​Students with SingHealth Group Chief Digital Strategy Officer, Mr Benedict Tan (last row, 4th from right), and ODS facilitators after the 23rd STePS presentation

​With the advent of digital technologies and systems, many SingHealth teams and departments are exploring various digital solutions to improve processes and workflows to increase efficiency. However, with limited resources, teams may face challenges in developing their ideas further, into working prototypes.

Since 2019, the SingHealth Office of Digital Strategy (ODS) has collaborated with Assistant Professor Lim Shi Ying (NUS School of Computing (SoC)'s Department of Information Systems and Analytics) and her undergraduates from IS4250: IT-enabled Healthcare Solutioning. This partnership was originally intended to comprise a series of hospital visits for the students, introducing the healthcare environment, showcasing how various systems in SingHealth support different functions, and shedding some light on the challenges and limitations faced. However, when the COVID-19 pandemic reached our shores and hospital visits were no longer permitted, ODS and Asst Prof Lim shifted the focus of the partnership – one which would instead tap into the students' skill sets to develop solutions to meet existing needs. With this new direction, the NUS students are now given the opportunity to help address real-life challenges faced by healthcare professionals, and SingHealth project teams get to work with the students to develop their ideas into workable proof of concepts or prototypes.

These collaborations begin with kick-off meetings between project teams and the students, where project details and requirements are discussed. The students then bring those requirements back to brainstorm, start developing and iterating their solutions with the project team, before presenting the final deliverables at the end of the semester at the SoC Term Project Showcase (STePS) presentation.

Since the start of project-based collaboration in 2021, 23 project teams across SingHealth have taken part, with many noteworthy prototypes and solutions developed. Here are two of the 23 collaborations undertaken since 2021:

Mo-Knee-tor Application (Singapore General Hospital)

Annually, about 1,500 patients undergo total knee replacement (TKR) surgeries at the Singapore General Hospital (SGH). Limited knee range-of-motion (ROM) is common following TKR and requires close monitoring for optimal recovery. Whilst the goniometer is the most used tool to assess ROM, it requires a trained assessor to perform the necessary measurements. With the rapid evolution of technology, including that of smartphone computational capabilities and accelerometer accuracy, technological devices possess the capability to allow the self-measurement of knee ROM and assist with clinical decision making.

As such, a team of physiotherapists from SGH, led by Senior Principal Physiotherapists Ms Eleanor Chew, Mr Pua Yong Hao and Mr John Tan, worked closely with the students to develop a mobile application that utilises the smartphone's in-built accelerometer to measure knee flexion and extension ROM accurately. This can be done by simply placing the smartphone along the patient's shin, who then flexes or extends the leg as much as possible. The smartphone will then display the measured angle, which can be recorded by the patient for monitoring purposes.

Subsequently, the application was used in a scientific study to validate the reliability and validity of self-measuring the knee ROM using an accelerometer-based smartphone application. The results of the study affirmed that the smartphone application is feasible, reliable and accurate, and can be used with confidence in the self-assessment of knee ROM post-surgery.

The team is now in discussions to commercialise the application and make it available for other SingHealth patients across institutions.

Walk Less, See More (SingHealth Nursing)

Another example is the nursing route optimiser, developed with inputs from Adjunct Assistant Professor Ang Shin Yuh, Deputy Director for Nursing Innovation, Quality and Research at SingHealth, and Senior Nurse Clinician (SNC) Fu Liqing from the National Neuroscience Institute (NNI).

As hospitals expand to accommodate the growing number of patients, the amount of time nurses take to travel from one ward to another also increases. To maximise efficiency, Advanced Practice Nurses providing inpatient care spend 30 to 45 minutes daily just to review, prioritise, and schedule ward rounds for between 15 to 20 patients.

The usual practice is for the ward rounds to take into consideration the geographic location of the patients. However, there may be urgent cases which need to be reviewed on a timelier basis.

The team worked with the NUS students to develop a prototype of the route optimiser, which automatically returns the optimised route for multiple nurses, accounting for the urgency of patients' conditions, as well as distance between the wards. The prototype built by the students also had configurable parameters, allowing the nurses flexibility to change the priorities of various conditions, depending on the different circumstances.

SNC Fu noted that it was a good learning opportunity not only for the students, but also herself, as both parties leveraged each other's knowledge and skillsets to design and build the prototype to address the problems faced.

The team plans to continue iterating the prototype and share it with their colleagues. There are also plans to explore possibilities in incorporating this algorithm in future generations of the Electronic Medical Records system.

As the partnership between SingHealth and NUS continues to grow from strength to strength, the team also hopes to explore other similar collaborations and more ways to leverage IT to improve healthcare solutions and workflow.

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