REALIZING THE PRODUCTIVITY - DR. CHONG YOKE SIN CEO, IHIS - AIC AGENCY FOR INTEGRATED CARE
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REALIZING the
PRODUCTIVITY
VALUE of IT in
Healthcare
Dr. Chong Yoke Sin
CEO, IHiS
Who We Are
IHiS architects and manages highly integrated award-winning
systems across Singapore’s public healthcare sector.
To lead and deliver
technology for
PASSION excellence in healthcare
TRUST & RESPECT
INTEGRITY
DYNAMISM
To be the trusted
INNOVATION technology partner
in healthcare
What We Do
1,200
Professionals
> 780
Systems and
Interfaces
supporting
40,000
Healthcare users
6 Clusters 1 Agency
9 Hospitals
8 National
Specialty Centres
18 Polyclinics
Our Systems
>70 Regional & Local
Awards 7mins only
for Pharmacists’ Review,
9 Singapore Public Healthcare
Institutions
from 51 mins
Closed Loop Medication
Management (CLMM) System
CGH Emergency Department (ED)
88 average
Real-Time Dashboard System
90%
waiting time
mins for 95%
of A&E
Automated robots pack
patients, drugs dispensed
30% faster
than before
23 minutes
Waiting time for up to
waiting
time mins 95% of NUH patients and
for urgent cases, 50% of TTSH patients
36% faster than before
Outpatient Pharmacy Automation System (OPAS)
Our Systems
Ageing in-Place (AIP) Program Lab Automation System
Remote post-discharge care
helped reduce readmission rates
from 150%
3.5 Increased capacity
times 1.3
times
to handle specimens
Faster turnaround time
For first OR 10,000 0.5 mins
to sort
45 mins
to complete all
400 patients more urgent tests at one time specimens urgent tests
IHiS Healthcare Cloud
Increased resiliency for IT systems
(H-Cloud)
99.99%
infrastructure availability
Reduced compute
provisioning time,
from 6-8 weeks to days
Supporting the National Agenda
• Changing the • StrengtheningBEYOND HC2020
• Standardizing
healthcare the links and
conversation between converging
• Addition of • Increased • Introduction between providers to wherever
new focus on of new patient and facilitate appropriate,
facilities and patient payment provider – seamless care be it processes
increased safety and health DEVELOP CULTIVATE
making the
TRANSFORM andPUBLIC- such as
capacity through insurance ONE PUBLIC
clinic visit but
HEALTHCARE information
PRIVATE procurement,
HEALTHCAR
process schemes one of DELIVERY
the ways transition
• Creation of
SECTOR Eservice
SYSTEM
improvements to get help, and PARTNERSHIPS delivery, IT
new service to reduce • Optimization • Opening up
notSINGAPORE
HEALTHCARE IN necessarily systems, to
offerings or errors and of healthcare avenues to
the best enjoy
extension of improve delivery new healthcare synergies and
existing ones
INCREASE IMPROVE
accuracy processes
ENHANCE • Providing the frontiers in economies of
into new
ACCESSIBILITY QUALITY that
AFFORDABILITY right support so primary, scale
locations • Information- encourage that people can community
driven savings in ensure their and home
• Improved strategies to the system own health care through
care promote now and for the collaborations
transitioning standards for future
and right data and
siting efforts workflows
HEALTHCARE 2020
REALIZING the VALUE of IT
More IT
Lower Enabler
Faster
Medical Turnaround
Reduce Cost Time More
LOS Shared
Data
Better
Clinical 360
Outcome Patient
view
More Time
Eliminate
for Quality
Manual
Care
Charting
Increase Up
Patient Staff
Enhance
Satisfaction Satisfaction
Patient Safety
HIMSS EMRAM - an international benchmark for advanced technology used in patient care Changi General Hospital (790 beds) KK Women’s & Children’s Hospital (832 beds) Khoo Teck Puat Hospital (550 beds) National Heart Centre Singapore (185 beds) Ng Teng Fong General Hospital (700 beds) National University Hospital (991 beds) Singapore General Hospital (1590 beds) Tan Tock Seng Hospital (1200 beds) IMH (2000 beds) – Validation Underway
Smart Hospitals
Living the Dream Smart Healthcare Today
Provider Care Enablement
Infant Tagging using RFID
Infant Tagging
Mother, infant and cot are tagged with
RFID to ensure 100% match.
