Chen Li, Senior Nurse Manager, Tan Tock Seng Hospital, Singapore

How do you use technology/policy to improve citizens’ lives? Tell us about your role or organisation.

At TTSH, we believe the future hospital is one without walls, where care follows the patient after discharge and the hospital is responsible for the health of the population it serves. Digitalisation is at the heart of this transformation.
We strive to provide care anytime, anywhere. In recent years, we have incorporated technology in nursing practice to provide safe and effective care to our hospitalised patients as well as to improve work efficiency. Two key systems that our nurses deployed are:

1. SmartSense system – it uses Radio-Frequency Identification (RFID) technology to track real time patient location, and provide non-intrusive continuous body temperature monitoring via a RFID tag. It facilitates more efficient bed allocation and patient flow, improves clinical management through real time temperature monitoring for clinical decision making, and reduces nursing time in taking and charting temperature manually.

2. PreSAGE system – It uses thermal imaging sensors to provide highly accurate object recognition and Artificial Intelligence (AI) techniques to predict movement in order to effectively predict falls.

Other technologies (examples include assisted bed mover, auto bed turner and assisted shower bath) aim to reduce mundane tasks that nurses do. These help nurses to spend more time on value-added activities such as assisting post-operative patients to ambulate early.

In the years to come, we aim to develop a more integrated and connected care model that covers a patient's entire journey from home to hospital, and back to community.

For example, healthcare records of patients and patients-to-be will be readily available to allow smooth and timely flow of information between home, hospital and community. Another example would be using sensors and AI equipment that can pre-empt the care needed, so that earlier interventions can be done.

With technology, patients and caregivers will be empowered by technologies to make timely and real-time decisions anytime and anywhere. The patients and their caregivers will be equipped with the tools to allow them to learn about the conditions they are facing and be involved in the decision-making process.

Finally, we seek to continually introduce enabling technologies which would optimise cost and values for patients and staff in the care delivery and streamline processes.

I am working with a team of enthusiastic colleagues in exploring latest technologies and digital tools to develop the next-generation ward that provides care from pre-hospital, to hospital and back home.

What was the most impactful project you worked on this year?

It has to be Next Generation Electronic Medical record (NGEMR), which is set to go live in the 3rd quarter of next year at TTSH. NGEMR is a mega project which aims to review and harmonise diverse IT systems in Singapore to achieve one single consolidated system standardised for all healthcare institutions.

Through NGEMR, patient’s clinical data is stored digitally hence facilitating information sharing, care coordination and decision making. NGEMR is a key element of digitalization. I am part of the project team and had the opportunity to be involved in the system design and configuration.

What is one unexpected learning from 2020?

Covid-19 is unexpected in 2020. The whole nation reacted swiftly towards the changes, so did Tan Tock Seng Hospital. We opened new facilities and deployed new technologies with speed. Set up and training were conducted in a well-coordinated fashion.

In a crisis, the pace escalates, and we must adopt technology to remain efficient and effective. We have to be technologically prepared and have an open mind towards technology adoption in order to succeed.

What tool or technique particularly interests you for 2021?

One area would be patient assessment and communication technologies. Our team is working on the use of advanced contactless/wireless sensors to perform clinical monitoring such as heart rate, respiratory rate and temperature; as well as safety surveillance such as falls prediction and prevention and behaviour monitoring.

We envision this monitoring can be continued from hospital to home. Coupled with data analytics, it can help us to monitor patients in the community and predict the likelihood of a patient requiring hospitalisation, hence allowing us to render early interventions. Projects along this line will be my interest for 2021.

What are your priorities for 2021?

My priorities for 2021 will be NGEMR implementation and digital technology adoption in the wards.
NGEMR implementation involves many things. It includes getting the system ready, conducting testing, preparation of hardware, user training, etc.

One of the most exciting NGEMR implementations is a mobile application for nurses that provides not only medication administration at bedside, but also other functionalities, such as performing review of patient condition, completing documentation, and uploading wound images on-the-go from an encrypted mobile device. This is going to change the way nurses work on the ground. With improved mobility, it will bring greater efficiency as information is readily available.

Digital technology adoption involves collaborating with vendors to develop or deploy technologies that are relevant for care in the future. Importantly it also involves using technology to redesign care. I am working closely with IHIS (Singapore’s IT arm for healthcare) to ensure technologies and digital innovations are stackable and coherent as a whole.

What advice would you give to women looking to start a career in GovTech?

Digital transformation is exciting as it is more than just technology, it is about how we use technology for better people care. Nursing is a good starting point. Nurses are the primary users of healthcare technology and often deal with technology at first hand.

Thus, nurses play a vital role in deciding which aspects of the care can be delegated to technology and how technology can be leveraged to its full potential in augmenting high levels of care when it is delivered in person.

I believe High Tech can empower High Touch. Nurses are at the forefront in demonstrating this as caring and human touch are at the core of nursing. Nurses should be looking beyond rendering care to patients, but also on how to foster human connections with patients.

Write a message for your future self.

The future of healthcare will involve many advanced technologies, such as mobile technology, robotics, Artificial Intelligence, Virtual Reality and Augmented Reality. My goal is to familiarise with the latest development and make sense on how to best utilise them.

I see myself working hand-in-hand with technologies and healthcare providers in embracing healthcare technologies, ensuring human caring perspective is infused into technology and keeping nursing relevant in high tech environments.