How Singapore hospitals are using tech to keep in touch with patients

By Tian Jiao Lim

Interview with Asst Prof Eric Wong, group clinical informatics chief at Singapore’s National Healthcare Group.

Some illnesses can never be cured, but they can still be managed. Diabetes, high blood pressure, and even HIV can all be treated successfully but they require constant medical attention to prevent severe illness.

Traditionally patients must visit a clinic for regular appointments every few months, but much of this can be better managed with innovation.

At Singapore’s National Healthcare Group (NHG), Group Chief Clinical Informatics Officer Eric Wong’s team are augmenting traditional methods with tech to ensure easier lives for patients with chronic disease. He shares with GovInsider the lessons and opportunities that they have learned from this process.

Helping patients “own” their health

Wong’s team prioritised three big reforms. First, they wanted to enable patients to take ownership of their health. “We want our system to encourage our patients to participate in their journey of recovery as partners with our healthcare teams, instead of passively receiving instructions,” Wong says.

Enter the trusty smartphone. NHG plans for a “mobile-first engagement strategy” to provide personalised care between appointments. For instance, doctors could use a mobile app to prescribe “micro-services” educational materials or blood sugar monitoring. These reminders can encourage patients to practise better self-care and reduce the risk to their health.

‘Digital interventions’ such as these will be particularly useful for patients who require constant monitoring and long-term medication - for instance those with heart problems. “A regular clinic consultation typically lasts 10-20 minutes, after which patients are expected to follow the medical advice given for the next three to six months,” Wong tells us. Periodic digital reminders can bridge the gap between these consultations.

Many patients are increasingly tech savvy, with Apple Watches and Fitbits tracking everything from sleep cycles to decibel levels. “The increasing popularity of mobile devices has fundamentally changed how humans interact,” and healthcare institutions’ digital offerings need to keep pace, Wong says. Doctors should mirror the principles of social networks by ensuring the continuation of “our doctor-patient relationship even when they are not physically with us”.

Bringing convenience to patients

The second major reform is to improve patient experience - using tech to make things feel easier and better for the customer. “The primary focus of informatics should be to save time and cost for our patients,” Wong says.

NHG is using telehealth programmes to minimise the number of trips patients need to take between polyclinics, hospitals, and specialist centres when they consult specialists, Wong says. For example, when patients go to polyclinics to manage a skin condition, clinicians use a secure web-based platform to discuss their treatment options with dermatologists at the National Skin Centre. Patients with less complex skin conditions can then be managed on-site, saving them time and travel expenses.

Telehealth options have become even more important during the Covid-19 pandemic, as patients avoid non-essential outings. Responding to a “surge in demand”, most NHG departments are beginning to offer tele-consultations, Wong commented. This keeps healthcare “accessible” even in these extraordinary times.

Next, AI-powered chatbots are also helping NHG to respond to patients’ queries faster. Over the past year, NHG has piloted chatbots which can automate simple tasks, such as “logging [staff members’] temperature for temperature tracking, looking up phone numbers, and assisting with corporate information queries”.

An automated pharmacy system has also helped NHG to prescribe and dispense medicines more efficiently. At select pharmacies and hospitals, an automated system selects and packs the drugs required once medication orders are confirmed, delivering them to pharmacists at the front counter. This results in “shorter waiting time for medications by our patients,” Wong says.

Maximising data use

Behind the scenes, Singapore’s healthcare providers are also working hard to ensure that staff have access to comprehensive information when tending to patients. “All data collection and insights generation are pointless if they do not improve patient care,” Wong says.

[blockquote] “All data collection insights... are pointless if you they do not improve patient care” [/blockquote]
Singapore's public healthcare providers are set to integrate analytics frameworks into patients’ electronic medical records. A revamped medical records system — a joint effort between NHG and the Ministry of Health, Integrated Health Information Systems and National University Health Systems — is underway. Once complete, it will be linked to the NHG’s upcoming analytics engines and provide clinicians with “real-time” alerts and decision support prompts as they work.

The new medical records system will also help patients take charge of their healthcare experience, he says. Potential mobile apps could give them healthcare advice, as well as the option of electronic clinic check-ins, the ability to manage self-service appointments, and access to educational materials into the system, Wong adds.

Wong believes that healthcare is about to “transform itself fundamentally”. NHG is leading on this vision, bridging the gap between consultations, providing greater care, and ensuring a healthier population.