Senior Consultant
National Centre for Infectious Diseases
Director
Infectious Disease Research and Training Office
National Centre for Infectious Diseases
Associate Professor
Yong Loo Lin School of Medicine
National University of Singapore
Associate Professor
Lee Kong Chian School of Medicine
Nanyang Technological University
Professor Lisa Ng Fong Poh (伍芳葆)
Executive Director
Biomedical Research Council
Agency for Science, Technology and Research
Executive Director
A*STAR Infectious Diseases Labs (ID Labs)
Agency for Science, Technology and Research
Dr Barnaby Young
Consultant
National Centre for Infectious Diseases
Head
Singapore Infectious Disease Clinical Research Network and
NCID Research Clinic
Infectious Disease Research and Training Office
National Centre for Infectious Diseases
Dr Chia Wan Ni (谢宛妮)
Research Fellow
Emerging Infectious Diseases Programme
Duke-NUS Medical School
“For their instrumental contributions and significant achievements in COVID-19 research, and management of the pandemic response in Singapore and globally.”
The year 2020 presented an unprecedented challenge for healthcare systems across the world. With reported COVID-19 cases rising in Asia, there was an urgent need to understand the novel coronavirus. This led to the establishment of the COVID-19 Research Workgroup (RWG), chaired by Professor Leo Yee Sin, Executive Director, National Centre for Infectious Diseases (NCID), with Associate Professor David Lye, Director, Infectious Disease Research and Training Office, NCID as Deputy Chairman, and advised by Professor Tan Chorh Chuan, Chief Health Scientist, Ministry of Health (MOH). The RWG convened on 22 January 2020, a day before Singapore reported its first confirmed COVID-19 case, aimed at conducting studies to better understand COVID-19 and its transmission in Singapore.
A critical component of the RWG’s research was “PROTECT” – a multi-centre prospective study to detect novel pathogens and characterise emerging infections according to a pre-established outbreak drawer protocol developed in 2012 and coordinated by NCID. This protocol served as a foundation platform covering all public hospitals in Singapore, and enabled the collection of clinical data and biological samples for research. The first PROTECT subject was recruited on 24 January 2020, and as of December 2020 over 600 COVID-19 patients had participated.
The RWG has made significant research contributions in the COVID-19 pandemic, including the development and validation of diagnostic tools, deeper insights and understanding of virus pathogenesis and transmission, biomarkers of disease severity, investigation of COVID-19 clusters in Singapore, characterisation of environmental contamination with the SARS-CoV-2 virus, development and evaluation of potential therapeutic agents, and a greater understanding of the socio-behavioural aspects of the pandemic on healthcare workers and other segments of the community. These research efforts in turn led to improved standards of care, diagnosis, health outcomes, and management of COVID-19 patients both locally and globally.
To date, the RWG has contributed to some 212 publications. Notably, 23 of these publications are top-tier scientific journals, including the New England Journal of Medicine, The Lancet, JAMA, Science, Nature, and Cell.
Importantly, the RWG’s research findings have been translated and incorporated into investigation of outbreaks, infection control measures, and public health policies on quarantine and isolation, as well as the development of diagnosis and treatment methods benefitting patients and the wider community, both locally and internationally. Some of the significant diagnostic tools and treatments against COVID-19 include the world’s first SARS-CoV-2 neutralisation antibody test (cPassTM) to identify people previously infected with the virus and who subsequently developed an adaptive immune response; the use of remdesivir and baricitinib in the treatment of COVID-19 patients in Singapore, through the RWG’s participation in international clinical trials led by the United States’ National Institutes of Health and which contributed to national and international treatment guidelines; and the provision of patient samples used to develop the Regeneron monoclonal antibodies, which have since been shown to be effective in treating hospitalised patients with severe COVID-19 in the RECOVERY trial in the United Kingdom.
For their instrumental contributions and significant achievements in COVID-19 research, and management of the pandemic response in Singapore and globally, the COVID-19 RWG is awarded the National Clinical Excellence Team Award 2021.
