Central command system gives TTSH and NCID bird's eye view needed to fight Covid-19 outbreak

Tan Tock Seng Hospital's Command, Control and Communications (C3) system at its Operations Command Centre, the first of its kind intelligent healthcare facility worldwide.
Tan Tock Seng Hospital's Command, Control and Communications (C3) system at its Operations Command Centre, the first of its kind intelligent healthcare facility worldwide.ST PHOTO: NG SOR LUAN

SINGAPORE - On Feb 4, Singapore saw its first locally transmitted case of Covid-19, and the definition for suspect cases was changed.

Within a day, a surge of nearly 500 people - almost double the usual number - began showing up at the National Centre for Infectious Diseases' (NCID) screening centre, posing a risk of overcrowding.

But instead of being overwhelmed, the centre was able to quickly open another hundred beds for patients and safely manage the crowd flow, all thanks to a newly-launched Command, Control and Communications (C3) system at the nearby Tan Tock Seng Hospital (TTSH).

The system, a first worldwide, won the Excellence Champion Medal at this year's National Healthcare Innovation and Productivity awards by the Ministry of Health (MOH).

Dr Jamie Mervyn Lim, chief operating officer of TTSH and Central Health, told reporters on Monday (July 27) that up till 2008, TTSH had relied on a "pen, paper and phone" system of managing its operations, with each department doing its own thing.

"It was very inefficient, we weren't able to optimise the process because there was no visibility about where empty beds were, who was discharged, and so on," he said.

But following the successful use of technology such as radio frequency identification (RFID) chips and computer algorithms in the hospital in the following years, the decision was made in 2015 to try and leverage technology further to support decision-making and enhance the hospital's workflows.

So the C3 system was launched in December last year.Located in the TTSH Operations Command Centre, it serves as the "brain" to both TTSH and NCID, helping to control the flow of resources across both institutions, which share the same pool of manpower.

The system gives a team of about a dozen staff in the centre a bird's-eye-view of everything that is going on in TTSH and NCID - from crowds forming at potential chokepoints to which rooms are about to be vacated so the housekeeping staff can quickly prepare them for the next patient.

"There's a lot of back-end coordination, and the (C3 system) provides that level of visibility of where the different resources are, who we can activate and how quickly, and lets us deploy them," said Dr Lim.

The C3 system, which was co-developed by TTSH, Integrated Health Information Systems (IHiS) and ST Engineering and supported by MOH, also comes with multiple pre-planned scenarios modes which allow it to adapt to various real-life situations, such as a civil emergency, an infectious disease outbreak, or a fire in the hospital.


Dr Lim said the system has helped TTSH and NCID deal with the difficulties posed by the Covid-19 outbreak.

"When you go into outbreak mode, you are going into an unknown... we needed more data points," he said.

Using devices known as Real Time Location Trackers, the C3 system helps provide data about staff and patient movement, allowing the institutions to track who Covid-19 patients may have come into contact with.

It also keeps track of how many gloves and masks have been used each day, which enables the institutions to anticipate and plug any shortages long before they arise.

The system also helps to quickly assign the best beds to patients, sorting quickly through around 300 considerations such as gender, ward class preference and illness - something that had to be done manually in the past.


Dr Lim said the system is continually being adapted and upgraded, with the eventual aim of linking it with other partners in the healthcare network, such as community hospitals, ambulance service providers, polyclinics and other public hospitals.

"No two outbreaks are the same and we co-developed the outbreak module as Covid-19 evolves.

"We learned along the way, and we have to be nimble enough to adapt with each step of the journey," he said.