Singapore unveils national Health IT Master Plan (HITMAP)
The Minister for Health, Mr. Gan Kim Yong, today revealed the strategic Health IT Master Plan (HITMAP) that has been guiding the healthcare sector’s IT programmes since 2014. With seven transformation programmes, the strategic HITMAP enables the Ministry of Health’s (MOH) three key shifts of moving beyond quality to value, beyond hospital to community, and beyond healthcare to health. It also supports policy formulation and evaluation, systems governance, public health and operations management, as well as strengthens IT resiliency and improves cost effectiveness. New projects such as the admissions prevention predictive model for the Ministry’s Hospital to Home Programme, Health Marketplace, and Vital Signs Monitoring were also unveiled in Minister Gan’s speech at the 9th National Health IT Summit 2017 held at Singapore Expo. The seven transformation programmes are:
This involves the understanding and analysing relevant data of Singapore’s population (including genotypic, phenotypic, social, financial and lifestyle data) for more proactive and effective provision of health services, right-siting of care and care plan development. Profiling the population is an important element to support targeted efforts in various areas including disease prevention, chronic disease management, stratified medicine, healthcare financing etc. The use of behavioural analytics will likely increase effectiveness of intervention programs. The enabling platform for this is the Business Research Analytic Insight Network (BRAIN), which enables analytics to be performed in a federated manner by providing common software and platform-as-a service to business and research users with end-to-end common analytics toolsets to discover and unlock insights from data. It also facilitates collaboration amongst different users and researchers through sharing of toolsets and know-how.
The population enablement programme will provide consumers/caregivers with the knowledge, insights and ability to manage their own and their dependents’ health and healthcare finances. This involves multi-channel close collaboration and active partnership between the population and their care providers so as to help individuals develop a high level of healthcare literacy, discipline and self-guided health services navigation on a contextualised basis.
Enabling platforms include HealthHub, Telehealth and Health Marketplace. HealthHub is the one-stop online health content, information and services portal for Singapore residents. Featuring a user friendly mobile application and website, HealthHub aims to encourage those who are well to adopt healthy lifestyle practices, provide those who have health conditions with tools to self-manage their conditions, and equip individuals who care for others in an informal capacity with the necessary information and tools. Telehealth enables the shift from institution-based care towards home and community care, and is a “workforce multiplier” to help healthcare providers improve productivity and multiply care provisioning capacity.
Health Marketplace is online matchmaking platform that links patient/ caregiver to home-care services and supplies. The idea includes unlocking existing untapped resources (e.g. nurses or therapists on their off hours or volunteers in the neighbourhood) to offer home care services. Complimentary offerings such as transport, meals or personal care services can be further orchestrated, providing holistic care for the patient at home.
Prevention and Continuity of Care
This programme will place consumers in the centre of healthcare with holistic and orchestrated approaches at the various stages of a person’s lifetime. The scope of prevention encompasses proactive and personalised approaches to health promotion and disease prevention, raising the level of health literacy to keep Singapore’s population healthy and delaying onset of disease for those at risk. The scope also focuses on early detection of diseases, followed by appropriate intervention.
It further aims to help individuals with chronic conditions, maintain their health and promote quality of life by delaying progression of their conditions, and preventing complications. Continuity of Care refers to the transition and coordination of patient care from one care provider to the next. It is characterised by a set of plans, goals or outcomes pertaining to the patient’s care, and applies to providers from the clinical, social and community space. Providers in different care settings will function as one team and have ready access to health, social and if needed financial information for a holistic view of the consumer in order to deliver seamless, coordinated and quality care across the care continuum.
The enabling platform for this is the National Electronic Health Records (NEHR), which enables accessibility and sharing of patients’ health records across the national healthcare network, meeting MOH’s vision for “One Singaporean, One Health Record”. The system provides clinicians with secure near “real-time” access to care records for each patient including problem lists, medications, discharge and event summaries, allergies, immunisations, investigations, and procedures. The long-term goal of the NEHR is to allow primary, acute and community-care clinicians to access and contribute clinical data that help enhance medical treatment and improve patient safety.
Another enabling platform is the Care & Case Management System (CCMS), which enables a multidisciplinary approach to clinical care, thus enabling improved coordination among clinicians and care providers across the continuum of care and provides care transformation from the traditional doctor-centric model to a team-based, patient-centric model. It goes beyond the boundaries of the public healthcare sector to connect the community and intermediate and long term care (ILTC) sector who are critical partners in the management of patients with comorbid conditions and need healthcare and social support from different care providers.
Provider Care & Operations Excellence
The Provider Care and Operations Excellence programme will uplift clinical care delivery and operational capabilities within health institutions while subscribing to common support services across care settings. This may leverage mature technology innovations applicable to healthcare and could also involve the streamlining of clinical care and operational processes to improve quality, cost effectiveness and efficiency of health services delivered to consumers/patients.
Enabling platforms include GPConnect, an integrated IT system for GPs, to support local clinical processes. GPConnect comprises a customised Clinic Management System (CMS) and Electronic Medical Records (EMR) solution. With its links to many national systems, GPConnect facilitates the seamless exchange of relevant clinical information between GPs and other healthcare providers. This improves the efficiency of GP clinics while ensuring an integrated continuum of patient care. In addition, claims for various national schemes can be done automatically through GPConnect.
Healthcare Financial Excellence
This programme will bring increased transparency to financial health and agility of financial operations. It will enable views of resource utilisation and requirements across the health system including detailed information about each cost driver for health services and procedures so as to support financial resource allocation, healthcare finance policy planning and development of pricing models.
Policy & Public Health Workbench
The Policy & Public Health Workbench programme will be critical in supporting MOH’s operations and role as an NE operator during periods of civil and national emergencies, through public health surveillance, situational awareness and real-time performance indicators of the current healthcare system. It will also assist health system administrators to formulate more effective healthcare policies through a data-driven, and evidence-based approach, with the ability to simulate and predict the impact of such changes to policy levers prior to implementation.
The enabling platform for this is the Business Research Analytic Insight Network (BRAIN), which is also shared with the Population Enablement programme.
IT Foundation & Resiliency
This programme will set up the foundational IT infrastructure, processes and resources needed to support the other health IT programmes. Once in place, it will provide economies of scale for the health system and enable seamless interconnectivity and information flow between various care providers, institutions and consumers/patients/caregivers in a secured manner. These IT foundations must be architected to adapt to changes in business requirements and future technology shifts.
The enabling platform for this is the Health Cloud (H-Cloud), which is based on a modular architecture that would provide a single platform for clinicians to access, analyse, and update patient EMRs, while also guaranteeing disaster recovery and uptime for all clinical centres during and after any emergency.