latest it systems at phis in singapore

IHiS and the public healthcare institutions in Singapore have made significant strides

in harnessing latest technologies to meet the country’s healthcare challenges.

Singapore has one of the world’s fastest ageing populations with increasing burden

of chronic disease patients who need treatment from skilled healthcare staff.

Today, the country has the region’s largest number of public hospitals and national

specialty centres with HIMSS EMRAM Stage 6 IT implementation. Its public healthcare

institutions are highly integrated, with several ‘world’s first’ innovative systems. Systems

developed and implemented by IHiS have garnered over 60 awards globally and

locally, enabling Singapore’s patient care to rank among the best in the Asia Pacific.

Here are the latest systems implemented at the public healthcare institutions that

have transformed care, substantially benefitting patients and improving healthcare

staff’s productivity.

• Hospital Clinical Systems

• Hospital Ancillary Systems

• Patient Systems

• Healthcare Analytics

• Community Care Systems

About IHiS

Contents

1) Clinical Systems • Medical Device Interface - Medical Devices Middleware Integration Solution pg 4 - SmartSense System pg 6

• Dashboards - Integrated Interactive Inpatient Andon Baord (i3Andon) pg 7 - Enterprise Management Dashboard System pg 8 - Computerised Integrated View of the Customer (C-IVOC) pg 10

• Theatre Sterile Supplies System - Instrument Management System pg 11 • Telestroke pg 12

2) Ancillary Systems • Pharmacy Systems - Outpatient Pharmacy Automated System (OPAS) pg 13 - Closed Loop Medication Management System pg 16 - Multi-Dose Medication Management System pg 18 - Antimicrobial Surveillance and Clinical Decision Support System pg 20

• Laboratory Systems - End-To-End Laboratory Automation pg 21 - Digital Pathology System pg 22

• Radiology Systems - Radiology Information System (RIS) pg 23 - Picture Archiving and Communication System (PACS) pg 24 - Scanned Medical Records System pg 25

3) Patient Systems - 1 Queue 1 Bill pg 26 - One Medifund Assessment System pg 27 - Real-time Ambulatory Patient Information Deployment Enabler (RAPIDE) System pg 29 - Electronic Meal Ordering System pg 31

4) Healthcare Analytics - Electronic Health Intelligence System (eHINTS) pg 32 - Business Information (BI) System pg 34

5) Community Care Systems - ILTC Referral Management Systems (IRMS) pg 36 - Ageing-In-Place (AIP) with Tele-Monitoring pg 37 - ILTC Portal pg 39 - Nursing Home IT Enablement Program (NHELP) pg 40 - Tele-Geriatics pg 41 - Patient Relationship Management System pg 43 - NHGP Telecare pg 44

6) Mobile Applications • Apps For Patients - Clinical Apps pg 45 - Apps for Patients in Hospitals pg 49 - Apps for Patients’ Convenience pg 50

• Apps For Healthcare Staff pg 52

IHiS Systems Booklet | 2014 - 2015

Clinical Systems Medical Device Interface (MDI)Medical Devices Middleware Integration Solution (MDMIS)

• Software based, vendor neutral Medical Devices Integration (MDI) solution

• Automatically collects and integrates patients’ vital signs data generated from various

medical devices to the Electronic Medical Records (EMR) system wirelessly

• Eliminates healthcare staff’s time taken to manually record and input readings into

the EMR

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Benefits• Improves timeliness and accuracy of patient data in the EMR system for better diagnosis

and treatment plans• Ensures the 5 rights are in place – right entry of the right data from the right patient and

right device, at the right time, for more timely patient care• Eliminates manual charting, and data entry and transcription errors• Reduced documentation time allows healthcare staff to spend more time on direct

patient care

Where it is used • Changi General Hospital• Ng Teng Fong General Hospital• Jurong Medical Centre

How it works• The solution collects and integrates data from various medical devices to the EPIC

EMR system • It deploys a middleware to communicate with the EMR using HL7 messages centrally,

while using many protocols to talk to the hospital devices• Runs on standard computing platforms and supports existing computers and workstations• Devices include a Bluetooth enabled connectivity box ‘HBOX’, which extends

connectivity to medical devices that are not located near a computer or workstation


SmartSense System

• RFID tags attached to patients provide non-intrusive continuous temperature and location monitoring, giving patients uninterrupted rest

• The RFID sensors and bedside tablets automatically chart patients’ temperature and vital signs data on a single platform

Benefits • Real-time, online overview of patients’ vital signs and graphs enable timely care• Automatic charting reduces transcription errors• Patients no longer need to be woken up by temperature taking, but get better rest for recovery• Frees up nurses’ time previously spent on manual recording, allowing them to spend more

time on direct patient care • Location tracking and minimal patient contact for temperature recording, enable better

management of patients’ and staff’s safety, especially during pandemics • Location tracking makes it easier for nurses to find patients to administer care • Real-time information enables better bed, capacity and resource management

How It Works• The system is integrated with the Electronic Medical Records system• RFID receivers in the wards transmit patient data, temperature and location information• Dashboards on nurses’ computers display patients’ vital signs and location • Nurses use bedside tablets to enter other patient data, eg pain score, onto a single platform

Used At Tan Tock Seng Hospital

Awards Won HIMSS Elsevier Award 2013, Outstanding ICT Achievement

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DashboardsIntegrated Interactive Inpatient Andon Board (i3Andon)

• Custom built application that provides healthcare staff an easy-to-read, real-time overview of each inpatient’s status and care journey• Keeps staff updated on each inpatient’s real-time status, medication and test orders,

and required procedures, for more timely care

Benefits • Provides key patient information at a glance, without staff having to toggle between

systems, for staff’s quicker execution and more efficient patient car • Collective, organised view of information and the ward’s order status improves nurses’

situational awareness of patients’ critical needs, enabling them to better prioritise and carry out treatments

