3月6日，新加坡衛生部兼通訊及新聞部高級政務部長普傑立醫生在國會上有關健康SG計劃系統的發言。
以下內容為新加坡眼根據國會英文資料翻譯整理：
衛生部兼通訊及新聞部高級政務部長（普傑立醫生）：賽義德哈倫醫生詢問支持健康SG計劃的醫療數據計劃。為了給醫院和社區護理環境中多個醫護人員提供的全面的數據，我們需要簡化醫護人員訪問和共享數據的方式。許多家庭醫生強調了數據與系統支持的重要性。
國家電子健康記錄（NEHR）是支持全面和整合護理的關鍵工具。它作為關鍵健康信息的集中存儲庫，醫療專業人員可以訪問並更新，其功能將得到升級，更安全可靠的方式滿足更廣泛的醫護人員，使不同護理環境中的醫護人員在照顧患者時能夠做出更好的決策。
針對初級護理，我們已經支援家庭醫生診所及其資訊系統供應商升級其IT系統，簡化行政流程，改善數據傳輸，同時確保數據共享安全。例如，在健康SG計劃的支持下，我們已經推出了初級護理診所的診所管理系統（CMS）分級框架，以確保私人家庭醫生診所使用的資訊系統系統與國家計劃整合，以更無縫地提供護理服務。
我們還增強了國家數字健康應用程式HealthHub，以賦予居民管理自己的健康能力。通過HealthHub，居民可以註冊健康SG計劃，查看他們的個性化健康計劃，管理醫療預約，查看他們的健康篩查結果和疫苗接種記錄。我們計劃在未來擴展通過HealthHub可用的健康記錄類型。
林偉傑醫生和佳馥梅女士建議利用AI來優化醫療服務，以實現成本效益和改善患者結果。我們的醫療機構廣泛使用經過驗證的、具有成本效益的技術，來自動化手工任務並增強臨床決策。例如，門診藥房自動化發藥系統（OPAS）有助於自動化藥房藥物的包裝和發放。
患者還可以利用HealthHub安排藥物補充和管理他們的醫療預約。所有這些都有助於減少等待時間並增強患者體驗。衛生部還正在探索利用AI輔助放射診斷系統進行病理檢測，自動分析醫學圖像，支持臨床醫生識別有緊急護理需求的患者，並幫助放射科醫生生成放射學報告。
文禮佳博士建議利用人工智慧來改善心理健康護理的可及性。目前，Mindline利用一款AI聊天機器人，人們可用匿名分享他們的情感困擾，並在需要時指導他們獲取幫助，如心理治療練習和諮詢服務。儘管我們歡迎創新並利用技術，但患者安全仍然是至關重要的。衛生部將繼續評估這些新技術在臨床和成本效益方面的效果，並評估它們在我們的醫療系統中各種用途的安全性和適用性。
佳馥梅女士要求更新已進行試點的價值導向護理計劃，並詢問這些計劃是否已在整個醫療系統中擴展。自2015年以來，衛生部一直在加大對價值導向護理工作的重視。這些努力旨在以可持續的方式提高健康結果，同時管理隨之而來的成本增加。這些計劃範圍從國家系統計劃到針對個別醫生和特定程序的計劃。
自癌症藥物清單（CDL）實施以來，該清單將終身健保和綜合保障計劃的覆蓋範圍重點放在經臨床驗證和成本效益高的癌症藥物治療上，公共部門的CDL藥物價格平均降低了30%，某些藥物甚至降低了超過60%。這也使我們能夠補貼更多的藥物，並提高了可負擔性。從長遠來看，我們預計這將緩解癌症藥物的成本壓力。我們正在將焦點更多地放在上游，並將價值導向護理應用於支付模式，例如定額制和通過健康SG計劃進行的預防工作。
為了讓大家更健康，這將是一個長期的措施。政府和醫護人員將為居民提供優質的醫療保健，但個人責任至關重要。我們每個人都必須對自己的健康負責，採取更健康的行為，與家庭醫生建立聯繫，並主動干預慢性疾病。與此同時，醫護人員將重新調整為預防性護理，而政府則建立系統、項目和激勵措施，支持醫護人員在社區為居民提供護理。
在未來，政府加強預防保健，居民為健康做出行動，我們的目標是每個人都能將定期家庭醫生作為首要聯繫點，並持續得到全面的支持。在多樣化的初級保健環境中，將提供一致且以證據為基礎的護理，我們所有人都可以採取積極措施，保持個性化的健康計劃。團結起來，我們所有人，每個人，都可以在改善我們的健康方面發揮作用。
以下是英文質詢內容：
: Senior Minister of State Janil.
The Senior Minister of State for Health (Dr Janil Puthucheary):Dr Syed Harun asked about systems integration plans to support Healthier SG. To facilitate holistic, integrated and coordinated care provided by multiple healthcare providers across hospital-based and community care settings, we need to simplify how our healthcare providers access and share data. The importance of a well-integrated and reliable IT system to connect healthcare providers has been highlighted by many GPs.
The National Electronic Health Record (NEHR) is a key tool for supporting holistic and integrated care. It serves as a centralised repository of key health information that healthcare professionals can access and can contribute to. Its capabilities will be enhanced to cater to a wider spectrum of care providers in a safe and secure manner, enabling healthcare providers in different care settings to make better decisions when caring for their patients.
The upcoming Health Information Bill will also establish the framework to govern the collection, access, use and sharing of selected health information across various settings to facilitate the continuity of care.
Specific to primary care, we have supported GP clinics and their IT vendors to upgrade their IT systems, to simplify administrative processes and to improve data flows, while ensuring data sharing is secure. For example, under Healthier SG, we have rolled out the Clinic Management System (CMS) Tiering Framework for Primary Care to ensure that IT systems used by private GP clinics are integrated with national programmes, for a more seamless delivery of care.
We have also enhanced our national digital health app, HealthHub, to empower residents to manage their own health. Through HealthHub, residents can enrol for Healthier SG, view their personalised health plans, manage medical appointments and view their health screening results and vaccination records. We plan to expand the type of health records available through HealthHub in the future.
Dr Lim Wee Kiak and Ms Mariam Jaafar suggested making use of technology and artificial intelligence (AI) to optimise healthcare delivery for cost effectiveness and improved patient outcomes. Our healthcare institutions use proven, cost-effective technology extensively to automate manual tasks and augment clinical decision-making. For example, the Outpatient Pharmacy Automation System (OPAS) helps to automate packing and dispensing of pharmacy medication.
Patients can also utilise HealthHub to arrange for medicine refills and manage their medical appointments. This all helps to reduce waiting times and enhance the patient experience. MOH is also exploring the use of AI-assisted radiology diagnosis systems for pathology detection, to automate the analysis of medical images, support clinicians to identify patients with urgent care needs and help radiologists to generate radiology reports.
Dr Wan Rizal suggested utilising AI to improve the accessibility of mental health care. Currently, Mindline employs an AI-enabled chatbot that allows people to share their emotional struggles anonymously and guides them to self-help resources such as psychotherapy exercises and counselling services where needed. While we embrace innovation and leverage technology, patient safety remains of paramount importance. MOH will continue to evaluate these new technologies for clinical and cost effectiveness and assess their safety and suitability for various uses in our healthcare system.
Ms Mariam Jaafar asked for an update on value-based care initiatives that have been piloted and whether these initiatives have been scaled up across the healthcare system. MOH has been placing increasing emphasis on value-based care efforts since 2015. These efforts aim to improve health outcomes while simultaneously managing the attendant cost increases in a sustainable way. These initiatives range from national system initiatives to programmes that target individual doctors and specific procedures.
