Millions of dollars spent on Healthcare IT: Trend, Ideas, and Dreams Dr Thomas Sim Senior Manager School of Health Sciences Ngee Ann Polytechnic

Intersection between Healthcare & IT

Why do I call it Healthcare IT?

Singapore’s use of Healthcare IT… Singapore Budget Speech 2009 by Minister of Finance, Mr Tharman Shanmugaratnam G.19.We are committed to a substantial expansion of the healthcare sector. Over the next five years, we will invest $4 billion in healthcare infrastructure , which will include the redevelopment of older hospitals, medical centres and a new hospital in the west, as well as seeing through existing projects like the Khoo Teck Puat Hospital in the north. G.20. MOH is also developing an electronic health records system accessible to authorised medical practitioners at our hospitals and polyclinics, and eventually extending to the community care sector. It will allow for more effective treatment of patients who may receive a spectrum of healthcare services from different providers. We will be spending about $200 million to get this project launched over the next two years and will be among the first in the world to implement such a system nation-wide.

Singapore Budget Speech 2009 by Minister of Finance, Mr Tharman Shanmugaratnam

G.19.We are committed to a substantial expansion of the healthcare sector. Over the next five years, we will invest $4 billion in healthcare infrastructure , which will include the redevelopment of older hospitals, medical centres and a new hospital in the west, as well as seeing through existing projects like the Khoo Teck Puat Hospital in the north.

G.20. MOH is also developing an electronic health records system accessible to authorised medical practitioners at our hospitals and polyclinics, and eventually extending to the community care sector. It will allow for more effective treatment of patients who may receive a spectrum of healthcare services from different providers. We will be spending about $200 million to get this project launched over the next two years and will be among the first in the world to implement such a system nation-wide.

Singapore’s use of Healthcare IT… The Straits Times 18 Feb Page B2 “… An attending nurse can call up the medical records on the PDA...”

Healthcare IT in Singapore… Electronic Medical Records Electronic Medical Records Exchange HL7 (Health Level 7) Standards But why focus on EMR? Patients “doctor-shop” Patients change hospitals due to perceived or real issues with standards of care or just location. Problems of repeated tests and X-rays

Electronic Medical Records

Electronic Medical Records Exchange

HL7 (Health Level 7) Standards

But why focus on EMR?

Patients “doctor-shop”

Patients change hospitals due to perceived or real issues with standards of care or just location.

Problems of repeated tests and X-rays

Electronic Medical Record

Near Future at SGH…

3 minute Ad-break

NP’s PDA project started in Nov 2006, way ahead of anyone else… “ Students of nursing at Ngee Ann Polytechnic will be the first in Asia…to use PDAs…”

Healthcare IT education at NP Adopter & Sponsor Convener & Sponsor Solution Developer & Integrator Supported by: Supporter – (Sponsors 6 x Banners & 360 XBOX) Drug Database Licensor

Project Highlights 1 st in Asia to fully exploit and embrace Pocket PC/ Mobile technology for nursing education 1 st campus wide deployment of Pocket PC (reaching 700 in 2008, 1500 in 2009) 1 st Mobile Translator (NPpalm Translator) 1 st local drug database application for nursing students to be developed by a nursing school in Singapore – leverage on MIMS database 1 st healthcare project to leverage on nationwide wireless infrastructure ,i.e. Wireless@SG

1 st in Asia to fully exploit and embrace Pocket PC/ Mobile technology for nursing education

1 st campus wide deployment of Pocket PC

(reaching 700 in 2008, 1500 in 2009)

1 st Mobile Translator (NPpalm Translator)

1 st local drug database application for nursing students to be developed by a nursing school in Singapore – leverage on MIMS database

1 st healthcare project to leverage on nationwide wireless infrastructure ,i.e. Wireless@SG

Overview of NPalm NPalm stands for Ngee Ann Polytechnic Augmented Learning Media NPalm consists of 4 core modules: NPalm Explorer – proprietary e-content viewer (designed for NP) NPalm Nursing Assessment – eLogbook, eGradeBook, eLearning Journal, etc NPalm Clinical Reference – Drug Database, Health Assessment , Pathophysiology NPalm Translator – word and phrase-translator Mobile Learning Mobile Assessment Mobile Reference Mobile Translator NPalm Productivity e.g. Email, Note-Taking, Contact List

NPalm stands for Ngee Ann Polytechnic Augmented Learning Media

NPalm consists of 4 core modules:

NPalm Explorer – proprietary e-content viewer (designed for NP)

NPalm Nursing Assessment – eLogbook, eGradeBook, eLearning Journal, etc

NPalm Clinical Reference – Drug Database, Health Assessment , Pathophysiology

NPalm Translator – word and phrase-translator

Sample Screenshots

NPalm Translator Developed in-house by NP Database with sound capability of commonly used phrases by nurses in Mandarin, Hokkien, Cantonese and Malay More features/enhancement to be released next year NPalm Mobile Translator

Developed in-house by NP

Database with sound capability of commonly used phrases by nurses in Mandarin, Hokkien, Cantonese and Malay

More features/enhancement to be released next year

End of Ad

Why use IT in healthcare at all? Some researchers report a preventable medical error rate of 1.3 to 18%. Preventable medical errors account for more deaths than car accidents. Using Healthcare IT lowers the rate of medical errors. Electronic Medical Records are only the beginning

Some researchers report a preventable medical error rate of 1.3 to 18%.

Preventable medical errors account for more deaths than car accidents.

Using Healthcare IT lowers the rate of medical errors.

Electronic Medical Records are only the beginning

Trends, Ideas, and Dreams… Patient gets into a major car accident, LOC, goes into A&E at Hospital A Patient’s IC/Passport is scanned for medical history and drug allergies X-rays are conducted X-rays tele-mailed to India for diagnosis Blood tests are run All x-rays and blood tests are kept on EMR. Patient wakes up discovers he is in Hospital A, wants to be transferred to hospital B. After being stabilised, transferred to Hospital B All medical records are up-todate with the EMRX. I cheated, all these are reality NOW, not just ideas!

Patient gets into a major car accident, LOC, goes into A&E at Hospital A

Patient’s IC/Passport is scanned for medical history and drug allergies

X-rays are conducted

X-rays tele-mailed to India for diagnosis

Blood tests are run

All x-rays and blood tests are kept on EMR.

Patient wakes up discovers he is in Hospital A, wants to be transferred to hospital B.

After being stabilised, transferred to Hospital B

All medical records are up-todate with the EMRX.

I cheated, all these are reality NOW, not just ideas!

Trends, Ideas, and Dreams… Clinical Decision Support System (CDSS) Doctor prescribes Drug X to patient, keys into CDSS. CDSS does a check, discovers patient is taking Drug Y which has contraindication with Drug X, CDSS reports an error. Netdoc™ I wake up in the middle of the night with symptoms X, Y, and Z. Log on to Netdoc, key in my symptoms, receive at instant diagnosis and advice. Useful for parents of babies and young children.

Clinical Decision Support System (CDSS)

Doctor prescribes Drug X to patient, keys into CDSS. CDSS does a check, discovers patient is taking Drug Y which has contraindication with Drug X, CDSS reports an error.

Netdoc™

I wake up in the middle of the night with symptoms X, Y, and Z. Log on to Netdoc, key in my symptoms, receive at instant diagnosis and advice.

Useful for parents of babies and young children.