It was as recently as 2008 that nurses would lead cows through the wards of Singapore’s hospitals.
This was more hygienic than you might think. COWs were an acronym for “Computers on Wheels”, explains Dr Chong Yoke Sin, Singapore’s healthcare technology chief. This was the cutting-edge once, but how the times are changing.
Now, the city’s hospitals are trialling robotics, delivery drones and augmented reality for doctors. The work is led by a crack unit under the Ministry of Health Holdings company, called Integrated Health Information Systems (IHiS).
Dr Chong started out on this in a part-time role, but massive advances have seen the unit take responsibility for integrating all public health technology needs. The IHiS Chief Executive sat down with GovInsider to set out her priorities for the year ahead.
Internet of Things and Robots
Her first area of priority is to see how cutting-edge hardware can assist doctors. For example, IHiS is testing glasses for doctors to read patients’ records without screens in front of them. “A few doctors have already tried that”, and the feedback has been “great”, she says.
IHiS is also testing how drones can be used to transfer medicines and equipment within and between hospitals. “If there is an emergency evacuation, or some other dangerous situation, we can use the drone to dispatch [equipment] and come back,” Dr Chong says.
Hospitals in Singapore are already using robots in a “big way”, she adds, from transporting lab samples to packing drugs for patients. IHiS is testing new robots which could be directly involved in patient care. One robot is being used to turn patients over as they rest to avoid bed sores, while another can move patients from their beds to the toilet.
Another ongoing trial is using sensors in the homes of the elderly, especially those with chronic diseases. The key is that the Internet of Things “enables you to have continuous monitoring”, she say. For example, a sensor can track when someone opens or walks through the door. A sensor placed underneath a pill box can alert caregivers if the patient has not taken their pill.
More sensors provide more granular data, which can help doctors make better decisions. Dr Chong’s second priority is to make sense of all this data and use it to improve healthcare.
For example, IHiS is using analytics to improve daily operations in clinics, like reducing waiting times. “We have data that helps us find out which of our polyclinics are more populated than the others and why people are waiting,” she says. Clinics can then address those problems.
One problem could be that patients get lost, but data can tell clinics how to provide clearer information to visitors, she adds. “Are they asking the same questions again and again? This tells us we would need to improve the counter signage.”
Apps and the Shared Economy
The third priority for Dr Chong is apps. Most recently, IHiS built the new Health Hub app and portal with the Health Promotion Board, which give citizens access to their online health records for the first time.
The project started by releasing children’s dental and immunisation records, and their school health test results. The next phase will be to give caregivers access to the elderly’s health records.
Ultimately, it will give citizens access to all of their medical records across hospitals and clinics. “Over the years, we will be beefing up the Health Hub with more and more medical health records from the hospitals and the clinics”, Dr Chong says. What is significant here is that the scope of the project will continuously expand, as it increases the number of records and services.
Dr Chong is also testing a new idea for an app that matches patients’ needs with suppliers, borrowing from the transport sharing economy apps. “We have actually started an Uber for carers and for the people who need them – matching them with suppliers for wheelchairs and nurses,” she says.
The first such app will be to help patients who have suffered strokes. Such patients have to make major changes to their lifestyle, including finding a wheelchair, redesigning the home, a new diet and a person to care for them at home, she says.
A common theme runs through all of these innovations. Singapore wants to find new ways to care for an increasingly ageing population. The nation’s biggest challenge it to keep patients healthy for longer and defer hospital admissions for as long as possible, Dr Chong says. “To me, the most challenging thing is to keep everybody healthy.”
Computers on wheels, then, simply won’t cut it. The challenge is about using data to understand patient needs, and innovating like crazy. Dr Chong started advising hospitals part-time, but this full-time unit looks like it’s going to be needed more than ever.