Projects / Publications

Explore the innovative efforts and evidence‑based publications shaping the future of patient care.

Projects

4-Dimensional Disease OutbreakSurveillance System (4D-DOSS)

Infection Prevention & Epidemiology and Department of Infectious Diseases (SGH) and Department of Cardiology (CGH)

The 4-Dimensional Disease Outbreak Surveillance System (4D-DOSS) is a pioneering digital twin project that integrates real-time data, machine learning,and predictive analytics to identify at-risk contacts and detect infectious disease clusters effectively. It incorporates virtual reality to simulate disease outbreaks, enhancing pandemic preparedness and resilience within the healthcare system. Jointly funded by various health innovation funds and developed by a multidisciplinary team from institutions such as SGH and Duke-NUS, 4D-DOSS has been operational in SGH since August 2024 and is being expanded to other hospitals like NHCS and CGH.

The ABxSG Mobile App Initiative

Department of Infectious Diseases, SGH

Antibiotic consumption in Singapore’s Restructured Hospitals is high, with about 50% of admitted patients prescribed antibiotics, and nearly 20% of these prescriptions deemed inappropriate. The Antimicrobial Stewardship Unit (ASU) at SGH developed the ABxSG mobile app, launched in March 2023, which provides easy access to antibiotic guidelines and resources. Within nine months of its launch, ABxSG has led to a 2.83% reduction in inpatients on antibiotics, resulting in potential savings of USD $37,000 (drug cost) and 540 nursing hours. Pharmacy-related antibiotic interventions decreased by about 37 per month, optimising their time.As of June 2024, ABxSG has around 2,500 users across three institutions, and the hospital plans to expand the app’s availability to maximise its impact on antibiotic management and healthcare costs.

Catheter Flow Restoration with Lytic DwEll at Community DiAlysis CentRe (CLEAR)

Department of Renal Medicine, SGH

SGH Renal Medicine, together with NKF, NIU, and renal physicians across all public healthcare institutions, launched a national quality improvement project in 40 NKF community dialysis centres to address tunnelled haemodialysis catheter (THC) malfunctions, a common issue that often leads to inpatient procedures and delays in dialysis. The project introduced BLAST, which standardises anticoagulation and catheter care techniques to prevent clotting, and CLEAR, which equips community dialysis nurses to administer thrombolytic agents on-site for timely restoration of catheter flow. With continued support from partners, the initiative aims to expand to more centres and increase national haemodialysis population coverage from 59% to 80% by 31 December 2024.

Improving the effectiveness of COPD Action Plan amongst COPD patients in SKH

Department of Respiratory Medicine, SKH

Acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of hospital admissions and deaths in COPD patients, making early identification and treatment crucial. Written COPD self-management plans can reduce hospitalisations,but many patients and caregivers find the currentplan difficult to understand, highlighting the need for improvement. The project team created a pictorial COPD action plan, resulting in a 92.8% improvementin patients’ knowledge scores. This intervention has empowered patients with the skills to self-manage COPD at home effectively.

Keeping Gout in the Community – Reducing admissions for gout

Department of General Medicine (Rheumatology), SKH

In 2021, 18.1% of the 608 acute simple gout patients attending SKH ED were admitted. To address this growing concern, an Acute Gout Clinical Management Protocol was developed to standardise treatment and enhance care quality. With education and reminders, the protocol successfully reduced admissions from 18.1% to 11.1% of gout attendances in SKH ED, resulting in cost savings for patients and better access to care for other acute cases amid bed shortages.

Augmented Intelligence in Infectious Diseases (AI²D)

Overuse and misuse of antibiotics remain a significant global challenge. At SGH, audits in 2018 found that approximately 30% of antibiotic use was inappropriate, with around half of inpatients receiving antibiotics at any time. Inappropriate use contributes to antimicrobial resistance and poorer patient outcomes, while clinicians often need to make early prescribing decisions before laboratory results are available.To address this, Augmented Intelligence in Infectious Diseases (AI²D), an AI‑enabled antimicrobial stewardship initiative was developed in collaboration with DXC Technology and Synapxe to support clinicians’ antibiotic prescribing decisions. AI²D analyses retrospective clinical data to determine whether antibiotics are necessary, with an initial focus on pneumonia and urinary tract infections. The pneumonia model was trained on data from approximately 8,000 patients and validated on a further 2,000 cases, achieving 90% accuracy in pilot validation and enabling safer, more targeted prescribing.In recognition of its impact, AI²D won the NHIP Award 2025 – Best Practice Medal (Care Redesign).For more information and opportunities to collaborate, please email Andrea Kwa (andrea.kwa.l.h@sgh.com.sg) and Sarah Tang (sarah.tang.s.l@sgh.com.sg).