• Real-time information shared across departments facilitates team-based care • Serves as a communication tool between Nursing and Radiology staff for scheduling of

radiological investigations, and eliminates about 700 phone calls a month between the two departments

How It Works• Integrated with the Computerised Physician Order Entry (CPOE), laboratory, radiology

and inpatient medical records systems • Key information extracted and consolidated is displayed on touchscreen monitors

located strategically at the wards and pharmacy, and is refreshed every five minutes • Icons show status of medication and investigation orders and results, allowing

nurses to keep track of key patient information • Equipped with a radiology scheduling function to facilitate communication

between nurses and Radiology staff, such as relaying of patient information for scheduling of procedures

Used AtKhoo Teck Puat Hospital


• Dashboards at strategic locations give staff real-time overviews of operational activities and patient volumes, for more informed decision-making & manpower deployment

• System extracts information from various sources to show key indicators at a glance

Benefits • Overview of the A&E situation enables prompt re-deployment of manpower and

better management of resources and workload, for more timely patient treatment and clinical interventions

• Better management of patient flow has helped reduce patient waiting times at the Emergency Department (ED) by 36%, from 36 minutes to 23 minutes for urgent conditions • 95% of ED patients are seen in 88 minutes, 30% earlier than before • Shorter waiting times have improved patients’ satisfaction by more than 10% (source: MOH Patient Satisfaction Survey 2013) • Public dashboards at A&E waiting areas, informing patients of waiting times, enable better management of patients’ waiting time expectations• Enables staff to anticipate and more efficiently handle the flurry of activities during a civil emergency

Enterprise Management Dashboard System

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How It Works• Dashboards are strategically located at ED and staff offices, and refreshed every 10 minutes • Personal dashboards can be customised and accessed from mobile phones/tablets

anytime anywhere for quick information retrieval

Used At Changi General Hospital

Awards Won HIMSS Elsevier Award 2014, Outstanding ICT Achievement

Public Dashboards display:

• Waiting times for triage & consultation

Staff Dashboards in ED display:

• A&E patient waiting times and workload • Inpatient bed occupancy rates, waiting

times for beds, admissions, discharge numbers

Operating Theatre Dashboards display:

• Status of operations • OT utilisation information • Operation movement charts


• Dashboard provides front-line staff with key relevant, non-medical information on patients, such as outstanding bills, frequency of visits and patient temperament

• Comprehensive, 360-degree view of patients on a single platform enables staff to more personally, effectively and efficiently interact with patients

Benefits • Promotes personalised care and improved patient relationships• Patients’ history allows staff to know the patient better, and to be more sensitive when

handling certain patients • More personalised level of service increases patient satisfaction • Staff can obtain information at a glance, enabling them to process patients’ registrations more quickly

How It Works• System integrates patient demographic data to create a comprehensive, summary view of the patien• The data is shared and can be accessed via other systems• Business Analytics can further analyse the non-medical patient data


Computerised Integrated View of the Customer (C-IVOC)

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• Provides tracking and accountability of surgical instrument sets used for each patient to ensure high sterilisation standards and efficient management of instruments • One of region’s first to provide full instrument traceability and to electronically link all instruments used to each patient

Benefits• With full traceability of instruments, Theatre Sterile Supplies Unit (TSSU) can ensure all

instruments meet sterilisation process parameters• Eliminates risks of complications and infections from use of non-sterile or faulty

instruments, and enhances patient safety • Enables timely product recall and prompt follow-up when necessary• Automatically monitors inventory and prompts staff when instruments need to be

maintained, or stocks in theatre stores are low • Helps to keep instruments in optimum condition, reducing instrument downtime and repair costs

How It Works• Every instrument set is barcoded and tracked, from point of decontamination to use

in operating theatre• Sets are scanned for quality checks, and tagged to patients before surgeries

• Once used, instrument sets are collected, scanned and processed at the Decontamination area, and sterilised before being repacked

• TIMS automatically alerts packing staff if the set needs special maintenance

Used At• Singapore General Hospital

• National Heart Centre Singapore

Theatre Sterile Supplies System Instrument Management System


• Using video-conferencing technology, neurologists remotely guide administration of intravenous r-TPA to eligible patients with acute stroke, at hospitals without round-the-clock in-house neurology services

• A neurologist is needed to assess the patient’s suitability and prescribe the medication, which if given to eligible patients within 3 hours of stroke onset, can improve outcomes and reduce disability

Benefits• Timely evaluation and treatment of acute stroke patients, with real-time remote access to

stroke specialists 24/7• Patients no longer have to be redirected to other hospitals for urgent acute stroke care• Timely treatment enables faster patient recovery, shorter hospital stays• At Sep 2014, TeleStroke at Changi General Hospital and Khoo Teck Puat Hospital has

enabled neurologists to make timely assessments of over 1,050 ischemic stroke patients and treat more than 350 patients with tPA

How It Works• The project uses a Hub and Spoke model NNI, the comprehensive stroke centre, serves as

the Hub, and the hospitals without 24/7 in-house neurology services are the Spokes • The hospital A&E doctor activates the Neurologist-on-call at NNI Patient’s brain CT

scan is transmitted via the TeleStroke server to the Neurologist • Digital CT scan and video conferencing enable the Neurologist to assess patient with the

A&E physician• If r-TPA is needed, Neurologist will remotely guide A&E doctor’s administration of the drug • Neurologist enters clinical findings into TeleStroke system

Used At National Neuroscience Institute, supporting:• Changi General Hospital • Khoo Teck Puat Hospital

TeleStroke

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Ancillary Systems Pharmacy Systems Outpatient Pharmacy Automated System (OPAS)

• A combination of multi-disciplinary technologies, such as robot machines, conveyor assembly, LED, barcode and RFID, automates the prescription filling process, and improves manual picking accuracy for certain drugs

• Revolutionary approach enables pharmacies to handle high prescription loads safely and efficiently

Benefits • Streamlines processes, ensuring consistent and efficient output, with less re-work• Reduces risks of medication errors and enhances patient safety Near misses have

dropped by 274%• Up to 95% of prescriptions are now filled within 15 minutes• Shorter patient waiting times, higher patient satisfaction• Reduced reliance on trained manpower• Pharmacy staff can focus on more patient-centric tasks, increasing their job satisfaction• Easily scalable to keep up with Singapore’s rapidly ageing population


SGH NHG Pharmacy/NUH/TTSH

Doctors enter prescriptions electronically.