When the right baby is brought to the
right mother, a soft lullaby will be heard.
Otherwise, the tag will beep.
RFID Tag on Infant
RFID Tag on Mother RFID Tag on CotAutomates Vital Signs Recording
SmartSense system
SmartSense System
The SmartSense RFID tag attached to
the patient Continually Records his
Temperature and wirelessly upload their
vital signs data into its medical
records system so nurses no longer
need to wake him to check his
temperature.
Doctors and nurses can Instantly view
online the patient’s Latest Vital Signs to
provide Timely Treatment.
The RFID tag also Tracks Patients’ Locations, enabling staff to Better Manage infection
control during pandemics. It also Protects Nurses’ Safety as there is Minimal patient
contact for temperature recording.
The system is a first in Southeast Asia in functionality and peripheral interfacing. There are
plans to integrate SmartSense with other clinical charting applicationsImproving Accessibility Through Telehealth
See Your Doctor Over A Webcam
The Telegeriatric system
It uses video-conferencing and online sharing of patient's data and images to allow
doctors to assess and treat patients without needing them to be at the same place.
The session is facilitated by a nurse from hospital, who carries the tablet with her to
patient’s home. The nurse is trained to do a physical examination. She then relates her
findings to the consulting doctor through the camera. The teleconsultation costs less than
a third of the cost of a doctor's visit at hospital.Improving Accessibility Through Telehealth Tele-consultation with neurologists NNI Neurologist can view patient via live feed video from camera at CGH Solution: Telestroke – Remote consultation for Stroke patients @ Changi General Hospital Benefits/Outcomes: Uses technology (video conferencing, internet and software applications) to enable NNI help administer intravenous recombinant tissue plasminogen activator (rTPA) to eligible patients with acute ischemic stroke admitted to CGH that did not have in-house Neurology service.
Deliver Better Care Productively
RAPIDE System
Uses RFID to update recliners/beds
occupancy, resulting in 80% of patients wait
less than an hour for treatment.
RFID Reader
Sensor MatsMedical Devices Middleware Integration
System (MDMIS) – reduces charting errors,
productivity boost
MDMIS integrates and transmits medical data from medical devices into
EMR.
Reduce charting errors and freed up nursing time to care for patient.
Dialysis Unit
IABP
Anesthesia Unit and Monitor
Cardiac Output Monitor VentilatorsWarehouse Management System (WMS)
WMS provides a quick and easy way for
Clean Utility Room
users at service points to raise top-up
request.
Eliminates the need to do manual stock
counting and allows faster turnaround of RFID
Drop-
stock supply, thereby improving inventory Box
management and fulfillment.
Medication Room Medication Room
2 Bin System
with RFID Card
PDAsSmart Robots
Minimally Invasive Robotics Surgery with
The Da Vinci surgical system
At least five hospitals here now use
robotics
The surgeon thus has More
Range of Motion, Better
Visibility and More Precision.
With the robot, the robotic arms
are able to reach areas
Conventional open surgery is not
able to.
To perform surgery in hard-to-get-
to places or to leave as Little
damage as possible to the
surrounding tissue.
The benefits were obvious from the start with patients Recovering Faster and Losing
Less Blood and Less Painful.
Better Aesthetic results
http://www.sgh.com.sg/about-us/newsroom/News-Articles-Reports/Pages/doctor-robot.aspxRobots take up the slack in
CGH's Labour Crunch
Robot Nico is an industrial robotic
arm that can extract data, such as
blood pressure or temperature,
from wearable devices on patients
and send the data to a doctor's
computer.
Nico can be used in the wards
to keep an eye on patients. It
can sense when a patient tries
to get out of bed and advises
patient to call for a nurse
instead of making their own to
the washroom.
Nico can be used at home to remind patients with early dementia to take their
medicine as well. Interestingly, it can also carry out simple conversation, or
entertain young patients with song and dance and can even be programmed to
speak in different languages or dialects!
Source: http://www.straitstimes.com/singapore/health/robots-take-up-the-slack-in-cghs-labour-crunchHOSPI Robots
Aid Hospital Operations at CGH
In line with the country's goal of becoming a
Smart Nation, Changi General Hospital (CGH)
is implementing assistive robotics technology to
improve operational efficiency of a hospital.
