theceomagazine.com | 123“With 10 years of partnership and collaboration with NHCS, we are
glad to share the same vision, mission and core values with our Made
for Life philosophy, which is a longstanding commitment towards our
partners and patients.” – Masami Tanaka, General Manager, Canon
Medical Systems Asia Pte Ltd.
A HEALTHY HEART
NHCS is a Singapore Government-owned
healthcare institution that specialises in treating
cardiovascular disease. It has 185 beds and treats
more than 100,000 patients each year. The centre
is part of Singapore’s largest healthcare group,
SingHealth, which includes five national specialty
centres, three hospitals, a community hospital and
a network of polyclinics.
In 2015, the centre launched a new initiative
in partnership with SingHealth Polyclinics that aims
to give patients a faster diagnosis. In a conventional
healthcare system, when a patient comes in with
chest pain or shortness of breath, they will usually
need a test to be done. This could be a treadmill
test, an ECG or an ultrasound of the heart.
“Usually, what happens is the primary care
physician would refer this patient to see a
cardiologist, the cardiologist would order the tests,
and then see the patient again,” Terrance explains.
“So, in a sense, the cardiologist is the gatekeeper
of the test that has to be done.”
While this process is beneficial – in that the
cardiologist can decide whether a specific test is
appropriate – one major problem remains.
“It creates a delay for the patient and requires
more clinic visits because they need to see a doctor
first, who will examine them and take their medical
history,” Terrance says. “Then they have to get an
appointment to see a cardiologist, who will
examine them and take the whole history again,
and then order the tests.”
So, NHCS partnered with SingHealth
Polyclinics to launch the ‘front loading’ initiative,
which cuts down one specialist consultation. “We
wanted to design a system that allowed a patient
to go straight to the tests after seeing the family
physician,” Terrance notes. As tests can be done
faster and a diagnosis provided much earlier, this
initiative saves patients time and money.
Terrance acknowledges the reasons that could be
raised from having family doctors order tests but
has found a way to overcome them. “The reason
why this wasn’t done previously was because of
concerns that the doctor – who’s not a specialist –
might not order the most appropriate test for a
specific problem. So, there was a policy to only
allow the specialist to order the test,” he says. “To
get around this problem, we came up with agreed
protocols, such as the test would be ordered based
on certain criteria and the best medical evidence.
And to make sure the tests were appropriate, they
are ordered by a team of staff, including a
cardiologist, who looks at the referral from the
doctor, and then works out what exact tests should
be done.”“BY RE-ENGINEERING
THE PROCESS, WE
ARE TRYING TO
IMPROVE CARE AND
REDUCE RESOURCE
CONSUMPTION.”NHCS has used this system for over 3,000
patients, finding that it is a great help. Now the
centre wants to refine it. “By re-engineering the
process, we are trying to improve care and reduce
resource consumption,” Terrance continues. “All of
which are big issues in many healthcare systems.” »Interview | INVEST