KEYNOTE SPEECH BY DR JANIL PUTHUCHEARY, SENIOR MINISTER OF STATE FOR HEALTH, AT THE CHI INNOVATE ON 4 NOVEMBER 2022

Prof Philip Choo

Group Chief Executive Officer, National Healthcare Group

Prof Eugene Fidelis Soh

Chief Executive Officer, Tan Tock Seng Hospital & Central Health

Chairman, CHI Co-Learning Network

Towards a Smarter & Healthier SG

               Ladies and gentlemen, good morning. I am pleased to join you this morning for the flagship day of the Centre for Healthcare Innovation - CHI Innovate 2022.

2.             Earlier this morning, I had the privilege to officially open Tan Tock Seng Hospital’s (TTSH) Medical 3D Printing Centre in its new home in CHI. Previously located at TTSH, the new centre houses seven machines (and counting) to meet the increasing demand and popularity of 3D-printed technology for application in healthcare. Since its inception in 2020, the centre has printed over 200 3D models for various clinical, education and research purposes. The patient-specific and customised anatomical models facilitate patients’ understanding of their medical conditions, and enable surgeons to practise and plan beforehand, saving precious intra-operative time. In addition, 3D printed surgical adjuncts provide a cost-effective solution in helping surgeons achieve more precise and efficient clinical outcomes.

3.             By innovating with purpose, we have made significant strides in applying healthcare technology cost-effectively and found smarter ways to provide better care for our patients and empower them to live healthier lives.

4.             This is especially important for us as our population ages rapidly. Singaporeans aged 65 and above are expected to increase from one in six today, to one in four by 2030. With our people falling sick more often as they age and the rising prevalence of chronic diseases such as hypertension and hyperlipidaemia, there will be considerable  health, emotional and financial burden placed on our families in the coming years.

5.             Hence we are embarking on one of our most significant transformations – Healthier SG – taking action now to prevent or delay the onset of ill health, and slow or even reverse these trends. As we move our emphasis from  caring for those who are sick, to proactively preventing individuals from falling ill, it is imperative that we continue to innovate to create a Smarter & Healthier SG.

6.             Under the Healthier SG strategy, there are five key features. We will first, mobilise family doctors to deliver preventive care for residents. Currently, only three in five Singaporeans have a regular family doctor. We will grow this number by bringing more doctors on board Healthier SG, working with them to enhance their capabilities to practice effectively as a family doctor and encouraging residents to develop a trusted relationship with them with a focus on improving their health before they become sick

7.             Second, we will develop health plans that include lifestyle adjustments, regular health screening and appropriate vaccinations which family doctors will discuss with residents based on their health condition. The doctor will also have regular check-ins with their enrolled residents on their health plan, to find out the latest developments in their overall health and discuss their adherence to the health plan and progress in achieving their health goals.

8.             Third, we will activate community partners to support residents in leading healthier lifestyles. A health plan needs to be carried out in between their clinic visits, and in one’s daily living. Healthier SG will empower residents to chart their own journey towards healthy and active lives, supported by community partners such as the Health Promotion Board, Agency for Integrated Care, People’s Association, Sport Singapore and National Parks Board, which run various activities and programmes, from brisk walks, qigong and community gardening to ball games and workouts with coaches.

9.             Fourth, we will launch a national enrolment exercise for residents to commit to seeing one family doctor and acting on a health plan. Residents will be able to choose which family doctor to enrol with. While family doctors will serve as the first point-of-contact to holistically manage the residents’ health, the national enrolment programme will be coordinated by our three healthcare clusters – the National Healthcare Group (NHG), National University Health System (NUHS) and SingHealth (SHS), each looking after approximately 1.5 million residents. The clusters will work with family doctors and other partners in the region to reach out to as many residents as possible, and drive population health in their respective regions. To build the participation base progressively, enrolment will open to residents aged 60 years and above in the second half of 2023, followed by those in the 40 to 59 age group in the subsequent two years.