Prescriptions are reviewed at the pharmacy.

Pharmacy technicians, located at specialist clinics, review, clarify, confirm the medication orders.

This allows almost immediate collection of medication once patient reaches the pharmacy.

Reviewed prescriptions are placed in RFID baskets on conveyor belts, which run through outpatient pharmacy. This triggers the packing process.

Once pharmacist confirms the prescription, system processes the orders, triggering the packing process at pharmacy.

LED lights guide staff to the right drugs that require manual picking.

Packed medication is placed in RFID tagged baskets. When system detects that the prescription has been filled, the baskets are automatically assembled and delivered via RFID-enabled conveyor to pharmacists at front dispensing counters.

Packed medication is delivered to pharmacists at front counters via barcode-enabled conveyor system.

Robot machines automatically pick and pack the drugs.

How It Works

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Used At • National Healthcare Group Pharmacy • Singapore General Hospital (SGH)• National University Hospital (NUH) • Tan Tock Seng Hospital (TTSH)• KK Women’s & Children’s Hospital

Awards Won • Singapore Project Management Institute Project of The Year Award 2014/2015• MOH IT Excellence in Providing Quality Care Award 2015• National Infocomm Award 2014, First Runner-Up, Most Innovative Use of Infocomm

Technology (Public Sector) • Singapore Infocomm Technology Federation Award 2014, Gold - Best Public Sector Product• CIO Asia Award 2014


• Integration of automated and intelligent systems to close the inpatient medication management loop

• Enhances patient safety and improves efficiency of entire medication management process, from prescription to the supply and administration of medication

Benefits • Enables timely pharmacist review of prescriptions and automates checks at handoff

points to ensure correct medication serving• Reduces risks of medication errors and adverse drug events• Improves medication inventory management, reducing annual holding costs by 30%• Enhances staff productivity and efficiency• Faster turnaround for timely administration of medication and better patient outcomes

Used At• Changi General Hospital (CGH) • National University Hospital (NUH)• Institute of Mental Health (IMH) • Singapore General Hospital (SGH)• Khoo Teck Puat Hospital (KTPH) • Tan Tock Seng Hospital (TTSH)• KK Women’s and Children’s Hospital (KKH)

Closed Loop Medication Management System

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Awards Won • HIMSS Elsevier Award 2013, Outstanding ICT Achievement • CIO Asia Award 2012• Best PS21 Project 2011, Gold Award

• Singapore Infocomm Technology Federation Award 2011, E-Government• National Infocomm Award 2010, Winner, Most Innovative Use of Infocomm

Technology (Public)

How It Works

NUH, TTSH, IMH KKH CGH, KTPH SGH

The barcoded sachets are kept in intelligent electronic cabinets at the wards.

Nurses select patient names and trigger specific drawers to open and light up, guiding nurses to quickly pick the correct drugs.

The barcoded sachets are stored in medication carts and wheeled to the wards.

Doctors enter patients’ medication orders into Electronic Medical Records system.

Clinical Decision Support System prompts doctors with information to avoid drug interactions, allergies and adverse drug events.

Pharmacists verify medication orders, which are then sent automatically to Inpatient Pharmacy Automation System (iPAS).

iPAS’ robot machines pack and supply the medication into unit dose or patient specific sachets.

Medication is stored at the wards, and loaded onto medication carts.

QR-coded medicine sachets are loaded into patient specific drawers on medication carts. Ward stock drugs are stored at the wards’ Automated Medication Cabinets (AMCs), and can be queued remotely from the medication carts.

Scanning of the patient’s RFID wrist tag unlocks the assigned drawer. Nurses scan the drugs’ QR-code to ensure serving of the right medicines.

Barcode scanners are used to verify that the right patient is given the right drug.

Nurses scan the QR barcodes on the patient’s wristband and drug sachets, before serving medicines.


Multi-Dose Medication Management System

• Patients’ medicines are pre-packed into individual sachets, according to the right dosage, date and time the drugs need to be consumed

• Sachets are organised and labelled accordingly, enabling patients with multiple long-term illnesses and medications, and their caregivers to ensure that the patient takes the right medicines at the right time and in the right dosages

Benefits • Ready-to-administer sachets simplify medication serving and reduce risks of

medication errors • Empowers chronic disease patients to manage and administer their medication

independently at home• Saves caregivers’ 17 man-hours a day previously spent preparing medication (for a

typical 200-patient nursing home)• Medication packaging robot dispenses medicines 14 times faster than humans,

increasing pharmacy’s capacity and staff’s productivity

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How It Works• MMM system interfaces with hospitals’ Electronic Medical Records system, Computerised

Physician Order Entry and Clinical Decision Support System modules • The Pharmacy system and Automated Dispensing & Packaging System (which includes

the robot packing machines), combine the various drugs into a series of ‘multi-dose’ sachets and label them

• The sachets are then fed into the Automated Medication Inspection System for quality checks, ensuring patients receive the right drugs

Used At National Healthcare Group Pharmacy, which provides services to:• National Healthcare Group Polyclinics• Institute of Mental Health• Nursing Homes and Day Care Centres

Awards Won• CIO Asia Award 2013• Singapore Infocomm Technology Federation Award 2012, Bronze


Antimicrobial Surveillance and Clinical Decision Support System

• System’s analytical tools enable staff to collect, analyse, report patterns of antimicrobial resistance and utilisation