NATIONAL CLINICAL EXCELLENCE TEAM AWARD 2021
GPFIRST PROGRAMME
Clinical Associate Professor Steven Lim Hoon Chin (林训进)
Senior Consultant
Accident and Emergency
Changi General Hospital
Programme Director, GPFirst
Changi General Hospital
Clinical Associate Professor
Duke-NUS Medical School
Clinical Associate Professor How Choon How (侯俊豪)
Senior Consultant, Family Physician
Changi General Hospital
Director, Primary Care, SingHealth Office of Regional Heath
Changi General Hospital
Ms Priscilla Goh (吴素卿)
Manager, Primary Care Integration, GP Engagement
Changi General Hospital
Dr Oh Hong Choon (胡鸿春)
Assistant Director, Health Services Research
Changi General Hospital
Assistant Director, Health Services Research & Evaluation
SingHealth Office of Regional Health
Adjunct Assistant Professor
Duke-NUS Medical School
“For their timely contributions in enhancing Accident & Emergency efficiencies and shaping a holistic and collaborative healthcare ecosystem with better health outcomes for the community.”
The GPFirst programme, an initiative spearheaded by Changi General Hospital (CGH) in 2014, was designed to improve the efficiency of Accident & Emergency (A&E) services for better management of patient load, and to optimise the prioritisation of care for patients requiring emergency treatment. The programme aims to encourage patients with mild to moderate conditions to visit a General Practitioner (GP) instead of presenting themselves at the A&E Department at first instance.
In right-siting care, the GPFirst team adopted a multipronged approach, which involved reducing the number of non-emergency cases seen at the A&E; engaging, empowering and collaborating with GPs to enhance their management of mild-to-moderate conditions within the community; and shaping healthcare-seeking behaviours in the community.
A joint study by CGH and Singapore University of Technology and Design showed that individuals who perceive their medical conditions to be critical were 3.5 times more likely to visit the A&E, even if their condition could be attended to by GPs. Recognising the need for a paradigm shift in mindsets, behavioural nudges were incorporated in the data-driven programme to help individuals rethink the level of care needed when they are making decisions on where they should seek treatment. Patients who are referred to the A&E by the participating GPs will be accorded priority over minor emergencies and they will also receive a $50-subsidy to offset their A&E attendance fee.
The GPFirst team also carried out public education campaigns to improve health literacy and empower the community in making their choice of healthcare provider wisely. Partnerships with the People’s Association, Community Centres and Resident Committees were forged to further increase the programme’s reach through community outreach events.
Through the development of GPFirst, the programme team has established strong collaborations with the network of 305 GP clinics in the eastern region of Singapore. To date, more than 80% of GP clinics in the network have participated in the regional primary care programmes, forming a lively eco-system to provide accessible, holistic and integrated care with better health outcomes for patients.
GPs in the GPFirst programme were invited to Continuing Medical Education activities to enhance knowledge-sharing in managing mild-to-moderate conditions within the community and improve the quality of care. The active engagement and collaborations with GPs increase their management of these conditions and contribute to their role as “gate-keepers” to A&E services. GPs are also able to reach out to a CGH A&E consultant via a 24/7 hotline.
The GPFirst programme has benefitted more than 33,000 patients in the East from 2014 to 2019. It also saw a 14 percent reduction in proportion of attendances at CGH A&E with mild and moderate conditions and a 36.6 percent reduction in walk-in attendances. Referral appropriateness under the programme has maintained at 97 percent since 2016. The reduction enhances the A&E’s ability to achieve greater streamlining of valuable resources to focus on emergency care, thus providing more timely treatment. In a survey of patients who experienced the programme, 87.3 percent of participants rated their overall experience as good or excellent, with 92.3 percent of them stating that they would recommend family and friends to visit the same GPFirst clinic for mild-to-moderate conditions prior to any A&E visit.
Following the successful rollout of GPFirst programme in CGH, coupled with the strong support across multi-disciplinary teams in the hospital, the GPFirst team worked closely with the Ministry of Health (MOH) and other local public hospitals in the sharing of its programme experience to facilitate the expansion of the programme on a national level. The GPFirst programme has since been implemented in other hospitals including Khoo Teck Puat Hospital, National University Hospital, Ng Teng Fong General Hospital, Sengkang General Hospital, and Woodlands Health Campus to-date. The GPFirst team continues to be MOH’s key partner in facilitating care shifts from the hospital to the community by expanding the GPFirst programme to more healthcare institutions.
For their timely contributions in enhancing Accident & Emergency efficiencies and shaping a holistic and collaborative healthcare ecosystem with better health outcomes for the community, the GPFirst team is awarded the National Clinical Excellence Team Award 2021.