Expand list of notifiable diseases to help identify problems: Doctors
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SINGAPORE — Doctors here have suggested expanding the list of notifiable diseases monitored under the Infectious Diseases Act, tapping big data analytics as well as encouraging more informal communication among medical professionals to identify potential problems, in the wake of the hepatitis C outbreak at the Singapore General Hospital earlier this year.
Nevertheless, they also cautioned against over-reporting cases, as this could put a strain on resources.
Yesterday (Dec 8), following the findings of an independent review committee, the Ministry of Health (MOH) and SGH announced plans to tighten infection control and response times to outbreaks. Among other measures, a taskforce led by Minister of State (Health) Chee Hong Tat will be set up to improve the national healthcare system’s ability to detect and respond to infectious disease outbreaks in hospitals and the community.
The review is expected to be completed by the middle of next year, the MOH said today. More details on the taskforce’s composition and work plan will be released later.
The committee had noted that Singapore’s system works well in detecting and containing community outbreaks of known infectious diseases and common healthcare-associated infections (HAIs) but there are gaps in handling unusual HAIs — these include salmonella, chicken pox and norovirus, among others, said the doctors whom TODAY spoke to.
Dr Leong Hoe Nam, an infectious disease specialist in private practice, said more infectious diseases under the Act could be monitored by healthcare institutions. Under the Act, the authorities have to be notified of cases such as cholera, dengue fever, and hand, foot and mouth disease within 24 hours, while cases such as acute hepatitis C and measles must be alerted to the authorities within 72 hours. The monitoring should also be accompanied by a notification system to alert the authorities, added Dr Leong.
Oncologist Tan Wu Meng, who is a Member of Parliament for Jurong Group Representation Constituency, noted that modern hospitals today have a lot of data and clinical observations that can be spread out over multiple departments.
“The future of surveillance will involve better use of electronic medical records, with inter-operable databases, and big data analytics to help human experts pick up problems sooner,” said Dr Tan, who will sit on the Government Parliamentary Committee for Health when the 13th Parliament convenes in January.
Colorectal surgeon Koh Poh Koon, who is also an MP for Ang Mo Kio GRC, cautioned against a “knee-jerk response”. The authorities will have to strike a balance between scrutinising every unusual case and increasing the burden of the tasks performed by the medical professionals, he said.
“This is really just a one-off event that happened after so many years … overall, our processes are robust and sound,” he added.
Professor Paul Tambyah, an infectious diseases physician and secretary-general of the Asia Pacific Society of Clinical Microbiology and Infection, said that healthcare institutions here “already have very comprehensive systems in place for surveillance of both common and less common (HAIs)”.
He added that communications within MOH need to improve significantly. “When doctors report these infections to MOH using the well-developed frameworks already in place... the regulators in MOH need to be able to react quickly,” said Prof Tambyah, who contested the recent General Election under the Singapore Democratic Party banner.
Today, the MOH reiterated that it has reminded all healthcare institutions and providers that they “need to strictly comply with clinical protocols and guidelines, including infection prevention and control safeguards”.
Measures the ministry has put in place include having the Communicable Diseases Division of the ministry oversee the surveillance of all infectious diseases, as well as the notifications, reports and analyses of infectious diseases information.
MOH said it has also revised its notification criteria for acute hepatitis C virus to be “in line with international best practices”.