• Advises doctors on antimicrobial orders, based on hospital’s antimicrobial guidelines at point of prescription, to better manage antimicrobial use and control resistance

Benefits • Facilitates monitoring and reporting of antimicrobial-resistant organisms and

antimicrobial utilisation• Previously, doctors had to manually compile the data and took weeks to generate

reports on antimicrobial utilisation, which the system can now do in minutes • Optimises antimicrobial use to reduce resistance and infections, improving patient outcomes• Helps assess effectiveness of Antimicrobial Stewardship Programmes (ASP), which aim to

manage antimicrobial utilisation and resistance

How It Works• System streamlines collection and analysis of microbiology results and antimicrobial

utilisation data• Key results on reports and dashboards help ASP doctors, microbiologists and

pharmacists to more easily analyse and report antimicrobial resistance and utilisation• Based on the patient’s condition, the system will recommend suitable antimicrobials

for treatment and trigger the ordering process • It also tracks appropriateness of antimicrobial use and doctors’ acceptance of the

system’s recommendations

Used At• Tan Tock Seng Hospital • KK Women’s and Children’s Hospital• Changi General Hospital • Singapore General Hospital

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Laboratory Systems End-To-End Laboratory Automation

• Complete end-to-end automation of specimen testing, to better manage high patient volumes, speed up handling of test orders and results, and expand the laboratory’s capacity of tests that it can handle at any one time

• Uses a single Computerised Physician Order Entry barcode throughout

Benefits• Increases specimen management efficiency. Time needed to sort and requisite

specimens has dropped to just 05 minutes per specimen, from 2 minutes previously• Faster test turnaround times – 50% of urgent tests completed within 30 minutes, and all

urgent tests within 45 minutes (at May 2014)• Increases laboratory capacity – to handle 150% more urgent tests, and up to 10,000

specimens at one time • Doctors can view the results directly from the system, enabling more timely review and

reporting of laboratory results• Single CPOE barcode eliminates mismatching errors that resulted from the previous dual

barcode system How It Works • When specimens are collected, CPOE barcode labels are generated • Specimens are dispatched via pneumatic tubes, from any point in the hospital to

the laboratories, within 5 minutes • Auto-sorter machines scan the barcodes, sort and requisite the specimens into

Laboratory Information System (LIS) • Specimens, colour-coded for urgency, are loaded onto the automated line of

laboratory analysers for processing • Test results are automatically entered online into LIS for review, and then

released into the Electronic Medical Records Doctors can view results online from their computers

Used AtSingapore General Hospital – Clinical Biochemistry Laboratory


Digital Pathology System

• Converts glass slides for microscopic evaluation of tissue samples, into digital images (virtual slides) that can be shared and viewed by pathologists at different locations,

in real-time • The virtual slides are exact replicas of slides viewed under microscope• Pathologists can more easily and quickly collaborate or obtain second opinions on

tissue sample evaluations, promoting accurate diagnosis and quality patient care• Slide images, in high resolution, are automatically stored in system’s virtual archive for

easy retrieval

Benefits• Enables more efficient slide management for operational diagnostic, multidisciplinary

meetings, education, research• Facilitates specialty and subspecialty collaborations – “Pathology without Borders”

– Pathologists can conduct reviews and secondary consultations across different locations, to obtain expert opinions, thus achieving diagnostic precision

• Automatic processes relieve laboratory staff of tedious sorting, archiving, retrieving of slides• Potential to extend use of the digital slides with digital image analysis tools to facilitate

high throughput evaluations

How It Works • Slides are scanned and converted into images, which are automatically sorted and

stored in system’s virtual archive • Integrated with the Laboratory Information System, slide images are automatically

sorted by case, patient and reporting pathologist. This streamlines retrieval and archival of the images

• Pathologists can more easily collaborate for further opinions. For example, a pathologist in operating theatre conducting frozen section analyses can set up an impromptu real-time consultation session, and share digital slides with colleagues in main laboratory, to seek advice and subspecialty opinions

Used AtSingapore General Hospital

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Radiology SystemsRadiology Information System (RIS)

• RIS provides quick access to data relating to imaging from any location, and creates a unified imaging patient file

• Facilitates easy sharing of radiology and patient information across institutions, to give clinicians a seamless view of patients’ images acquired at other institutions

Benefits• Integration of radiology orders to Electronic Medical Records (EMR) system automates

ordering process and reduces data entry errors• Auto-syncing of reports to images ensures the right image is matched to the right patient • Integration with patient registration and billing systems removes billing error, improves

staff productivity• Voice recognition feature allows radiologists to easily create reports, reducing report

turnaround time • RIS tracks patient movements at Radiology departments, ensuring timely patient handling

How It WorksKey Components• Rule-based Appointment Scheduling – enables efficient planning, optimises resources• Patient Billing – integrates with hospital billing system to ensure correct invoices

• Reporting function – integrates with PACS for easy viewing of medical images

Used AtMost public healthcare institutions in Singapore


Picture Archiving and Communication System (PACS)

• PACS stores, distributes and displays medical images for interpretation and review• Clinicians now have more timely and efficient access to the digital images, and no longer

need to manually file, retrieve or transport the film images

Benefits • Reduces reporting errors due to mismatch of orders, results, images• Enables prompt reading by radiologists for urgent studies u Digital imaging and data handling enables faster turnaround of reports for timely

patient diagnosis u Enables radiologists to report cases from any location u Online sharing of images, reports increases collaboration among radiologists, clinicians• Reduces duplicate exams, eliminates lost films, saves space previously used for storing films• Provides clinicians with chronological views of patients’ radiology histories• Facilitates better diagnosis with advanced image processing tools such as 3D, lesion

management, vessel analysis, and decision support tools such as Computer Aided Diagnosis (CAD) for breast, lung studies

