NHG operates in a dialectical environment of increased medical knowledge, rapid innovation, rising costs, intense competition, high expectations of increasingly well-informed patients and an ageing population.

To achieve better care for our patients, we utilise technology to help us.

Filmless Radiology/Teleradiology
In filmless technology, images such as x-rays are taken, stored and read digitally. Patients benefit from a shorter waiting time for their results. It also allows seamless transfer of patient information between care providers, leading to improved care.

Within NHG, the digitisation of x-ray images and teleradiology has allowed efficient sharing of resources among polyclinics and hospitals. Singapore’s long-term goal is to make public healthcare institutions a seamless environment in medical imaging and position the country as a medical imaging hub.

In December 2005, NHG became the first healthcare cluster in Singapore to introduce teleradiology with a pilot programme initiated at Ang Mo Kio Polyclinic to test the feasibility and quality of outsourcing the reading of routine x-rays to Teleradiology Solutions (TS) in India. TS is one of the leading teleradiology centres in India and is accredited by the US-based Joint Commission on Accreditation of Healthcare Organisations (JCAHO).

Teleradiology enables high quality reports within an hour, compared to the usual two to three days previously. Thus polyclinic patients no longer have to return and incur the additional cost of a second trip to collect their results. In addition, the switch to digital x-rays has helped NHG save $160,000 a year in film and chemical costs. This savings are passed on to patients with reduced x-ray costs from December 2006.

Since the completion of the successful pilot, all NHG polyclinics have outsourced the reading of routine x-rays to TS.

NHG Centres/Departments that have gone filmless:

• All NHG Diagnostics (NHGD) centres
• TTSH’s Orthopaedic Surgery, Otorhinolarygology, Ophthalmology, Psychological Medicine and General Surgery Departments
• NHG Polyclinics

Plans are also underway to include MRI and CT-scans into teleradiology.

Mobile Communications
Tan Tock Seng Hospital started a pilot leveraging a smart messaging system in October 2005. The system which replaced doctors’ pagers with mobile phones was designed to cut down on unnecessary waiting times between the communication of doctors and nurses. The pilot study also concluded that the use of mobile phones did not compromise patient safety. With the success of the pilot, TTSH issued mobile phones to all its doctors in January 2006. Its success also prompted the InfoComm Development Authority of Singapore (IDA) to approve a grant of $494,000 to NHG to deploy mobile phone system across its institutions and to further develop the system for other applications.

Computerised Clinician Order Entry (CCOE) System
This paperless system allows doctors to order tests and medication for patients electronically. It checks for appropriateness of orders and suggests other relevant orders, if necessary. It also alerts doctors to repetitive x-rays and laboratory tests orders, thus avoiding unnecessary duplication.

E-prescription also checks and alerts doctors to drug allergies, drug-to-drug interactions, and dosage caution for certain medical conditions.

Patients can expect quality, consistent and safer care as a result.

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