Taskforce On Strengthening Outbreak Detection And Response Completes Its Review

1.    The Taskforce on Strengthening Outbreak Detection and Response, led by Minister of State for Health Mr Chee Hong Tat, has submitted its report to the Minister for Health. Please refer to Annex A for the list of Taskforce members.

2.    In March 2016, the Ministry of Health (MOH) had accepted and implemented some of the Taskforce’s initial recommendations. These include the setting up of a National Outbreak Response Team; a review of the list of notifiable diseases under the Infectious Diseases Act; as well as improvements to the modes of notification, timelines and escalation process.

3.     In conducting its review, the Taskforce consulted healthcare professionals from public and private institutions. It also sought inputs from resource persons from academia and government agencies, and adapted best practices from overseas jurisdictions. MOH would like to thank the members of the Taskforce and stakeholders who provided suggestions and feedback for the review. 

Recommendations

4.    The Taskforce has come up with 15 recommendations under the following five key areas. Please refer to Annex B for details.

I) Improve information gathering on infectious disease threats

5.    The Taskforce recommended that surveillance could be strengthened through improving the comprehensiveness of information gathered for infectious diseases. MOH will expand the list of notifiable infectious diseases from the current 43 to include six additional diseases (see Annex C). These will complement the surveillance programmes of public health partner agencies, the National Environment Agency (NEA) and the Agri-Food and Veterinary Authority of Singapore (AVA).

6.    To facilitate earlier detection of outbreaks, the Taskforce recommended setting up an enhanced surveillance system to extract test results related to infectious disease data from laboratories. Laboratory reporting of positive diagnostic test results to MOH will also be automated, to simplify the reporting process and improve data analysis.

II) Make notification of cases and reporting of incidents more user-friendly

7.    The Taskforce recommended making the notification of cases and reporting of incidents more user-friendly, to facilitate timely reporting and reduce the administrative burden for healthcare workers. MOH has modified its processes to allow doctors to notify MOH via multiple modes (e.g. online, fax, phone) to best suit the workflow of their clinical practice. Doctors will notify MOH of each case only once, without having to duplicate the notification from laboratories. To encourage a culture of open reporting, MOH will put in place a system to accept anonymous reports of infectious disease outbreaks and incidents from healthcare professionals.

8.    MOH will also leverage information technology systems to facilitate infectious disease reporting, including the use of system prompts built into daily workflows and linked databases that allow for auto-population of data fields.

III) Enhance data sharing and analytic capabilities to improve detection and response to outbreaks

9.    The Taskforce recommended that MOH enhance its data analytic capabilities to monitor the local infectious disease situation, detect abnormalities and trigger alerts. This includes the surveillance of disease syndromes that can help pick up cases of new and unfamiliar diseases. Physicians in the front line will continue to play a critical role in recognising symptoms and surfacing unusual trends.

10.    MOH will consolidate data from different sources and design the IT system to trigger warnings if there are abnormalities detected. This will facilitate timely investigations and response to emerging infectious clusters.

11.    MOH has accepted the Taskforce’s recommendation to share the aggregate data which it has collected with healthcare institutions, with appropriate safeguards to protect data confidentiality. This two-way information flow will help to improve surveillance and early detection, enhance situational awareness across institutions, and encourage sharing within the healthcare system for better infection prevention and control. This will be supported by partnerships and informal networks between MOH and the wider healthcare community.

IV)    Establish clear accountability in MOH to integrate infectious disease information and to deal with outbreaks

12.    The Communicable Diseases Division (CDD) has been designated as the clearinghouse within MOH that is responsible for overseeing surveillance of all infectious diseases and outbreak reporting. MOH will strengthen CDD’s resources to deal with an increasingly connected and complex environment, with emerging infectious diseases spreading across borders, and through animals and food.

13.    MOH will implement the Taskforce’s recommendation to strengthen our operations centre and enhance the framework for assessment and classification of incidents to enable timely escalation and decision-making, taking into consideration the severity and impact of different infectious diseases.

V) Strengthen local, regional and national outbreak response capabilities

14.    MOH will work with healthcare institutions to strengthen local capabilities for infection control and outbreak response. We will implement platforms to encourage inter-institutional learning, including peer reviews and collaboration with academia and research institutions. We will develop capabilities within the Regional Health Systems to respond to and control outbreaks within their areas, including in community facilities beyond acute hospitals. 

15.    To strengthen our ability to respond to serious incidents, MOH has set up a National Outbreak Response Teamin March 2016 to augment efforts to deal with major infectious diseases. The team will include representatives from our partner agencies like NEA and AVA. 

16.    These efforts will complement the establishment of the National Centre of Infectious Diseases in 2018 to further enhance national-level capabilities in the surveillance, diagnosis and management of infectious diseases.

MINISTRY OF HEALTH

8 JULY 2016

• Annex A [PDF, 9KB]

• Annex B [PDF, 45KB]

• Annex C [PDF, 10KB]