• Enables radiologists, clinicians to view PACS images on mobile devices• Supports research, teaching, training

How It Works Key Components• Image Acquisition system – captures images from imaging devices e.g. MRIs, CT Scans• Storage Archival system – stores, retrieves large volumes of images • Application & Workflow Management system – provides improved views with

advanced tools to manipulate and process images Supports image routing, worklists• Workstations are medical grade, high resolution multi-monitors for radiologists• Secure Network distributes patient images and information• Based on DICOM standard for image storage, communication among PACS components

Used AtMost public healthcare institutions in Singapore

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Scanned Medical Records System

• Central, online repository for SingHealth’s and EH Alliance’ medical records, for healthcare staff to more easily access and share patients’ records across the institutions

• Repository is seamlessly integrated with Electronic Medical Records (EMR) system

Benefits• SMR complements EMR clinical documentation by making notes, previously on paper,

available online for clinicians anytime, anywhere, improving efficiency and patient care • Several clinicians can view a patient’s records at one time, even if patient has several

specialist appointments that day• Enables institutions to go ‘paper-less’ and frees space, previously used to store records, for

care of more patients• Staff who previously retrieve, deliver paper records are redeployed to oversee repository,

with higher job satisfaction

How It Works• Paper medical notes, test results are scanned, stored into cluster SMR system• Healthcare staff access SMR through EMR system, with same log-in rights• Clinicians assess patients’ scanned records across SingHealth, EH Alliance to provide

timely care

Used At• Changi General Hospital

• KK Women’s and Children’s Hospital• National Cancer Centre Singapore

• National Heart Centre Singapore• SingHealth Polyclinics

• Singapore General Hospital • Scheduled for implementation at upcoming Sengkang Hospital


Patient Systems 1 Queue 1 Bill

• Issues ‘1 Queue 1 Bill’ slips when patients scan their appointment or identity cards• Slip has one queue number and a list of service points the patient is visiting for the entire

appointment. One consolidated bill is generated at the end of the visit • Connected to the Outpatient Management system, processes are steamlined to create a

hassle-free experience for patients

Benefits• Reduces at least 3 queue tickets and 2 bills from previous workflow• Patient’s personalized journey plan printed on ‘1 Queue 1 Bill’ slip, with 1 queue number

for the patient’s entire journey• Less confusion, less hassle and less queuing for patients • Streamlined operations enable shorter patient waiting times and less crowding at

registration area

Used At National Heart Centre Singapore – Cardiac Clinics

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One Medifund Assessment System

• System standardises assessment criteria of patients’ eligibility for Medifund assistance across institutions at SGH Campus and SingHealth Polyclinics

• Reduces the multiple Medifund assessments that patients visiting different SingHealth institutions had to undergo previously

Benefits• Enables sharing of patient’s assessment and assistance information across institutions• Patients only need to be assessed once by a medical social worker (MSW) when applying

for financial assistance, regardless of number of institutions they seek treatment at • Eliminates 4000 patient re-assessments, with estimated savings of 168 MSW man-days

a year• MSWs now have more time to help more patients, more quickly• Less confusion for about 2,000 Medifund patients who no longer need to go for multiple

interviews at various institutions with different subsidy eligibility criteria • Surveys show 4-fold increase in MSW’s job satisfaction as they now have more time to

help patients’ with psychosocial issues

How It Works• System leverages SingHealth’s Medical Social Worker Case Management system to

include generic and specific financial assessment criteria by MSWs • Enables MSWs across institutions to share financial assistance data, access

information in SingHealth’s database • Improves coordination and efficiency among institutions and MSWs


Used AtAll SingHealth Polyclinics and SGH Campus institutions (Singapore General Hospital, Singapore National Eye Centre, National Cancer Centre Singapore, National Dental Centre Singapore and National Heart Centre Singapore)

Awards Won• Singapore Health Quality Service Award 2015, Best Team for Service Initiative

Improvement• Singapore Healthcare Management Award 2014, Third in Service Quality category• Singapore PS21 ExCel Award 2014, Certificate of Recognition

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Real-time Ambulatory Patient Information Deployment Enabler (RAPIDE) System

• The RFID-enabled system provides quick real-time visibility of patient location, drug status and resource availability on a single platform

• The shared platform allows front counter staff, pharmacists and nurses at the unit to communicate, schedule appointments and manage operations efficiently

• Uses colour codes to indicate patient and resource status• Sends patients an SMS reminder 30 minutes before their appointment• Generates reports for analysis of workflow and patient load

Benefits• 8% reduction in patient waiting times and 45% of pre-scheduled patients receive

treatment within 30 minutes• Improves communication. More efficient scheduling of appointments and operations

management• Better management of resources has increased the unit’s treatment capacity by 22% • Saves nurses 825 hours a year previously spent manually searching for available resources • More effective appointment making, saving front counter staff 744 hours a year


How It Works• Patients and nurses wear RFID tags• Pharmacists update the drug preparation status in the system, before patients are

called in• RFID readers on ceilings, near each resource, and sensor mats on beds and

recliners detect patients’ and nurses’ locations• The signals update ‘treatment’ status and resource availability• When treatment ends, patient drops tag into dissociation box and Rapide releases the

resource for the next patient

Used AtNational Cancer Centre Singapore, Ambulatory Treatment Unit

Awards Won • NTUC May Day Model Partnership Awards (Management Category), 2015 • HIMSS Elsevier Award, 2014• Hongkong RFID Award, Bronze - for Most Innovative Use of EPC/RFID and Best EPC/RFID

Implementation, 2013

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Electronic Meal Ordering System (EMOS)

• Web-based system empowers patients to choose their preferred meals from personalised menus, customised to their dietary requirements

• Gives patients a better understanding of their diet and meal, improves patient satisfaction and reduces food wastage

• Ensures patients eat the right food for their medical condition, to facilitate their recovery

Benefits• Gives patients the choice to choose their meals and enables them to better understand

their dietary requirements• Through visuals and a built-in filtering system that only shows the ‘right’ food for the

patient’s dietary needs, EMOS prevents wrong diet orders • Ensures patient’s diet type ‘follows’ him wherever he is warded in the hospital• System has improved productivity in wards and kitchen. Saves 7 man-hours a day through

reduced errors and work to rectify errors. Nurses can focus on providing quality care• Patient’s family can access EMOS web to order meals for them from mobile phones or

laptops, without having to be at the hospital

How It Works• Nurses take meal orders via iPads instead of recording on paper slips 3 times a day.

