Speech by Minister for Health, Mr Gan Kim Yong, at the official opening of Tan Tock Seng Hospital B2 Pharmacy Featuring Soft Launch of Outpatient Pharmacy Automated System, 15 September 2014

Dr Eugene Fidelis Soh, Acting Chief Executive Officer and Chief Operating Officer, TTSH

Distinguished guests,

Ladies and gentlemen,

Madam Salimah,

Good Afternoon.

Introduction

I am very happy to join all of you today at the opening of this new pharmacy for Tan Tock Seng Hospital’s outpatients.  Let me first thank Mdm Salimah for allowing me walk through her patient journey with her.  Mdm Salimah has been a patient with TTSH for the last one year.  She just had a surgery on her hand earlier this year and has been here several times and has been collecting her medication every few weeks and hence has witnessed the transformation of the pharmacy here.

2.          As we were walking, Mdm Salimah shared that in the past, she often had to wait for quite some time at the pharmacy for her medication and that it was often very crowded. Now, in this new pharmacy, her experience has been very pleasant, with the more organised environment and the wider aisles.  She also has opportunities to talk to some of the nurses and pharmacists about the available drugs and possible allergies. She has more opportunity now to consult the specialists here. She has noticed that there seem to be fewer people in the new Pharmacy and that the medication collection process is more efficient. The waiting time is also much shorter.

Robotics in Healthcare

3.          The health needs of Singaporeans have been evolving rapidly over the years as a result of both economic progress and social-demographic trends.  At the same time, non-communicable diseases such as cancer and heart disease have replaced infectious diseases as the major causes of death.  Our healthcare system has to keep pace with these changes to meet the evolving needs.

4.          Robotics has been gaining much ground in healthcare. The precision, speed and performance achievable through robotics have brought about breakthroughs in research, simulation, training, surgeries, rehabilitation, prosthetics and care delivery.  Today, we see the impact of robotics and technology on yet another aspect of healthcare – the pharmacy.

Challenges in Pharmacy Operations

5.          The dispensing of medication is a critical step in all healthcare institutions.  It is often the last stop in a patient’s journey, and yet a most important one.  It involves prescription review and checking the 5 rights: the right patient, the right drug, the right dose, the right route and the right time.   When a change in medication is required, the pharmacist will consult the doctor and the process is repeated.  In other words, the pharmacy is the last safety stop before the patient leaves the hospital. Hence, the accuracy, efficiency, safety and clarity of drug use are of utmost importance.

6.          In a busy public healthcare institution like Tan Tock Seng Hospital, a large number of patients go through its pharmacy’s doors, approximately 1800 patients every day.  There is hence intense pressure for the process of medication preparation and dispensing to be done without delay to patients.

7.          In the face of increasing patient numbers, and wider range of medications used, the traditional and manual method of preparing medications, may no longer be practical.  A more efficient, yet safe, solution is clearly needed. 

Robotics in Pharmacy

8.          In recent years, our institutions have been exploring how they can leverage on technology and robotics to address the challenges faced by our pharmacies. Some institutions, such as KK Women’s and Children’s Hospital and Singapore General Hospital, have begun implementing solutions for their inpatient and outpatient pharmacies respectively.  Tan Tock Seng Hospital, National University Hospital, National Healthcare Group Pharmacy and Integrated Health Information Systems, riding on an earlier successful collaboration that transformed inpatient pharmacy operations, decided to embark on an ambitious outpatient pharmacy transformation journey together. Such collaborations are encouraged, particularly across clusters and at the national level, to ensure that best practices are shared to benefit our patients.   

9.          The Outpatient Pharmacy Automation System (OPAS in short) automatically reads the e-prescriptions, simultaneously picks and packs the various medications, ensures the tagging to the correct patient, then delivers medications to the pharmacist at the counter. In this way, the pharmacist is freed up to focus on conducting the final check and on counselling the patient. With the improved efficiency and processes, the wait time for most patients at the pharmacy will be shorter.

TTSH: Transforming care experiences

10.      With OPAS automating 80 per cent of the medication dispensing process at TTSH, the hospital’s pharmacists can now focus on delivering better and more personalised services such as reviewing and reconciling the medications, addressing patients’ needs and concerns and ensuring that patients fully understand their medications before they leave the hospital. 

11.      TTSH has also started to redeploy some of their pharmacy technicians who were previously involved in the medication picking and packing into the specialist clinics. Some 19 of them (60%) are now performing higher value and frontline tasks.  Through job redesign, these pharmacy technicians have now taken on the task of verifying the prescribed medications’ dosages and quantities with patients and doctors where necessary before transmitting them to OPAS to execute the picking and packing. This prevents unnecessary rework or additional wait time for patients at the pharmacy.

12.      Preliminary data shows that this new process has great potential in reducing the rework rate significantly from 30 per cent in 2011 to less than 5 per cent today. 

13.      At the same time, the redesigned job scope with greater emphasis on patient-centered care gives our staff greater job satisfaction as well as better care for our patients.

OPAS Soft Launch

14.      Since June this year, TTSH has been progressively rolling out OPAS for some of its patients.  Thus far, the system has processed about 7,000 prescription orders. 

15.      The preliminary results show that about 40 per cent of patients have achieved its “zero needless wait” target.  This means that the medications are ready for collection when these patients arrive at the pharmacy from the clinics upstairs.   

16.      This is a positive start for OPAS. Patients like Mdm Salimah have already noted the difference in their experience at the pharmacy, which she shared with me just now.

17.      TTSH is amongst the first in the collaborative effort to roll out OPAS. It targets to achieve full roll-out of OPAS for all its clinics by early next year. NUH has also embarked on this automation system in its new Medical Centre, which will go ‘live’ next month. Likewise, NHG Pharmacy is currently piloting OPAS in its Choa Chu Kang Polyclinic and the system will be rolled out progressively to the rest of its polyclinics by the end of next year. 

Conclusion

18.      The advancement of technology has brought new opportunities to review and transform the way we deliver care. Such opportunities allow our healthcare institutions to give better care and create a more personalised, accurate and efficient healthcare system.

19.      Congratulations to all the people who have been involved in this project.  I look forward to the full implementation of this project and the benefits it will bring to our patients.

20.      Thank you.