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Public Sector Tech Project of the Year

Imagine linking 13 medical laboratories onto a single system, and imagine building automation and robotics capabilities in two of the largest. An overly-ambitious plan? Well, several industry experts thought so. But the National Healthcare Group was convinced the benefits would outweigh the potential risk of putting such a system together.In 2003, the Singapore healthcare provider--also a ZDNet Asia Smart50 company--embarked on a bold initiative to build a Lab Information and Automation System (LIS), integrating all of its 13 laboratories into a common platform. At the same time, the National Healthcare Group (NHG) was keen to introduce automation and robotics in two of its largest labs.
Written by Eileen Yu, Senior Contributing Editor

Company
One of Singapore's major healthcare providers, the National Healthcare Group (NHG) provides healthcare services through a network of four hospitals, several specialist institutes and nine polyclinics.

Project
Lab Information and Automation System (LIS)

Objectives
•  Create a "one patient" vision, providing consistent care across the NHG.
•  Enable authorized care providers to access a patient's lab results electronically.
•  Improve the quality and consistency, and lower overall cost of processing lab tests.
•  Provide a faster turnaround time and at the same time, still maintain a laboratory process that is safe for patient and staff.

Budget
S$3.15 million (US$2.97 million)

Timeline
Implemented over two phases, and on schedule, the first started in May 2004 and ended in January 2006. The second began in August 2005 and was completed in January 2006.

Tech partners
IBM Singapore, EGIS Healthcare Technologies, Beckman Coulter and Bayer

Key learnings
Because the risk of failure was high with such a large-scale project, the NHG set up a change management team tasked with building communication with the staff, training and putting together a command center for helpdesk calls. The team ensured that users were well-informed of the impending change, increasing the level of acceptance.

Deserves the award because...
Industry experts had cautioned that the initiative was too risky and chances of success were low, but the NHG was undeterred. Convinced that the benefits to patients would be huge, it forged ahead and was able to accomplish its objectives with careful planning and determination.

The objective was to create a "one patient" vision, providing seamless and consistent care across the group's hospitals and healthcare facilities. Authorized care providers would be able to access a patient's lab results electronically via the system.

Another goal was to improve the quality and consistency of lab tests, lower the overall cost of processing such tests, provide a faster turnaround time and, at the same time, still maintain a laboratory process that is safe for patient and staff.

Prof Sunil Sethi, chief of laboratory medicine at the National University Hospital, said: "We wanted to refresh and standardize the many lab systems we were running onto a new robust version, so that we could share information [across the various hospitals] and save costs.

"At the same time, we were able to consolidate and build voluminous lab test results rapidly. Over time, such a huge repository of lab results can be mined and used for determining the appropriate pathways of care," Sethi said.

However, industry experts advised that such an undertaking would be too risky and chances of success were low. But the NHG was steadfast in its belief that the benefits of LIS would be worth the effort, and mitigated any potential risk with careful planning and much determination.

It set aside S$3.15 million (US$2.97 million), and sought the help of four IT and biomedical services providers: IBM Singapore, EGIS Healthcare Technologies, Beckman Coulter and Bayer.

Implemented over two phases, the project began in May 2004 and was completed in January 2006--on time, and on budget.

NHG CIO Linus Tham acknowledged: "The risks of a project of this scale are certainly high. We were worried about the product scalability and timelines. To mitigate the risks, we intentionally put together a change management sub-team when we started on the project.

"This sub-team focused on building communication [with the staff], training, a command center for helpdesk calls, and so on. The team ensured that users were well-informed of the impending change and helped increased the level of acceptance and buy-in," Tham said.

Today, with the LIS running for the entire NHG cluster, the system is able to rapidly scale up as the group's lab unit opens more branches, he said. In addition, lab-related data is now more readily available to the NHG's EMR (electronic medical records) systems. This allowed doctors to quickly get lab results and cut down on treatment time.

Sethi explained: "Given the unified process and standards, the labs in the hospitals can work together like a huge virtual lab.

"The labs can help out other labs which are overloaded, thus, ensuring a certain level of service."

Before introducing automation into the LIS, there was a high level of human intervention in the entire lab process, even though tests were processed by the machines. Because the new system helped eliminate a huge part of human intervention, potential human errors were greatly reduced.

Patient care was also improved in other ways. Previously, a patient would have to retake similar tests as he moves from a community clinic to a specialist institute, because the various healthcare facilities may use different systems. Transferring medical records was also too much hassle and took too long. This is no longer the case with the LIS.

Having a common system will help the NHG, with the use of newer laboratory technologies, save an estimated S$10 million (US$6.3 million) in reduced cost per lab test over the next seven years.

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