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Data Can Shape the Future of Healthcare

When asked what started his research career, Professor Marcus Ong had the unlikeliest response: bar brawlers.

More specifically, the Emergency Medicine doctor was racking his mind for a way to close scalp lacerations without the use of needles – the inebriated are not usually the most cooperative lot – and without giving patients a bald patch.

With the timely introduction of medical glue and out-of-the-box thinking, Prof Ong created the Hair Apposition Technique (HAT), a wound closing method that was faster, more efficient and less painful for everyone.

After a successful randomised trial, the HAT trial was published in the leading Emergency Medicine journal and other international media, and the technique is now widely used in hospitals all over the world.

“Through this experience, I was bitten by the research bug,” he recalls fondly.

Prof Ong’s research aspirations only grew from there, having published over 240 papers in international and local peer-reviewed journals such as the Annals of Emergency Medicine, JAMA and Lancet.

And the self-professed “geek” – he once wrote a thesis on signal processing and dabbled in machine learning to study heart rhythms – has even courageously delved into the realm of big data.

Combining deep tech and healthcare

In 2009, he became a faculty member of the Health Services and Systems Research (HSSR) programme at Duke-NUS Medical School, where the team studies gaps in the healthcare system. His colleagues hail from vastly different fields and include the likes of biostatisticians, health economists, psychologists and industrial engineers.

 “The idea is to bring science from different fields into healthcare, and see how we can use our combined knowledge to fix problems in the system,” he explains, but there was a missing piece to the puzzle.

“We needed data to power our evidence-based approach,” says Prof Ong, who saw to the hiring of data scientists and analysts, many of whom previously worked with tech giants, to help process massive loads of electronic health information to improve healthcare.

“Our ultimate aim is to empower improvement in the system to bring about cost effectiveness, higher-quality care and better outcomes for patients and make life better for healthcare providers,” he adds.

Life saving advances

One of his pet projects – one that’s over 15 years in the making – is the introduction of a risk stratification triage tool for patients who report chest pains. By being able to detect heart rate variability through machine learning and artificial intelligence using a large clinical database, high-risk patients can be attended to in minutes, explains the clinician-scientist who has patented the invention.

“Emergency Medicine is perfect for research. As cases are acute, whatever decision we make determines if a patient gets well or worse, lives or dies. We need data to drive evidence and best practice. And there is always room for improvements,” he says.

Long before big data became a buzz phrase however, Prof Ong was already making headway. In 2001, he started a cardiac arrest registry to get a deeper understanding of emergency medical services in Singapore. “The survival rate for out-of-hospital cardiac arrests was just two per cent. The data collected showed the systems gaps that needed to be addressed and the interventions we needed to make,” he says.

After sending through an impactful white paper to the Ministry of Health, which outlined a five-year plan to improve emergency medical services, Prof Ong was tasked to bring his proposal to fruition through the set-up of the Unit for Pre-Hospital Emergency Care (UPEC).

UPEC became a vehicle to translate research evidence into policy and practice. The office handles everything from helping to craft laws and establishing best practices to data collection and community engagement. The team even jointly developed a mobile application called MyResponder with the Singapore Civil Defence Force. The location-based app is designed to get help to heart attack patients sooner, with the help of nearby voluntary responders (who are app users).

An ally in data science

The AM-ETHOS Academic Mentor Development Fellowship gave a much appreciated leg-up for Prof Ong, who was paired with Dr Jeffrey Ferranti, the Chief Information Officer and Vice President for Medical Informatics at Duke Health.

The duo are now working together to launch DEDUCE (Duke Enterprise Data Unified Content Explorer) in our Academic Medical Centre. Prof Ong describes the tool as “a Google for healthcare information”. “Rather than needing a computer programmer to run queries for you, you can search for healthcare information using common terms,” he explains.

They have also put together a fully-subscribed data science workshop in Singapore. “We realised there’s a huge pent-up demand. Within 24 hours of opening up registration, all 100 places were taken. Attendees range from clinicians and nurses to researchers and admin staff,” he shares.

In response to the workshop’s popularity, they plan to launch a series of classes called “Citizen Data Science” that will cover topics like data management and date visualisation. The idea is to get everyone literate in data science, not unlike how we are literate in finances, shares Prof Ong.

It all starts with a simple dream

“I’m a very practical person. I hope to make things better for my patients, colleagues, the health system, for Singapore, and maybe even globally,” he says of his aspiration.

And to make Academic Medicine a long-term reality, Prof Ong stresses, “We need to take a thinking approach to how we do things. We need research and best evidence, and ensure sustainability, so that what we learn is passed on to the next generation for lasting change.”

And while challenges remain, Prof Ong chooses to see the bright side of his multiple responsibilities. He says, “There are advantages in straddling different institutions. I try to bridge differences between clinicians and researchers, letting them see we all have the common goal of helping patients. And my work with UPEC allows me to engage academia, healthcare workers, politicians and policy makers – this is how we are able to create change on a national level.”

About our awardee

Professor Marcus Ong
Senior Consultant and Clinician Scientist, Dept of Emergency Medicine, Singapore General Hospital
Director, Health Services and Systems Research (HSSR), Duke-NUS Medical School
Director, Health Services Research Centre (HSRC), SingHealth
Medical Director, Unit for Pre-hospital Emergency Care (UPEC) and Senior Consultant, Hospital Services Division, Ministry of Health.
Chairman, Pan Asian Resuscitation Outcomes Study (PAROS)

Academic Mentor
Dr Jeffrey Ferranti
Chief Information Officer and Vice President for Medical Informatics, Duke Health