Amin, H. et al.:Planning the Development of the Singapore

National Health Portal

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PLANNING THE DEVELOPMENT OF THE SINGAPORE NATIONAL HEALTH PORTAL

04 September 2008MEDICINE 2.0 CONGRESS

Handy Amin, Active Health ManagementDr Shyamala Thilagaratnam, Active Health Management

Dr Andy Tan, Active Health Management Low Sau Chan, Chief Information Officer's OfficeTan Ping Ping, Chief Information Officer's Office

All About Singapore

An island city-state in Southeast Asia

>15,000 km from Toronto

Land area of 700 km2

Maps courtesy of The World Factbook

Geographic Location

The People of Singapore

Vibrant global city; thriving centre of commerce

Multi-ethnic resident population of >3.6 million Chinese 76.8%

Malay 13.9%

Indian 7.9%

Others 1.4%

Total population of <4.6 million

Images courtesy of the Singapore Tourism Board

Things to do in Singapore

Images courtesy of the Singapore Tourism Board

Reasons for a National Health Portal

Health Promotion Board (HPB) Established on April 1, 2001

Vision

A nation of healthy and fit Singaporeans

Mission Statement

We will be a centre of excellence for health promotion. With our partners, we create a supportive environment, and provide health education and preventive health services to empower every Singaporean to attain the best possible health throughout life.

The Health Promotion Board

The HPB Strategic Framework

Unhealthy & aware of health conditions

(patients)

Unhealthy & not aware of health conditions

NutritionSmoking ControlPhysical Activity

Positive Mental HealthTargeted Interventions

Early detectionChronic Disease Management

Patient Education/EmpowermentBuilding Bridges to our Partners

Exploit IT MaximallyResearch & Strategic Planning

ADOLESCENTS

AD

ULTS

ELDERLY

CH

ILD

REN

At-risk groups

People of Singapore

Healthy Unhealthy

Schools

Healthcare

Workplaces

Community

Industry

Web

The Chronic Disease Challenge

Promote the concept of Active (& Individualised) Health Management (AHM)

Empower Singaporeans to actively manage their own health

Provide relevant resources and tools to support AHM

Active Health Management

Reduce medical costs

Change medical encounters from episodic to continuous

Enable prevention and early detection of illnesses

Enable provision of quality healthcare services based on individual needs and requirements

Objectives of AHM

Exploiting IT, Enabling AHM

National Health Portal (NHP)

Personal Health Record (PHR)

Health education resources

Personalised health management tools Health Risk Assessment (HRA)

Behavioural Health Intervention Programmes (BHIP)

Health Trackers

Collaborative disease management between patient and care providers

Exploiting IT, Enabling AHM

The National Health Portal Project

The NHP Taskforce

Drive development and implementation of NHP

Comprising of representatives from various stakeholders:

HPB

Health Clusters (SingHealth, NHG)

Ministry of Health (MOH)

Healthcare professional organisations (e.g.. College of Family Physicians of Singapore)

Infocomm Development Authority (IDA) Healthcare Cluster

Feasibility study

Global review of health portals

Dialogues / focus groups with stakeholder representatives

Conceptualising the NHP

“A unified web portal for empowering individuals and their care-givers with health/medical information and preventive/monitoring tools for personalised health management so as to achieve better health outcomes.”

The NHP Vision

NHP Project – Phase 1

Phase 1- 2008 to 2009

Internet

National Health PortalHPB User

Public

Clinicians

Laboratories

MSB

Personal Health Info Health

Screening Results

Self-entered Personal Health Info

Laboratory Systems

Hospital Systems

Functionalities / Features:

PHR Self-entered records; no integration with Electronic Health Records (EHR)

Lab results from Integrated Screening Programme (ISP)

Drug allergies from Critical Medical Information Store (CMIS)

Health management tools HRA

Weight Management BHIP

Smoking Cessation BHIP

Diabetes Management BHIP

Health Trackers

Clinician Access to PHR Public healthcare sector

Interfaces Interface with clusters’ events calendar & eventshub.sg

Interface with CPF for Medisave / Medishield / Eldershield information

Phase 1- 2008 to 2009

Conditions

Family history

Allergies Food

Environmental

Drug (Critical Medical Information Store, CMIS)

Lab tests Results from Integrated Screening Programme (ISP)

Contact information

Print PHR Summary

Print In Case of Emergency (ICE) Card

Phase 1 PHR Features

Concept of tailoring More tailored, more engaging, more effective

HRA

BHIPs Weight Management

Smoking Cessation

Diabetes Management

Health Trackers

Phase 1 Health Management Tools

Low Tailored Story

Tailoring Variable Used In This Case:+ Gender

Phase 1 Health Management Tools

High Tailored Story

Tailoring Variables Used In This Case:+ Age+ Gender+ Ethnicity+ Marital status+ Smoking status of spouse+ Child in home+ Physically active+ Number of cigarettes smoked+ Job status+ Barrier+ Social support

Phase 1 Health Management Tools

Health Trackers Weight / BMI

Blood Pressure

Blood Sugar (fasting and non-fasting)

Smoking

Nutrition

Physical Activity

Hemoglobin A1c

Phase 1 Health Management Tools

Appointment Booking Interface with clusters’ appointment systems

Calendar of events Interface with clusters’ events calendar & eventshub.sg

Health education resources Content from HPB Online (e.g. articles, RSS feeds,

podcasts)

Search function

Health expenditures Interface with CPF for Medisave / Medishield / Eldershield

information

Health insurance & coverage

Phase 1 Other Portal Features

Beyond Phase 3, the NHP shall be operated via a Public Private Partnership (PPP) model

Outreach Strategy

Year

Phases

Cumulative Number of Users

Outreach For Recruitment Of Users

2009 1 10,000 Polyclinic and government specialist clinics patients

2010 2 50,000 Civil service workplace

2011 3a 100,000 Private clinics and hospitals patients

Selected private workplaces

2012 3b 200,000 More workplaces

Insurance policyholders

NHP Project - Beyond Phase 1

Additional Functionalities / Features:

Evaluation of Phase 1

PHR Integration with GPs’ Clinical Management Systems (CMS)

Health management tools Mental Wellness BHIP

Clinician Access to PHR Private GPs

Interfaces National Immunisation Registry (NIR)

Student Health Assessment Programme (SHAPE)

Integrated Dental Electronic Assessment for Students (IDEAS)

Phase 2 - 2009 to 2010

Additional Functionalities / Features:

Evaluation of Phase 2

PHR Full integration with EHR

Health management tools Other BHIPs (e.g. Nutrition BHIP)

Clinician Access to PHR Private hospitals

Community hospitals & nursing homes

Phase 3 - 2010 to 2012

Additional Functionalities / Features:

Additional languages

Remote monitoring devices

Extend mobile / non-web access

Social networking tools

In the Pipeline

Standardization of data entry, sharing, and interoperability No common national standard across all healthcare providers currently

MOH holdings (MOHH) has been set up to co-ordinate efforts

Legal & ethical concerns - data privacy & security Policy on EHR data yet to be determined

Managing users’ expectation

Concerns about healthcare providers’ responsibility and legal liability

Engaging relevant stakeholders Co-ordination of stakeholders’ involvement; garnering their full support

Minimising disruption to existing systems & workflows

Increasing user adoption Marketing the NHP to the different target audiences

Incentivising participation, while maintaining sustainability

Critical Success Factors

Thank youHANDY_AMIN@HPB.GOV.SG