The world marveled when China built a dedicated Covid-19 hospital in just one week. Could smaller nations ever hope to replicate this?
The answer is clearly yes – proving what can be done when government puts its mind to it.
Singapore has built two quarantine facilities to house recovering patients and those with milder symptoms.
One of these is at Expo, an exhibition venue which was converted into an isolation facility in five days. Tech has been crucial to allowing the facility to be up and running quickly, and operate with limited resources.
Here’s the inside story of how they did it.
The government deployed a multi-disciplinary team of 60 people, including tech engineers and clinical informaticians from IHIS, the Ministry of Health’s tech arm. “We have expertise we can tap on and formed a SWAT team very quickly to start off with the mobilisation and planning, as well as the configuration and deployment,” says team leader Hooi Ka Mei, Director of the Delivery Group at IHIS, speaking to GovInsider from the frontlines.
They worked 16-18 hours a day over five days to set up everything from WiFi, laptops and printers, to patient registration stations, and emergency buttons and remote monitoring devices in the wards.
The team had just two hours to set all of this up in the halls, with only minimal changes allowed once patients were inside. “We have to get things right, nailed down, and then the premise is locked down for incoming patients”. They worked with medical staff from the Woodlands Health Campus, which led the multi-agency effort, to design workflows around their needs, conduct user testing, and train them to use the tech. IHIS also worked with the Ministry of Health’s Office of Healthcare Transformation.
Rather than building from scratch, the IHIS team adapted software used in Singapore’s GP clinics to collect patient information. “The main crux of the system is what we call the GPconnect system to facilitate the medical team,” she adds. Staff use this to register incoming patients, triage them, track their vital signs, and enter and review clinical notes.
Crucially, this connects to the national electronic health records system so that doctors in other facilities can view a summary of patients’ medical history. If any isolated patients are transferred to another healthcare facility, the new medical teams would have access to their summary health record.
Monitoring vital signs
While the patients at these facilities don’t require extensive treatment, they do need to be closely monitored until they test negative. One of the most vital signs of Covid-19 patients’ health is the level of oxygen in their blood. “The oxygen saturation level typically starts declining before a patient begins to feel breathless,” IHIS says.
Hooi’s team has deployed remote monitoring kits that allow a medical team with “limited resources” to monitor the vital signs of hundreds of people. There were 450 patients within five days of opening on 10 April.
Patients are given “self-help” kits and telehealth kiosks with instructions to monitor their oxygen levels, blood pressure and temperature, and enter their own readings into a tablet three times a day. “The information gets sent to a dashboard, which the nurses are able to monitor,” Hooi says. They are alerted if any patient’s readings go beyond the healthy range and need to be attended to.
“It is not an ordinary frontline that we’re in.”
The number of cases in Singapore has tripled since the isolation facility opened at Expo, although it seems that the swift imposition of new measures is flattening an otherwise exponential curve. As of 19 April, there were a total of 6,588 cases, and 2,888 of these people are being cared for in the two isolation facilities. Two of the exhibition halls at Expo have been converted, and four others will be opened up progressively, the government has said.
Hooi has spent every day and night of the last two weeks in the isolation halls. She has lost track of time, she says, but feels a “great sense of pride” for the people she has worked with. “It is not an ordinary frontline that we’re in, I mean, sometimes having to be in the red zone.”
This virus is a test of many things – adaptability, social resilience, and whether institutions can act quickly enough to support their citizens. Singapore’s example shows how effective government is a force for good.
WHC was part of the multi-agency effort to plan and set up the Community Isolation Facilities at the D’Resort and Singapore Expo, as part of the nation’s efforts against COVID-19. We spoke to the team at the second Community Isolation Facility at Singapore Expo before it started receiving patients last week.
We are pleased to have collaborated with MOH, Temasek Holdings, Parkway Pantai, Singapore Expo, Surbana Jurong, Resorts World Sentosa, Certis CISCO, MOHT and IHiS on operationalising the Community Isolation Facility. We were also very fortunate to have volunteers from the private sector, Health Promotion Board, Singapore, National Skin Centre, Singapore, Institute of Mental Health Singapore and other agencies and organisations such as the The Singapore Army that have contributed manpower, equipment or resources to this massive effort.
Let’s stay united to overcome this challenge – do your part to fight the spread by staying home.
Posted by Woodlands Health Campus on Sunday, April 12, 2020