Some patients may order meals from bedside terminals or iPads • Orders received are displayed real-time on dashboards at the hospital’s kitchen

• Meal order slips are generated and sorted automatically for food preparation and delivery



Healthcare Analytics Electronic Health Intelligence System (eHINTS)

• A single enterprise data repository, which integrates clinical and operational patient data from multiple systems across healthcare institutions, to provide users with comprehensive, cohesive, trusted information to support business decisions

• Supports SingHealth’s Enterprise Analytics Platform which serves analysis and reporting needs of Business, Finance, Clinical users

• Includes web-based business intelligence to enable users to slice-and-dice data or drill down to information and location analytics. The platform is being enhanced with Predictive Analytics and Text Mining features

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Benefits • Easy access to analysed data facilitates more informed decision making, improves

operational efficiency, resource allocation and cost management• Users now spend only 20% of their time on data preparation, compared to 80% previously• Contributes to research on chronic and major diseases

How It Works• eHINTS cleanses, consolidates and standardises data, before uploading the information

for decision-support • The quality information generated is hosted on a web-based business intelligence tool,

easily accessed via a secured network • eHINTS data granularity and ‘self-service’ drill-down capabilities allow users to trend,

perform statistical analysis and potentially scrutinise, identify, isolate unusual occurrences in day-to-day hospital administration or clinical conditions

• Examples include a potential outbreak in a ward with sudden spike in temperatures recorded, and overloading of appointments to a particular clinic due to data entry error

• Key data are displayed on dashboards, providing management with timely information

Used At • KK Women’s and Children’s Hospital • National Cancer Centre Singapore• National Heart Centre Singapore • Singapore General Hospital• Singapore National Eye Centre • SingHealth Polyclinics• Scheduled for implementation at National Dental Centre of Singapore and upcoming Sengkang Hospital

Awards WonGSTF Business Intelligence Awards 2012 for Best Practice, Winner


Business Information (BI) System

• Integrates, monitors and analyses key clinical, operations and financial data in National Healthcare Group Polyclinics’ systems

• Key research and decision support tool for clinical and operations planning, budgeting

Benefits• Integrates information from within and across systems in the institution, to provide up-to-date, decision-making information to facilitate strategic planning• Enhances the institution’s capability in forecasting workload, for better resource

planning and management • Measures patient treatment outcomes, for better understanding of treatment effectiveness and to improve patient care

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How It Works• System consolidates patient data, classified by subject areas, into a single business layer,

for analysis and generation of routine and ad-hoc reports• It comprises: u ‘Extract Transform Load’ and specialised end-user tools for quality data assessment

and integration u A Web Intelligence Tool to enable users to do free-form, ad-hoc, self-service analysis u Management Dashboard, an interactive platform which displays key real-time data u A Fee Revision Simulation feature

Used AtNational Healthcare Group Polyclinics

Awards Won GSTF Business Intelligence Awards for Best Practice, Runner-Up, 2012


Community Care SystemsILTC Referral Management Systems (IRMS)

• ILTC Referral Management System (IRMS) enables seamless transfer of patient information from hospitals to Intermediate and Long Term Care (ILTC) facilities and services, and between ILTC facilities

Benefits• IRMS interfaces with hospitals’ and ILTCs’ systems, reducing manual data-entry in ILTC Portal

and input errors, and improving staff productivity and patient safety• Standardises referral workflows, so public healthcare staff can easily make referrals to

ILTC providers • Improves coordination between referral parties, gives real time updates on referral status• The integrated information source facilitates data analysis and trending for better policy

decisions. Rich registry on patient referrals enables queries to be answered quickly • Provides hospitals, Agency for Integrated Care (AIC), Ministry of Health (MOH) better

visibility of referrals across service providers. This enables better monitoring of process indicators and data analysis

• Reduces steps to query information from MOH New Means Test (NMTS) and National Electronic Health Record (NEHR) systems

• Automatically extracts key data from various sources to give holistic view of patients, for better care planning

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• Provides post-discharge care to patients with 3 or more admissions in 6 months, to reduce hospital re-admissions, A&E visits

• For the first 400 patients to undergo intervention under the program, re-admission rates dropped from 35 times to 13 times

• For some patients, tele-monitoring alerts nurses if their condition deteriorates, for timely action

Benefits of Tele-Monitoring • Empowers patients to actively take ownership of their health with user-friendly technology• Nurses can prioritise patients who need urgent attention and make early interventions• Dashboards on their tablets enable nurses to quickly monitor patients anytime, anywhere

Ageing-In-Place Program (AIP) with Tele-Monitoring


How It Works• Online referral form is sent to AIC, ILTC facilities and service providers, e.g. nursing homes,

community hospitals, hospices, elderly day care centres, senior home care, day rehab, psychiatry services

• Integrates with hospital systems for seamless patient context switching and information retrieval to reduce data entry when referring patients

• Integrates with national systems, eg NMTS, NEHR, to enable sharing of data• IRMS is being extended to Respite Care, Renal Care, new hospitals and facilities

Used At • Acute care hospitals and institutions• ILTC facilities receiving and raising patient referrals• Agency for Integrated Care

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ILTC Portal

• ILTC service providers use the portal to send their subsidy requests, clinical indicators, manpower and training data to MOH

