Exclusive: How Singapore Health uses AI to track its elderly care

By Medha Basu and Nurfilzah Rohaidi

Interview with Bruce Liang, CEO of Singapore’s technology agency for healthcare IHiS.

Bruce Liang speaking at the National Health IT Summit. Image: Integrated Health Information Systems (IHiS)

Across Singapore, healthcare providers are using cutting-edge tech to cope with a manpower shortage. Tan Tock Seng Hospital built an ‘artificial brain’ to manage 1,700 beds. The upcoming Woodlands Health Campus will be a “pioneer” in the use of tech for patient care. And one day, Changi General Hospital’s robotics research may even lead to robot bedside nurses.

Underpinning these developments is Singapore’s health IT provider, Integrated Health Information Systems (IHiS). The next step, says CEO Bruce Liang, is to use AI to see whether these new technologies are making a difference in the quality of care.

“The Ministry of Health is forking out funding to the hospital, the home programmes, preventive care programmes, and so on. How do we know we are actually doing well in those?” Liang points out. He adds that there will be “quite a fair bit of analytics involved” in looking at “cause and effect”.

The BRAIN behind it all

Over the next few years, Singapore’s health ministry is going to transform the healthcare system in three major ways, it was announced. Broadly, the ministry wants to help Singaporeans to lead healthier lives, enable Singaporeans to receive appropriate care closer to home, and give every Singaporean best value in care while keeping the system sustainable.
“Performance analytics” will help the Ministry to better gauge the effectiveness of their efforts in these areas, Liang explains. Healthcare is currently both a knowledge-intensive and labour-intensive industry, Liang says, so “technologies including AI can play a very big part in changing that”.

AI will also be used in “disease-specific strategies” where the ministry will zoom in on, say, “the war on diabetes”, Liang says. “We’re embarking on a national diabetes database [project] and that comes with a wide range of analytics, including predictive modelling to identify diabetic patients for early intervention programmes, support research to design improved care pathways for different cohorts of patients, and more.”
“We’re embarking on a national diabetes database [project] and that comes with a wide range of analytics.”
To support the three shifts in healthcare, IHiS has developed several platforms for health data collection and analysis. One of the platforms that IHiS developed, the Business Research Analytics Insights Network (BRAIN), allows IHiS to “pull a lot of information together from disparate sources more speedily for all sorts of profiling needs”, says Liang.

In the case of diabetes, BRAIN will allow the health ministry to figure out those people most at risk of developing the condition, and intervene with preventive measures. “For those who are at risk, what are the intervention strategies like? There’s a fair bit of machine learning in that space,” Liang says.

BRAIN will also display the demographic information of these diabetics, Liang adds. “Based on where they are located - that’s where the service capacity planning comes in - we know where to [locate] our facilities”.

There will also be a focus on smart wards, which will be manned by assistive robots. These robots could help patients with “all sorts of rehabilitation” to get them back to fighting shape as soon as possible. “That will be the main thing to regain body functions,” Liang says. “Rehabilitation can be a very high intensive, manpower-intensive thing if you don’t design the service properly,” he adds.

Profiling the population

But first, the ministry will build up a “foundation” of “population profiling” data, says Liang. IHiS platforms will link healthcare and non-healthcare data sources, and analyse all of that data to build a comprehensive, multi-faceted profile of the population for better decision-making.

Factors such as lifestyle and socioeconomic status can have a bearing on people’s health, and will be taken into account, Liang explains. “Profiling answers two kinds of questions: one, who needs what kind of help? Two, what is the appropriate intervention?” he says. “The intent is to look at multi-dimensional data.”

To carry out the health ministry’s objectives, IHiS will work with the local tech industry, according to Liang. “We’re trying to solve new problems collectively,” Liang says. IHiS will provide industry players with opportunities to come up with their own solutions to “problem statements”.
“We’re trying to solve new problems collectively.”
How will this work in practice? Social media companies are a good example: “If you tell them, ‘how could I have early intervention for those people who might be depressed’, those guys may have a way to tell these things,” Liang explains.

It is “not easy” to be able to work with healthcare systems of a country, Liang notes, and industry players could benefit from such a partnership. “The essential thing that we try to tell them is this: we are trying to solve new problems in healthcare, and IHiS can be the bridge between them and the healthcare system,” he adds.

Boosting startups

Working with IHiS could also allow smaller companies to ‘scale up’, particularly in a small market like Singapore. “The biggest problem for private guys trying to work with healthcare is that they can’t get the scale, then they cannot sustain, then they close their business,” Liang says.

Market failure affects the healthcare system as a whole. Liang shares the example of a company that sold tech solutions to hundreds of general practitioner clinics, and then folded — leaving those clinics stranded. “Some of [the GPs] said ‘I will never go back to technology again’. Then, we lose the opportunity to digitise,” he remarks.

AI is likely to be an integral part of Singapore’s healthcare landscape in the future, just as much by a patient’s bedside as behind the scenes, ensuring that things run smoothly.