Data, Science & Technology
Non-communicable diseases are the biggest contributor to the overall burden of disease, whether measured in DALY (disability-adjusted life years), YLL (years of life lost) or YLD (years lived with disability). There is significant opportunity in improving post-AMI outcomes and also mental health which is relatively underserved in SG.
AMI-HOPE (Acute Myocardial Infarction – Allied Health-Oriented, Patient-Centric and Digitally Enabled Care)
Cardiovascular diseases is the leading cause of deaths in Singapore, with some of our metrics falling behind other developed countries.
AMI-HOPE (Acute Myocardial Infarction – Allied Health-Oriented, Patient-centred and Digitally Enabled Care) is an initiative led by National University Health System (NUHS) in partnership with National Healthcare Group (NHG), SingHealth, Health Promotion Board (HPB) and Synapxe. MOHT contributes to the transformative aspects of the programme, including monitoring, technology solution design, development and implementation, as well as overall programme management.
The primary aim of this initiative is to improve post-discharge outcomes and reduce costs by empowering allied health professionals to actively manage and provide remote support to patients after their discharge from the hospital. One transformative aspect of the programme involves leveraging technology to provide personalised, just-in-time coaching methodologies aimed at encouraging and guiding patients towards better adherence and lifestyle changes.
Under this new care model, patients share their blood pressure and heart rate readings with pharmacists using Health Discovery+, a national vital signs monitoring platform. This facilitates timely medication adjustments and provides early advice to patients, as soon as one week after their discharge. Without AMI-HOPE, patients typically can only have their first consultation with their cardiologist three months after discharge.
Additionally, patients receive personalised guidance and recommendations for managing their diet, lifestyle and mental wellbeing the through HD+ and consultations with pharmacists. This helps in their recovery and may reduce the likelihood of a second heart attack.
With this additional support during the initial stages of recovery, patients with less complex conditions can be transitioned back to primary care in six months. This enhances the patient’s overall experience and increases efficiency in t healthcare delivery. As the first telehealth programme to span across care settings, AMI-HOPE has shaped the design of the patient transfer workflow within HD+.
HOPES (Health Outcomes through Positive Engagement and Self-Empowerment)
With MOHT playing an increasingly bigger role in the digital mental health space, it is timely to pursue new care models for mental health, an under-addressed segment of the healthcare burden. Recently, an exciting set of digital technologies has emerged, enabling in situ assessment and intervention strategies via personal digital devices. These technologies known as “digital phenotyping” and “digital therapeutics” respectively, offer new possibilities for addressing various mental health disorders.
The Health Outcomes through Positive Engagement and Self-Empowerment (HOPES) platform, co-developed by MOHT and the Institute of Mental Health (IMH), enables digital phenotyping from wearable devices and smartphones. It is a first-of-its-kind digital phenotyping platform featuring both passive and active data monitoring, paired with automated AI- and human-based interventions. The goal is to improve care of psychosis and mood disorder patients and enhance self-management of their condition. MOHT leads in the modelling of the digital phenotyping data and serves as the technology platform owner.
As part of an IMH service, patients are equipped with a fitness tracker and mobile app on their smartphone. This app empowers patients to monitor their daily activities, mood and sleep patterns. It also provides them with valuable self-help resources, mental health management tools (including journaling, psychoeducation materials and therapeutic exercises), and the automated provision of personalised just-in-time digital therapeutic interventions. The platform remotely tracks various biomarkers such as sleep quality, activity and sociability through robust safeguards. Any anomalies are promptly identified using AI algorithms, enabling the care team to access and implement appropriate follow-up actions.
Data Science and AI
While helming initiatives such as HOPES, DST also plays an enabling role in supporting several projects within MOHT through Data Science and AI and Architecture and Development Methodology.
In Data Science and AI, DST has been working with various teams to develop the following improved care models:
- A data-driven risk adjustment model based on financial costs that guides resource planning and identifies inefficiencies in the healthcare system;
- A personalised patient-coaching module for patients in tele-monitoring programmes, which aims to drive lifestyle change and medication compliance, thereby improving health outcomes;
- The anomaly detection engines in HOPES, which segments patients and triggers automated therapeutic interventions;
- A patient counselling tool based on a deep learning clinical risk profiler, which is being trialed at the National Heart Centre Singapore (NHCS).
Architecture and Development Methodology
In Architecture and Development Methodology, DST has been supporting the overall MOHT goal of healthcare transformation through Data-Driven Innovation, an agile development model and architecture for full solution development. DST adopts an agile approach based on the use of hybrid cloud and data anonymisation methodology, and by exploring new collaboration models with our technology partners in multiple projects including AMI-HOPE, mindline.sg, and others. We have achieved rapid and independent data-centric healthcare innovation while keeping strict compliance with HealthTech data security & privacy policies. DST is also working closely with the Integrated Health Promotion programme of MOHT on mental health website mindline.sg as the tech provider, providing data tracking capabilities and data analytics platforms. Mindline.sg is a digital platform that offers a wide variety of resources and tools designed to enhance the emotional wellbeing of users. This has proven to be essential for our digital marketing efforts and partnership building endeavours.
Partners:
Ministry of Health
National Healthcare Group, National Healthcare Group Polyclinics
National University Health System, National University Polyclinics
SingHealth, SingHealth Polyclinics
Agency For Integrated Care
Health Promotion Board
Synapxe
Current Initiatives:
AMI-HOPE at multiple hospitals and polyclinics
HOPES at the Institute of Mental Health
mindline.sg in collaboration with InHealth
Professor Robert Morris