Benefits• Enables ILTC providers to more easily send their subsidy requests and data to MOH for

faster processing, and for MOH to build a repository for analysis and policy planning• Reduces staff’s data entry work through integration with ILTC systems

How It Works• Web-based portal integrates with MOH subsidy processing system and ILTC Referral

Management System (IRMS) to enable easier data sharing • Allows ILTC providers’ systems to automatically extract and send required data through

file interface, so staff need not re-enter data into the ILTC Portal • Integrates with the New Means Test System (NMTS) for seamless query of patient Means

Test information

Used At ILTC and some acute care facilities


Nursing Home IT Enablement Program (NHELP)

• A collaborative tool for nurses to share information and provide coordinated care to residents

• System helps nursing homes improve patient care and staff productivity • Supports patient management, clinical documentation, medication and

administrative functions

Benefits• Nurses can quickly retrieve residents’ medical records online• Enables residents’ care planning, based on their health records, and automatic tracking

of care plan outcomes to improve care quality• Facilitates timely flow of residents’ information between nursing homes, care institutions,

National Electronic Health Records (NEHR), ILTC Portal and Integrated Referral Management System (IRMS)

• This improves decision-making and coordination for nursing homes to enhance care • Automates submission of required data to the Ministry of Health for subsidies• Greater automation gives staff more time for patient care and raises their productivity

How It Works• NHELP is developed as a ‘Software as a Service’ module and supports multi-tenancy • Alerts remind staff of resident’s next health assessment or care issues, to reduce

hospital re-admissions• Runs on common browsers and supports mobile devices, eg tablets, so clinicians can

access residents’ medical records anytime, anywhere • ‘Reports Builder’ function helps nurses create customised reports and analyse data to

improve care

Used At Nursing Homes

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Tele-Geriatrics

• Through video tele-consultations, doctors at the hospital remotely consult and manage the medical conditions of patients at nursing homes

Benefits • Enables early intervention and timely care, reducing complications • Doctors only need to visit the homes monthly, instead of weekly previously• Time saved from travelling allows doctors to tele-consult more residents• Extension of Alexandra Health System’s medical support to long term care facilities, eg

nursing homes• In line with hospital’s aim to help the elderly age in place, by bringing healthcare to them

How It Works• Tele-geriatric system comprises a trolley, video conferencing equipment with movable

camera, microphone, speakers, TV, laptop, secure fibre-optic line• Trained nurses from nursing homes act as extensions of doctors by performing simple

clinical examinations, reporting and making recommendations to the doctor • Doctors remotely observe and communicate with nurses, residents via the camera, which

can zoom in on body parts • Doctors use the online tele-geriatric assessment forms to enter care management

notes for nursing homes

Used At Alexandra Health System, supporting:

• Singapore Christian Home, Sembawang • Sree Narayana Mission Home, Yishun

• St Joseph’s Nursing Home, Jurong West • Villa Francis Nursing Home, Yishun


How It Works• A weighing scale, blood pressure monitor, transmitter are set up in the patient’s home • When used, patient’s blood pressure, heart rate, weight readings are wirelessly

transmitted to a data collection server • Readings are automatically monitored against a baseline, pre-set by the doctor

Nurses are alerted if readings fall outside allowed range • Nurses can remotely check patients’ readings through a dashboard, and drill down to

view trending graphs for a more complete assessment of their condition • Nurses support targeted patients with home visits, phone calls• Tablets enable nurses to securely access patient data, medical history from patients’

homes, and enter clinical notes on patients’ condition into the system • When necessary, tablets are used for video tele-conferencing between doctor at the

hospital, and nurse and patient at the patient’s home• Program has cared for 1,500 patients since Sept 2011 Over 700 are current patients

Used At Alexandra Health System (6-month tele-monitoring pilot for heart failure patients)

Awards WonSingapore Public Service PS21 Gold Award 2013, Most Innovative Project

2013

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Patient Relationship Management System

• Provides an integrated view of patient information, test results, interaction history• Nurse telecarers on the phone, guide patients in managing their condition at home• Gives alerts when key clinical indicators worsen

Benefits• Nurses can cost-effectively care for more people in the community• Enables early interventions and timely care, improving patient outcomes • Reduces patient A&E visits and hospital re-admissions

How It Works• Key information is extracted from patient’s medical records, to give telecarers an

integrated view of patient’s health status• Some patients are required to monitor and SMS their vital sign readings to hospital’s

data hub • System automatically scans the readings, and triggers alerts to telecarers when they

fall outside allowed range• A tele-monitoring trial for heart failure patients is in progress. Patients use monitoring

devices that send readings wirelessly to a data hub for automatic monitoring

Used At• Eastern Health Alliance (for chronic disease patients)

• National Heart Centre Singapore (for patients who had blocked heart artery procedures)

Awards WonFutureGov Award 2012, Healthcare Organisation of the Year


NHGP Telecare

• A home monitoring scheme that empowers patients with stable diabetes, hypertension or dyslipidaemia to better manage their conditions

• Patients’ readings entered regularly online, facilitate tele-consultations with care managers (trained nurses), and enable them to remotely monitor patients at home

Benefits• Reduced risks of complications, unnecessary clinic visits and hospital admissions • Reduced consultations enable clinicians to care for more patients, achieving improved

staff productivity, cost efficiencies• Right-siting of care from doctor to care managers for patients who are stable, well-

controlled• Re-allocation of clinician resources to help patients with more complex medical

conditions• Reduces crowds at clinics, which is useful during infectious disease outbreaks

How It Works• Patients or caregivers are guided by care coordinators to send glucose (if diabetic),

blood pressure, weight readings through an online portal • System auto-monitors the data and generates customised messages according to

patient’s prescribed care plan, to guide on actions to take eg diet or earlier clinic visit for review