As part of the hospital's porter management
system, the four HOSPI are able to deliver
fragile and bulky medicine, medical specimens
and patients' case notes 24/7, easing
manpower constraints.
HOSPI is equipped with security features to prevent
tampering, theft and damage during delivery. The
robot's contents can only be accessed with ID cards.
Automation enables HOSPI to move around using
the lifts and between facilities in CGH's Main
Building and The Integrated Building on its own,
delivering medicine and specimens.
Source: http://www.mynewsdesk.com/sg/panasonicapac/pressreleases/panasonic-medical-robots-hospi-aid-hospital-operations-at-changi-general-hospital-1195455Automated Laboratory System using
Robotics
End-To-End automation of specimen testing
using robotics
Saves time and manpower
Reduces errors
Improves service
standardsAutomating Medication Pick-and-Pack
OUTPATIENT PHARMACY Enhanced accuracy and workflow efficiency through
In 2015, OPAS was deployed in KKH,
AUTOMATION SYSTEMS (OPAS) and the collaboration between NUH,
automating at least 80% of workload TTSH and NHG Pharmacy
Combines multi-disciplinary (progressively).
robotic components which handle More than 90% traceability of drugs
the pick, pack and labelling of a dispensed, from zero previously, in the
variety of dosage forms including event of any drug recall activation
Over the course of 1 year,
box/blister/loose pills;
a workflow engine to manage Decrease in patient waiting time by as
1.70m KKH, NUH,
orders; an automated assembly
much as 50%; 95% within 15minutes at NUH, TTSH and NHGPh
and validation intelligence to
match collated package to
50% within 15 minutes at TTSH outpatients will
patient; and a guided picking benefit.
system for non-standard Reduction in prescription rework rates range
medications.
from 30% to 8%-5% at the dispensing end Furthermore, as NHGPh
serves all NHG’s nine
Enabled up to 50 FTE manpower savings per polyclinics, 1.77m
year; staff redeployed to frontline areas and directly at
clinics for better staff-patient interaction
NHGPoly outpatients
will benefit.
Potential savings arising from PHI’s
implementation of CLMM range from 38,000 to
95,000 preventable Adverse Drug Events or an
equivalent of up to S$8.5m per yearAutomated Outpatient Medication Delivery
Solution:
Outpatient Pharmacy Automated
System (OPAS) @ Tan Tock Seng
Hospital, Institute of Mental Health,
Singapore General Hospital, National
University Hospital
Benefits/Outcomes:
NHG packs for Renci Nursing Homes
Reduction of packing errors by 50%
Near zero waiting time Drug Cartridges in the Drug Re-sealable Bags and
Reduced rework rates from 30% to 5% dispensing System (DDS) Tagging System
Redeployed 10 – 20 FTEs to more
value added activities
Robotic Arm Picking Drug Dispensing System
MedicationsSmart Consumer
Your Guardian Health Angel
Consumer/Patient Navigation
Health Buddy
Features the latest medical information and
news, health and nutrition tips contributed
by local doctors and healthcare
professionals
Enables quick search for SingHealth
specialists, services, charges and
locations, as well as the nearest general
practitioner and CHAS (Community Health
Assist Scheme) clinics
Provides convenience to consumer/patients
through appointment scheduler and queue
watch web cam feature assess queue
length before visit to any SingHealth
Polyclinic and hospital A&Es.Your Guardian Health Angel
Consumer/Patient Navigation
Feedback forms & Queue
watch
Enable patients to provide feedback,
make enquiry, request for
medication top up, and watch the
NHGP polyclinics queue status.
Location Finder
Enable patients to navigate from
location to location. A map with route
and instruction will be shown to the
users and guide users navigating
from floor to floor.Your Guardian Health Angel
Provider Navigation
Nurses Pal
Helps nurses to better manage their day to
day work. Including:
Pressure Ulcer Prevention and
Management
Patient Fall Prevention Calculator
Drip Rate Calculator and Reminder
SingHealth Staff Directory
Provides staff directory information and
automatically synchronizes the latest update
into the smartphone
Provides convenience to staff allowing them
to find the official contact information staff
easily without the need to call the call centreYour Guardian Health Angel
Provider Care Enablement
Patient Care Communicator
Helps intensive care unit (ICU) patients
communicate to medical staff and visiting
family members. Enables the patient to
choose what language the text will be
displayed.