10.          Finally, we will implement the necessary enablers such as IT systems, manpower development and financing policies to make Healthier SG work. Our healthcare manpower needs to be suitably sized, differently organised and equipped with the right skills; IT systems should ensure seamless sharing of data to facilitate integrated care; and financing policies must incentivise all healthcare providers to place greater emphasis on preventive care, while ensuring that needed treatment continues to be delivered. Our healthcare clusters will function as regional health managers, working with the Ministry of Health (MOH) and other stakeholders and partners to positively improve the social determinants of health, that could include a variety of factors, from early childhood development, to employment, even our built environment and social networks that shape our outlook on life, as health outcomes are influenced by the way people grow up, live, work, play and age.

11.          Apart from IT and data sharing enablement, technology will also play a big role in our Healthier SG journey to support preventive health efforts and bring healthcare from hospitals to home. I am sure many of you are familiar with HealthHub – used by all of us to check our vaccination entries and test results over the Covid-19 pandemic. But it is also our national population enablement platform for digital health which can be conveniently accessed by Singapore residents through Singpass. Currently, residents are not only able to view health records of themselves and their loved ones, but also obtain health and wellness information, and perform transactions across public healthcare institutions such as appointments, bill payments and refilling of medication. Some of you might also have been using Healthy365, as you keep up with HPB’s Step Challenges! Beyond just convenient transactions, we plan to enhance HealthHub and Healthy365 to nudge residents to take meaningful healthier actions, in line with their health plan, such as keeping them engaged through recommendations and registration of lifestyle programmes, and tracking their achievement of health outcomes which are part of their health plan. .

12.          We are living in a golden age of digital innovation and are just only starting to skim the surface of what we could do to create exciting new models of convenient care for our residents. TTSH’s “Hospitals without walls” concept is one such example, where care is redesigned with digitalisation as the key enabler. Instead of being confined to the walls of the hospital, care follows the patient, who is increasingly empowered with digital tools to manage their health anytime, anywhere. I will now share three projects under this concept to better illustrate this.

13.          Firstly, “Clinic Without Walls” leverages the use of the HealthHub app to redefine patient experiences. The counterless clinic empowers patients to register on-the-go, keeps them up to date on the queue  as well as the number of patients ahead, therefore giving them better control of their schedule. It also reduces needless waiting time at self-registration kiosks. This helps to ease some load off our staff in our healthcare institutions as there is less reliance on them to support the registration process and answer enquiries on queue status.

14.          Secondly, with the use of AI-powered fall predictions and temperature monitoring sensors, remote care beyond the wards is now possible under the “Ward Without Walls” project. The sensors provide non-contact, non-intrusive and continuous patient monitoring which yield productivity gains. It also improves clinical outcomes and patient experience due to early detection. As initial trials were successful, this was expanded from a one-to-one setting in single rooms to a one-to-many setting to test the detection of a fall among any one of the multiple patients in a given setting. There are also plans to trial the technology for community and home-based care. .

15.          Finally, “Pharmacy Without Walls” was started with the aim of empowering patients and providing a better patient experience.  With a simple inclusion of QR codes on medication labels, this innovation, born out of user-centred, technology-enabled design thinking, empowers patients to better manage their own health anytime, anywhere. It increases patient activation and population health literacy through simplifying and improving accessibility to information about their medication, thereby increasing medication adherence.

16.          Every year, our public healthcare institutions and partners continue to imagine smarter ways of doing things so that we can serve our residents better.  For example, the “Enhancing Workforce Productivity through Digital Workers - SGH's Robotic Process Automation (RPA) Journey” project by Singapore General Hospital, is one of the winning projects for the Best Practice Medal (Workforce Transformation) under the National Healthcare Innovation and Productivity (HIP) Medals Award this year.

17.          RPA, an emerging technology, automates manual tasks and businesses processes through digitalisation. It uses software robots, machine learning and AI to emulate humans performing tasks, churning outputs at a much faster speed and with little to no chance for “human error”. RPA could help to cut costs, save time, create sustainable processes, and maximise the use of our valuable resources, especially our healthcare workers. SGH started using this technology in late 2020 and as of July 2022, reaped about S$650,000 of productivity gains each year through RPA alone.

18.          I would like to congratulate all our winning project teams and applaud them on making a difference and changing the concept of health delivery. It will take a bold re-imagination of our health landscape and the ambition to make big changes by all in our ecosystem, even if it means disrupting familiar processes and trying unfamiliar solutions, for us to make real progress in our transformation journey.

19.          The future of health holds exciting possibilities for us. So dream big and join us in our journey towards a Smarter & Healthier SG. Thank you.