Client Story
Providing next-level care for cancer patients between inpatient and outpatient settings at SingHealth
NCCS is a leading national and regional tertiary cancer centre with specialists who are experts in treating cancer. NCCS attends to the majority of cancer cases in Singapore's public healthcare sector. In addition to offering holistic and multidisciplinary oncology care, NCCS' clinicians and scientists collaborate with local and international partners to conduct robust, leadingedge clinical and translational research. NCCS also shares its depth of experience and expertise by training local and overseas medical professionals.
Officially opened in 1999, NCCS has since become one of the largest comprehensive tertiary cancer centre in the region. A multidisciplinary team of specialists comes together to review and determine the diagnostic and treatment techniques best suited for each individual patient.
As part of NCCS' commitment to deliver the best cancer care to patients in Singapore and the region, SingHealth started working on an extended e-chemotherapy project that encompasses the delivery of Sunrise Oncology as one component.
Reduced time taken for patient oncology records to be accessed across the care continuum
Reduced time taken for patient oncology records to be accessed across the care continuum
Improved efficiency and coordination among clinicians
Harmonised protocols and processes across institutions and venues of care
The intention is to create a paperless electronic oncology workflow by consolidating the workflow for medical oncology across multiple SingHealth institutions, including NCCS, Singapore General Hospital (SGH), KK Women's and Children's Hospital plus satellite, as well as outpatient cancer treatment centres at Sengkang General Hospital and Changi General Hospital. This brings together existing paper and electronic workflows into Sunrise to standardise and enhance the integration with patients' electronic medical records. For example, a patient may receive their diagnosis and undergo their initial treatment at NCCS (or even as an inpatient at SGH), but subsequently choose to receive the remaining cancer treatment in a satellite centre closer to where they live for greater convenience. With Sunrise Oncology, doctors, nurses and pharmacists from across SingHealth institutions will have visibility of key patient information including their prior treatment and any important notes (such as any adverse drug reactions).
"The implementation of Sunrise Oncology across SingHealth institutions provides a cluster-wide integrated oncology solution, which enables clinicians to access patient data more efficiently, improves patient safety and ensures seamless continuity of care for the patient," said Associate Professor Lita Chew, Head of Pharmacy Department, NCCS.
To meet growing healthcare needs, the new 24-storey NCCS building opened in phases in 2022 with increased capacity and expanded facilities dedicated to cancer care, rehabilitation, research and education.
As part of this expansion, Sunrise Oncology has been implemented in phases to standardise oncology workflows and streamline processes across all SingHealth institutions. This will support workflows for both solid tumours and blood cancers across oncology and haematology services - across institutions - and provide seamless integration with other Sunrise modules.
SingHealth and Altera Digital Health teams have worked closely to develop a solution that meets requirements across the different settings - inpatient, outpatient and in future, paediatrics. Supporting users through harmonisation across Clinician, Nursing and Pharmacy teams has enabled this to be achieved. An element of customisation and integration, to meet the specific needs of SingHealth, has meant that the final solution is fit for purpose and integrates seamlessly into current workflows and into the Sunrise ecosystem at SingHealth.
SingHealth Oncologists, Oncology Pharmacist and nurses, together with the Integrated Health Information Systems (IHiS), used the Agile methodology to create and design a customised app that enables clinicians to place their medication orders in the appropriate visit and session type. In addition, it provides in trend view, a complete view of the treatment received and any change of treatment plan for patients. Using Chart Group functionality, clinicians can maintain orders across outpatient visits. Together with the inpatient orders, clinicians can quickly identify where patients are in their treatment plan and monitor their progress through their care journey. It also supports the model of delivering high-quality and coordinated patient care.
Another element that the SingHealth and Altera Digital Health teams have worked together on is creating a customised status board for nurses and pharmacists to keep track of the status of patients, ensuring they continue to receive the timely administration of their chemotherapy treatments regardless of which healthcare setting they are situated at.
The flexibility of the Sunrise solution has enabled SingHealth to develop and build on the platform to deploy customised tools alongside a wide range of oncology protocol regimes. This ensures high-quality and standardised care, where patients can seamlessly move from inpatient care to outpatient care and vice versa.
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Ensuring a high level of the most up-to-date patient care is of utmost importance to SingHealth. As treatment protocols can change over time and according to specific patient needs, the ability for clinicians to easily adjust protocols is an important requirement. The solution includes an ad hoc order set to facilitate this quickly and easily, and to ensure that such changes are seamlessly added to the baseline roadmap and treatment plan. This helps clinicians gain visibility into all the changes made, which in turn enables them to make informed clinical decisions about any further amendments that a particular patient requires as part of their ongoing treatment. Additional functionality to provide an audit trail of dose adjustments is also valuable in terms of patient safety, greater accuracy and providing clinicians all the information they need each time they see the patient and prescribe subsequent treatments.
This harmonisation of patient records means information from various care settings is available to all users on the same platform. This eliminates the need for patients to repeat their medical histories during each consultation and, more importantly, enables clinicians to access up-to-date medical records, thereby providing a more holistic view of the patient's condition, enhancing patient safety and improving efficiency in care delivery.
"As healthcare needs evolve and digital technologies transform the way we deliver care, SingHealth will continue to enhance our IT and data infrastructure, working with partners like Altera Digital Health and through systems such as Sunrise, so that we can improve patient outcomes and experience, and stay ahead of the curve for our patients," said Mr Benedict Tan, Group Chief Digital Strategy Officer, SingHealth.
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