The Role of Digital Health in Singapore’s Healthcare Landscape

The city-state of Singapore ranks 6th in the world in health outcomes, yet lowest among high-income countries in healthcare expenditure per capita—according to William Haseltine, author of Affordable Excellence: The Singapore Healthcare Story.

In order for the health sector to sustain its effectiveness and efficiency amid a demographic shift in aging, the government in 2012 launched its Singapore Healthcare 2020 Masterplan. This strategy incorporates digital health tools that can help Singapore care for more residents who have gained universal coverage from expanded insurance plans, including seniors over 65 years old that will make up 20% of its population by 2030.

Health IT projects in Singapore are being aligned to allow seamless sharing of digital information, easy access to providers, and greater self-management of chronic diseases at home and in the community.

EHR/EMR

Digitizing health records is a top priority. The National Electronic Health Record (NEHR) program is a linchpin for Singapore’s Healthcare IT Master Plan. Launched in 2011, the NEHR system stores a unified medical record for every patient within and is used in more than 280 institutions by over 14,000 physicians.

"No matter which healthcare institution they visit, their health information will be made available across the various institutions, thus ensuring continuity of care," Health Minister Gan Kim Yong told The Straits Times.

A high number of hospitals in Singapore have achieved HIMSS Analytics Electronic Medical Record Adoption Model (EMRAM) Stage 6 certification.

"Forging ahead, future capabilities such as image sharing, care and case management will bring us closer towards realising the vision of 'One Patient, One Health Record' for Singapore," Gan told Channel News Asia.

Cloud Computing

Institutions implementing integration programs incur significant costs in running their own health IT systems. To lower costs, Singapore’s entire healthcare information exchange system is moving to the cloud.

The health cloud, or hCloud, will reportedly cost $50 million over the next ten years—around half of the total spending incurred by Singapore’s facilities for these operations today. The plan is to store healthcare information from different hospitals in the private cloud, which will have enough capacity to host additional applications in the future.

Asia One reports: “The hCloud will also offer greater security as users do not store any of the information in their terminals, so there will be no fear of leaks even if laptops or tablets are stolen. Instead, they will draw down the information as needed on dumb laptops or tablets, which can be remotely switched off if necessary.”

Telehealth and Telemedicine

Singaporeans are living longer but the elderly tend to live independently from younger family members. To bring health services closer to them, the government is committing to telehealth and telemedicine programs to help seniors manage chronic conditions beyond the acute setting. Present services include:

• Tele-rehabilitation for stroke patients performing rehab at home
• Tele-ophthalmology for patients in polyclinics receiving a virtual eye exam by hospital ophthalmologists

The telehealth programs can cut down unnecessary visits, offer convenience and savings to patients, and free up valuable hospital resources.

mHealth Apps

Seniors are also using mHealth apps to maintain their well-being.

In 2012, telecommunications carrier Singtel launched Project Silverline to give old iPhones loaded with health and wellness apps to seniors. In the same year, Japan’s NTT DoCoMo partnered with Omron Healthcare to design apps for residents that can track sleeping patterns, general health assessment and emergency services.

Homegrown companies are active in offering mHealth solutions as well. An example is Borderless Healthcare Group (BHG), which delivers three Android and iPhone apps, Smart Ageing, Heartsmart and Health Abacus via its “Borderless Clinic” mobile engine app. The apps allow live chat sessions when patients can ask their doctors questions about their conditions, medications and lab results.

Singaporean Dr. Wei Siang Yu, founder and chairman of BHG, said in a Borderless Minders article, “Given our multilingual, multiracial, multicultural population and our compact size, in addition to the government’s commitment to high technology standards, Singapore is a great place to introduce new technologies. As Singaporeans, our focus is on enabling the country to be the first in the world to reap the benefits of healthcare innovation.”

Meeting the Challenge

Singapore’s rapidly aging population presents many challenges to its healthcare system. But with more than 70 percent of older Singaporeans over 50 expecting to use digital health technology in the future, its adoption could be as successful as the government envisions.

Bill Crounse, M.D., Senior Director, Worldwide Health, Microsoft, said about a recent visit to the city-state: there is a "hunger and enthusiasm for technologies that will continue to place Singapore in the top ranks of the world’s economies. Whether in health, or any other sector, Singapore is leading the way in defining what a contemporary, efficient, highly productive nation can deliver to its citizens and all those who call it home."