During the 2003 SARS epidemic, Singapore brought in the military to build an operations centre to analyse data, dramatically improving its response to the epidemic.

The government has been reshaping its healthtech since, and just a few weeks before the coronavirus arrived in Singapore, it had launched a dedicated facility to coordinate responses to healthcare emergencies. This is run by Tan Tock Seng Hospital (TTSH), and supports the National Centre for Infectious Disease (NCID).

The two facilities have attended to 70 per cent of all confirmed and suspected Covid-19 cases on the island. “The key success factor in our outbreak responses lies in our ability to communicate and coordinate hospital-wide operations, based on timely data from across multiple systems and the frontline,” Dr Jamie Mervyn Lim, Chief Operating Officer, TTSH tells GovInsider.

The tech

At NCID’s Covid screening centre, every movement is recorded for contact tracing. All staff, patients and equipment are tagged with real-time location sensors. “This allows us to constantly monitor and facilitate load balancing, as well as ensure staff and patient safety through contact tracing,” says Bruce Liang, CEO of IHIS – Singapore’s public health tech agency.

The sensors record any extended interaction between patients and staff, he says, ensuring that they meet safety protocols. For instance, the tags beep to remind staff if they do not sanitise their hands after interacting with a patient. “An alert will also be triggered when patients and staff move from high-risk to low-risk areas,” he adds.

The centre uses data and AI to predict bottlenecks, Liang says. Analytics predict the discharge of Covid-19 patients, and daily and hourly arrivals of non-Covid patients. “This has helped TTSH to adjust our manpower distribution accordingly when the need arises,” Liang says.

The hospital has also used analytics to ensure a supply of personal protective equipment and Covid-19 medication. The command centre “computes the rate of issuing these consumables and medication to predict when to trigger for new supplies”, he adds. At the screening centre, it also monitors the volume of lab and radiology tests to track waiting times for results.

Videos have been critical to ensuring facilities are not overcrowded and safe distances are maintained. Feeds from CCTVs are being analysed to count the number of people in the hospital. The team plans to use video further to do contact tracing with image recognition, and limit contamination areas. “Covid-19 is an example of why video analytics are important,” Liang says.

Brain of the hospital

The disease response system is part of a wider effort to manage and automate hospitals in Singapore with a “command and control centre” (C3). It “allows us to automate admission, bed allocation and discharge workflows, and identify the location of patients”, says Lim, TTSH’s Chief Operating Officer. For instance, only two to three people are now needed to monitor over 2,000 beds across both TTSH and NCID, at any given time.

The command centre is the first of its kind in the world, he says. “Today, there is no such command and control centre in any healthcare facility worldwide. As the ‘brain’ of our hospital, [the centre] aims to be a smart system of systems that can sense, think and respond to optimise patient flow and care delivery.”

For instance, it helped the hospital and screening centre cope with a sudden surge in cases in early February, primarily due to a change in case definitions. “Through the data pooled from CCTV footage and real-time location sensors, the Operations Command Centre was alerted to the surge, before the ground team activated reinforcements,” Lim says. It deployed people and equipment to open up five more wards and increase support at the screening centre.

In the future, the command centre will anticipate workload in other critical parts of the hospital, like the emergency department which usually admits 90 per cent of the hospital’s patients. “Over time, C3 will also incorporate machine learning and predictive analytics to ensure better proactive actions and forward planning rather than taking reactive measures,” says Lim.

Singapore’s epidemics tech has been immediately put to the test just as it was launched. Sensors, analytics and videos have allowed healthcare officials to quickly adapt even at the height of the pandemic.