The choices are English, Chinese, Malay and
Tamil.
Integrated Healthcare Communicator
(ICOM)
Enables nurses convey instructions to
patients, therefore improving communication
between healthcare staff, patients and
caregivers.
Also facilitates healthcare staff’s self-learning
of different languages/dialects at their own
pace and environment.Your Guardian Health Angel
Provider Care Enablement
Ageing in Place
Supports the scheme with IT programs to
help address the hospital’s bed-crunch
situation, reducing the average patient
readmission rate from 3.47 to 1.34 times,
freeing up hospital beds for more urgent
medical cases.
Community nurses are equipped with
laptops linked to the patients’ medical
records, visit discharged patients at home
and guide them to better manage their
chronic disease.
The scheme clinched the gold award at the
civil service PS21 ExCEL Awards in Oct
2013.Your Guardian Health Angel
Provider Care Enablement
SGH Antimicrobial Guidelines
Helps healthcare professionals to determine
what antibiotic to administer and the dosage
based on a given event and/or scenario.
Provides detailed information of the different
antibiotics, information tree, calculator, and
guidelines.
Childhood Vaccine eBook and
Calculator
Enables healthcare professionals to
calculate the due and future vaccines of a
patient. It shows the date, vaccine name;
vaccine shot count, and dosage. The eBook
also contains the complete information for
each vaccine.Coordinated System of Patient Care
Health & Wellness Kiosk (Hawk)
Health & Wellness Kiosk
(Hawk)
A means for patients to conduct pre-
screening independently, these kiosks
aim to better utilise the polyclinics'
limited clinical resources and expedite
the registration process, reducing patient
waiting time.
Information is then sent electronically to
the polyclinic's medical records system
and logged - even before the doctor has
met the patient
Doctors can now spend more quality
time with patients during consults for the
assessment, diagnosis and treatment
advice to them.Your Guardian Health Angel
Enabling Renal Patients - Peritoneal Dialysis
Peritoneal Dialysis
Allows patient to enter their vital signs and facilities
communication (messaging) with their clinicians.
It alerts doctors when there is abnormal readings, so
they can talk to patients almost immediately to deal
with them.Health Hub
Take Charge of Your Health
Discover interesting and
useful health information for
the stage of life you’re in.
HealthHub pulls together
articles and features about
health concerns relevant to
your age, gender, and role.
HealthHub Deals brings
together deals for activities,
health equipment, meals,
exercise facilities, and
classes.Smart Care from Home
Comfort of Care from Home
Vital Signs Monitoring
Enable patients with chronic disease like
hypertension, diabetes, dyslipidemia and
heart failure to be monitored at home,
reducing frequent clinic visits
Regular readings facilitate tele-
consultations with care managers,
enabling them to remotely monitor
and assist patients in their chronic
disease managementRehab in the Comfort of Home
Tele-Rehabilitation
Enable continuity of rehab at home or community care facilities after hospital discharge
Reduced travel and time flexibility
for therapist to review patients’
exercises
Help meet demand of higher patient volumeTransforming Healthcare
Meeting the Needs of the
FutureA shift to More Participatory, Personalized and Predictive More Active role of Patient As technology advances, patients will play a more active role in their own health care by auto uploading their vital sign from their wearables to their personal health record, collaborating with doctors instead of just taking orders. Proactive Tracking Their medical team authorized to access doesn’t need to watch these vital signs. But when something seems awry and the machine sense that there’s trouble, their health care team or digital Health Butler will contact them early.
Technology-Enabled Care Innovation Today and Tomorrow Sensors, mobile devices, and IoT are presenting new opportunities in Health Care to better Diagnose, Monitor and Manage Patients and Treatment. Many employ these technologies along continuum of Wellness and Prevention, to Therapeutic remedies and Treatments for illness.
A Glimpse into the future: Robotics and Drones Many hope to introduce drones and robots capable of assisting seniors with health risks who want to stay in their home. Potential applications include household cleaning, retrieving medication from another room, and tasks that could reduce the risk of falls in elderly who live alone.
cyokesin@gmail.com Chong.yoke.sin@ihis.com.sg
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