• SMS reminders are sent when there is inadequate home monitoring readings• Care managers remotely monitor patients, preview readings prior to tele-consultations• System alerts them when a patient’s readings deteriorate, for timely intervention• Care managers can schedule patients’ clinic appointments, and arrange for home delivery of medicines to reduce Pharmacy queues, and for patients’ convenience

Used At National Healthcare Group Polyclinics

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Mobile Applications Apps For PatientsClinical Apps

Asthmacare BuddyDeveloped by SingHealth Polyclinics & IHiS

• App gives asthma patients real-time instructions on what to do & medication dosages to take when they experience various asthma conditions

• Empowers patients to pro-actively manage their disease • Provides easy-to-use tools and action plans to monitor and manage asthma conditions • A health diary enables patients to record and graph their peak flow meter readings and

asthma incidents to show their doctor


AxietyDeveloped by Khoo Teck Puat Hospital & IHiS

• App guides type 2 diabetic patients to administer insulin dosage based on their morning blood sugar reading

• Patient enters his blood glucose data into the app. Based on his treatment plan, app prompts him on dosage of insulin injection to administer for optimum blood sugar levels

• App helps patients manage panic attacks and set goals for recovery • A health diary helps users track their panic attacks and progress to discuss with

their doctor• Users rate the intensity of their panic attack, then choose to resolve it using three options

– soothing music, photos, videos

Diabetes PalDeveloped by Singapore General Hospital & IHiS

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• Generates graphs from the daily readings, so patients can see their progress in managing their diabetes

• Doctors and nurses can remotely monitor the patient’s progress and hypoglycaemic episodes. They can quickly intervene and modify his treatment plan, or communicate with him over the phone

Gacha Island Developed by Institute of Mental Health & IHiS

• Features games that simulate “killing” of monsters (mental illnesses) to convey that people need an arsenal of tools, such as social support, to deal with mental health issues

• Provides information on mental illnesses, with encouraging messages to seek help early• Variety of entertaining games, such as “mix and match”, with various difficulty levels

MyEyeGymDeveloped by Singapore National Eye Centre & IHiS

• Eye exercise app for people with certain types of squint which can cause limited or no binocular vision (Stereopsis or 3D vision)

• Provides many interesting images and games to encourage eye exercises • Exercises are of various difficulty levels. App tracks scores so doctors can

check patients’ progress


Awards WonSingapore Infocomm Technology Federation Award, Bronze - Best Social & Community Product, 2014

MyEyeDropsDeveloped by Singapore National Eye Centre & IHiS

• App reminds glaucoma and cornea patients to apply eye drops and medication, ensuring patients practise the prescribed treatment regime for better care outcomes

• A health diary allows patients to record frequency and intensity of their disease to facilitate management by their doctors

• Photos of various eye drops help patients quickly set up their medication list

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Thought BuddyDeveloped by Khoo Teck Puat Hospital & IHiS

• App helps users monitor and manage moods and depression• In the mood tracker, the user chooses a smiling or frowning face, and rates the intensity

of his mood. A graph charts his mood fluctuations over time• A thought diary helps users track and challenge negative thoughts, and build a healthy

thinking style

Apps For Patients In Hospitals

iCOMDeveloped by Changi General Hospital & IHiS

• App helps healthcare staff communicate with patients who speak in Chinese dialects

• Has common Cantonese phrases for use in hospital wards • Nurses tap the phrase in English, and app reads it out in Cantonese


Patient CommunicatorDeveloped by Changi General Hospital & IHiS

• App for patients in hospital wards to communicate with nurses when they cannot talk• Patients can choose words, pictures, draw or write to express their physical and

emotional needs• The pain-management chart allows them to point out body parts and pain levels• Has four languages – English, Chinese, Malay, Tamil

Apps For Patients’ Convenience

HealthBuddy Developed by SingHealth & IHiS

• One of region’s most comprehensive health mobile apps with latest advice from healthcare professionals

• Quick access to conditions and treatments, healthy living tips, videos

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• Mobile Appointments allow users to view, postpone and cancel appointments at SingHealth Polyclinics and Specialist Outpatient Clinics

• App provides useful information on SingHealth healthcare institutions eg clinical services, admission procedures

Awards WonSingapore Infocomm Technology Federation Award, Bronze, 2012

miHealthcareDeveloped by IHiS

• App gives useful information on all public hospitals, specialty centres, polyclinics eg

their clinical services, admission procedures• Queue Watch allows patients to view queues at Polyclinics and some Specialist

Outpatient Clinics• Mobile Appointment enables patients to view, postpone, cancel their appointments


Apps For Healthcare StaffNurses PalDeveloped by Singapore General Hospital & IHiS

• App helps nurses more quickly adjust patients’ intravenous drips, manage bedsores,

prevent falls• Features an intravenous (IV) drip rate calculator and alarm function which nurses can use

to enhance medication safety• Uses Braden Scale and Morse Fall Score to assess risks of bedsores and falls, and guides

nurses on preventive actions to take

Antimicrobial GuidelinesDeveloped by Singapore General Hospital & IHiS

• A mobile guide for clinicians with information on various antibiotics, information tree, calculator, and prevailing recommendations and practices at Singapore General Hospital

• Helps doctors decide antibiotic and dosage to administer, on a given event or scenario

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GPFirst Aide Mobile App Developed by Changi General Hospital & IHiS

• Helps GPs decide if a patient’s condition requires further management at hospital A&E• Provides clinical guidelines and videos • Has 16 emergency medical decision calculators/rules, including: u Back Pain Criteria - to diagnose serious spinal pathology u Glasgow Comma Scale - to assess consciousness after head injury u Head Injury CT Scan Criteria - to assess if scan required u Pneumonia Severity Index - to identify patients with community-acquired pneumonia u Stroke / Transient Ischemic Attack Risk Score – for use in triaging patients with acute TIA u Wells Score - to assess patients for Deep Vein Thrombosis

latest it systems at phis in singapore

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