Dr Wee was working on her first research project for the SingHealth Duke-NUS Head & Neck Centre, in early 2015, when she realised how inadequate its database registry was for data mining.
The next time someone tells you to curb your computer game obsession, you may want to refer them to Dr Hide (pronounced as “Heidi”) Wee.
The medical officer used to spend up to 12 hours a day playing World of Warcraft, a popular online game, which resulted in her failing a module in first year medical school. But this same dogged streak and her inner geek may have led her to the cusp of a major breakthrough for medicine today.
Dr Wee was working on her first research project for the SingHealth Duke-NUS Head & Neck Centre, a SingHealth Duke-NUS Disease Centre (SDDC), in early 2015, when she realised how inadequate its database registry was for data mining.
“There was a large variety of data entered manually on different systems. I was spending more time on cleaning up data rather than actual research,” she said. “Things had to change.”
Hide knocked on the door of SGH Division of Surgery Chairman, Dr Tan Hiang Khoon, with the idea of setting up an electronic tumour board database to capture both retrospective data and real-time data through a system of tabs, clicks and radio buttons. This one system would capture all information – from patient cases discussions at ‘tumour board’ meetings to case notes and patient records – for easy data input and retrieval.
Dr Hide Wee's tenacity and initiative has led to the birth of the Head & Neck database registry - an idea which many others, including overseas parties, are keen to adopt.
Dr Tan was sold. He pointed her to a similar idea mooted years ago by the Head and Neck Centre’s Resident Physician, Dr Stefan Mueller, using the web-based REDCap freeware. Within a day, Dr Wee kick-started the project with Dr Mueller and Khairul Anwar, a database executive at the Surgery Academic Clinical Programme.
Khairul translated the technical language and complex oncological information into a user-friendly programme. The team also recruited Thakshayeni Skanthakumar, a life sciences graduate, to help them go through the data and transfer them to the new system, down to the minute details.
Six gruelling months later, a version of the system, customised for the Head & Neck center was born. “REDCap is already used for research databases in many SGH departments and in many top medical institutions around the world, including Stanford Medicine and Mayo Clinic. We adapted it into a combined clinical and research platform,” explained Dr Wee.
The impact has been significant. For starters, paperwork and task duplication has been reduced considerably, while information retrieval is a breeze and instead of manually fixing paper forms to list patients for tumour board, nursing staff now retrieve the information online.
Screen capture of the Head and Neck database registry.
According to Associate Professor Gopal Iyer, head of the Head & Neck Centre, this system is probably a first in the medical world to be employed for tumour board purposes. He recalled a similar experience of creating an e-form during his stint as a fellow at Memorial Sloan Kettering Cancer Centre, New York, in 2010. The difference was the lukewarm response to adopting the e-form as his colleagues were too used to hand-writing their notes.
“It’s great that here, we have the technology and a tech-savvy generation of younger doctors and staff are enthusiastic to drive projects like this”
End-user Dr Mahalakshmi Rangabashyam, a Service Registrar at the Head & Neck SDDC, also saw the benefits to research right away. “With this system, we save time sifting through large amounts of data. In the near future, we may even be able to use this system to zoom in to new trends of patient outcomes that we haven’t looked at before.”
With the Head & Neck Centre being the largest in the region, the system also has the potential of collating the largest head and neck cancer database for Asian populations.
“This started out as a small project, but there has been a surprising amount of interest in it; I feel very humbled - all I wanted to do was save everybody 10 minutes!”
- Dr Hide Wee, Medical Officer, Head & Neck Centre
What was heartening to Dr Wee during her journey was how supportive her bosses were and the open-mindedness to try new ideas for better solutions. “I’m the most junior physician in this department. I’m very gratified by the faith my bosses had in this project.”
At a recent conference in Germany where Dr Wee presented about this project, she received queries from overseas doctors on the potential of adopting the system to facilitate cross-country and cross-population cancer studies.
The team credits the success of the project to teamwork, supportive senior consultants and buy-in from the end-users, including Medical Officers and Residents, who have adopted the system and consistently use it to record data.
“This started out as a small project, but there has been a surprising amount of interest in it; I feel very humbled,” said Dr Wee. “All I wanted to do was save everybody 10 minutes!”