Academic Medicine in Conversation:

More than Tech: Innovation is About Solving Problems

With the well-being of thousands of COVID-positive migrant workers and healthcare colleagues on the line, the SingHealth team at the Singapore EXPO Community Care Facility (CCF) tackled challenges head on with quick thinking and well-placed technologies.

• Faced with error-fraught data and an anxious atmosphere, the EXPO CCF team underwent an intensive data scrubbing process and employed novel telecommunication methods to raise compliance rates for self-monitoring to almost 100%.
• Because of the pandemic, the roll-out of healthcare innovations has accelerated in a drive to improve safety and quality levels in patient care.
• Beyond COVID-19, innovation can continue at the workplace by owning and solving everyday problems.

Dr Charles Goh thought he was only going to be reviewing chest X-rays at the Singapore EXPO CCF where thousands of COVID-positive migrant patients were sent for care, but the nuclear medicine physician wound up helping to manage the facility’s medical IT systems and the data gathered from there.

"It really was an adventure," said the affable doctor, whose sentiment was echoed by other medical team members at the EXPO CCF including Associate Professor Henry Ho and Associate Professor Daniel Ting.

The trio, along with a valiant group of SingHealth colleagues, abandoned the comfort zone of their respective specialties during their deployment and shared their experience in the debut session of Academic Medicine In Conversation.

Walking into the Unknown

The team at CCF knew they were in for a challenging ride from day one – the patient cohort had a 60 to 70% compliance rate for vital signs self-monitoring.

With up to 3,600 patients at full capacity and a small healthcare team in comparison, Assoc Prof Ho, Assoc Prof Ting and Dr Goh had to find a way to achieve high compliance with low staff intervention.

But an existing patient data list that was littered with errors (ranging from wrong discharge statuses to typos) made for an initially frustrating and inefficient workflow.

As such, Dr Goh and the nurses worked collaboratively and iteratively to identify sources of error before they finally whittled down the non-compliant call list to an accurate and leaner one. 

With truly actionable data on hand, the team eventually achieved a self-monitoring compliance rate of over 99%. But this wasn’t all.

To further optimise the well-being of patients while ensuring staff safety, an interactive robot by the name of Temi helped perform telemedical consultations. Later, migrant workers would use Temi as an entertainment system by playing their favourite Bollywood tunes.

Complementing Temi was the Doctor Covid chatbot – it was conversant in five different languages to facilitate communication with the culturally diverse migrant worker population. The software was also a way to push out social and entertainment news (and reminders to check vitals) to the patients.

Innovating in the age of COVID-19 and beyond

Harnessing data for insights and the implementation of robots like Temi and automation tools have become commonplace the world over during the pandemic. "These are all innovations that are about attempting to continue to provide the standard of care within the circumstance we are in," said Assoc Prof Laing.

What COVID-19 has enabled was not technological advancement per se, but the business case to put plans into action, he added.

Indeed, the EXPO CCF appeared to be a utopia for Academic Medicine practitioners. There was an urgency to quickly brings ideas to life and the flat reporting structure was empowering, said the panellists, but the spark can continue on campus long after COVID is gone.

An innovator doesn’t necessarily have to be a technical whizz – he or she just needs to be a "problem solver", said Assoc Prof Laing.

Facilitator Assoc Prof Chow agreed, adding, "Innovators are also those who own the problem that’s being solved."

In the near future, aspiring innovators can look forward to institutional support in the form of a Joint Centre for Technology, an Academic Medicine Innovation Institute and Innovation Centre and a Health Discovery District. These efforts strive to lower barriers to collaboration, provide a living lab to pilot new solutions and deepen relationships with external partners.

"I’m glad to also hear that some of these teachings and knowledge [from our COVID experience and upcoming innovation efforts] will be incorporated into residency programmes as we move forward," said Assoc Prof Chow.

Challenges notwithstanding, the future looks bright for Academic Medicine, going by Assoc Prof Ho’s closing comments. "The number of new talents that we’ve discovered from this episode has been tremendous, be it among nurses, allied health or new doctors. We’ve expanded the family of Academic Medicine."