealth

Professor Alex Sia, CEO of KK Women’s and Children’s Hospital

Associate Professor Ng Kee Chong, Chairman Medical Board of KKH

Distinguished Guests

Ladies and gentlemen

Good morning.

1.      It is a real pleasure to join you here this morning at the 10^th KKH Scientific Meeting. It is appropriately themed “Patient-Centric Care – Precision Medicine and Personalised Care. The focus is very much on the patient. To be able to do that, we need to make sure that the care is personalised to the patient as far as possible. I think that is the new mile in medical care.

2.      I would like to take this opportunity to congratulate KK Women’s and Children’s Hospital (KKH) for the 10^th edition of this Scientific Meeting, it has been 10 years now, demonstrating not only your commitment to renew, to re-educate and to relearn but to really move towards improving healthcare. I am encouraged to see so many healthcare practitioners, professionals as well as administrators from KKH here today, as well as other SingHealth and public healthcare institutions and even GPs and private healthcare practitioners involved in this scientific meeting. It is in itself testament to the fact that there is no one size fits all in terms of delivering healthcare to the patient.

3.      This is the first scientific meeting in KKH, I am told, to weave in patient experiences by inviting patients to share their stories as part of the conference. I think that in itself, is testament to the theme of this meeting. Because if you say it is patient centric, then I think we must listen to the patient more closely and to understand what is it that the patient sees in the healthcare system and understand those experiences and take them on board. This year’s conference also focuses on the use of genomics and other omics technology, and its promise for the next lap in medical science, known as precision medicine - very special, targeted, curated type of treatment for each patient. The treatment given to each patient may not be the same, and cannot be the same for all patients.

Precision Medicine as an innovative approach to transform healthcare

4.      In Singapore, the demands of healthcare are changing fundamentally. It is significantly driven by the ageing profile of our demographic. Not only are we ageing, but it is important that we bear in mind that we are ageing very quickly, and the increase is very sharp over the next ten years. This no doubt will lead to an increased prevalence of chronic diseases and generating the need to take care of these patients. Healthcare delivery therefore needs to evolve to not only address these demands, the demands of the ageing population and demographic, but also be able to take on innovative approaches to wholly transform healthcare, and thereby mitigating costs. The healthcare budget cannot keep increasing. At some stage, it will become unsustainable. So we do need to evolve, transform, innovate, to manage healthcare costs.

5.      Precision medicine is one such innovative approach that really shows potential promises. By integrating individual and group variability in genes, environment, and lifestyle, Precision Medicine aims to predict disease risk, diagnose diseases, tailor therapies and reduce clinical complications. Responsible use of Precision Medicine has the potential to transform healthcare at so many different points, at so many different junctures, of the care pathway. These include reducing burdens of late-stage chronic disease through targeted prevention and health promotion, avoiding complications in individuals at risk of serious adverse reactions and accelerating definitive diagnosis of patients with serious genetic disease, thereby reducing diagnostic testing and also treatment costs.

6.      Genomics is a significant feature of Precision Medicine and the advancements made in genomics present many potential opportunities for the diagnosis and treatment of so many diseases. An example of this is demonstrated in the in-house genetic test developed by a multi-disciplinary team at KKH. The first of its kind in Singapore, the test aids in providing faster diagnosis of rare genetic diseases in critically ill children. While the typical turnaround time for a standard test takes minimally a few months, this test only takes 10 working days for patients to receive a diagnosis. I think you all understand that speed is often very crucial, so the difference between a few months and 10 days, could in some cases, really be life changing. The KKH team leveraged advancements in genomic sequencing and their deep knowledge and experience with the Asian gene pool. What we might experience in our Asian population may be different from the experiences from the other parts of the world. So it is important to collect the data, to look at it and to understand it, in the context of our local patients. This was done to improve the accuracy as well as the speed of diagnosis, thereby allowing the ICU teams to streamline and specially curate their management of these children.

Launch of SingHealth Duke-NUS Genomic Medicine Centre

7.      We hope that more of such advances can be made to benefit our patients. I am pleased today to launch the SingHealth Duke-NUS Academic Medical Centre’s new Genomic Medicine Centre today, which seeks to employ genomic testing and data in the hope of advancing care for patients and families with genetic diseases in a thoughtful and responsible manner.

8.      The SingHealth Duke-NUS Genomic Medicine Centre brings together two entities, PRISM as well as KKH Genetics Service. PRISM is a research institute which, besides focusing on research, serves as a clinical sandbox to implement clinical workflows in a research environment. The KKH Genetics Service is a clinical service focused on patient care and sees about 2,000 patients a year.

9.      Leveraging these entities’ areas of expertise, the new Genomic Medicine Centre aims to utilise genomic data to provide better clinical care for our local population. The Genomic Medicine Centre aims to achieve this goal by developing highly-specialised care for genetic conditions. The Centre will also work closely with the National Precision Medicine Programme to study and validate clinical pilots exploring areas where the use of genomic medicine would potentially improve value-based healthcare. This would then serve to inform long-term public health as well as policy decisions.

New Centre Streamlines Care Pathway and Enhances Patient Journey

10.     The new Genomic Medicine Centre will also boost genomic expertise and standardise clinical care pathways for genetic conditions, expanding across all specialties. The Centre will set up specialty genetics clinics within SingHealth’s hospitals and institutions where patients and family members can then undergo testing, risk assessment, genetic counselling by genomics-trained physicians and genetic counsellors. Patients and at-risk individuals no longer need to be referred to a different site for genetics services to consult a genomics-trained physician. At the same time, doctors will be able to receive their patients’ genetics reports from the clinics within their institution and customise care plans accordingly. This pathway is not only more efficient and streamlined, it will certainly enhance patient care and of course, ultimately, the patient experience.

11.     The Genomic Medicine Centre will also establish a SingHealth registry of all genetic disorders to help healthcare professionals understand genetic disease trends, treatment plans and patient outcomes. The more we have this data to look at, the more accurate we will be, and the more advancements we can make. Indeed, having a Singapore-specific database, will enable doctors and researchers to better understand how diseases affect our local populations. This will in turn help them develop potentially useful treatments that work better for the Singaporean patients. Additionally, the Centre will introduce genetics education for medical staff to equip them with the tools needed to use this genomic data in a responsible manner for patient care.

Closing

12.     In closing, I would like to say that it is clear that there is untapped potential in genomic medicine. I look forward to seeing the Centre’s progress in improving clinical care, research and education through the use of genomic data, which will enhance care outcomes for patients and family members, thereby fully achieving the goal of today’s scientific meeting - to put the patient at the centre of everything we do.

13.     I wish all of you a fruitful, successful meeting. I would like you to bear in mind that occasions like these are not just for you to listen to the speakers up here, but to also interact amongst each other, to share ideas, to explore new collaborations, and generally, foster camaraderie.  I think that is really the true purpose of this weekend and I wish all of you a truly pleasant weekend, one that is fulfilling and fruitful.

Thank you very much.