The Singaporemedicine Story

• Best of 2007 •

This article was first[ Special printed in the Feature 15 October 2007 ] issue of APBN The SingaporeMedicine Story Dr Jason C H Yap MBBS, MMed (Public Health), FAMS, MBA (Information Systems), CISSP Director (Healthcare Services), Singapore Tourism Board

(or as it is more commonly known, Medical TravelMedical Tourism) is the deliberate travel for healthcare outside one’s country. Besides being an old practice of the more affluent, it is also a new economic phenomenon following the globalization of other industries. In the midst of a cacophony of national tourism organizations announcing their entry, Singapore is starting the fifth year of its government-industry partnership to develop and maintain its decades-old position as the medical destination of choice in the region. This is the story of SingaporeMedicine. Since its separation from the Malayan Federation in 1965, Singapore has developed into an efficient, international city rated by Political and Economic Risk Consultancy (PERC) as Asia’s least risky economy and most politically stable country in 2007. In its survey of national healthcare systems in 2000, the World Health Organization ranked Singapore sixth in the world and best in Asia. While Singaporeans have excellent life expectancies at birth of 78 years for males and 82 years for females, Singapore’s total healthcare expenditure is only about US$4 billion a year or about 3.5% of the national gross domestic product (GDP) of US$117 billion (S$194 billion), of which only one third comes from the government.

Why Does Singapore Serve International Patients? Every country has a political and social imperative to care for the health of its people. Why does Singapore, and more pertinently the Singapore government, explicitly direct efforts to the international patients? There are those who contend that local healthcare services should be for local people. There are ﬁve main reasons why the international patient plays an important part in Singapore’s healthcare economy and ecology.

Why International Patients? • Revenue • Medical Community • Medical Hub • International City • Local Needs

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1. Revenue Singapore has no hinterland, no minerals, and no resources other than its people. Ever since independence and the departure of the British military (which took away a sizable chunk of the economy), Singapore has had to earn its keep through international trade. Hence, the dollars earned by providing such healthcare services is simply part of the economic lifeblood of the country. In the same way, it is the attraction for the private healthcare industries in other medical travel destinations. Beyond the revenue from clinical services, patients and mounted medical missions when the business and social reasons that their traveling companions also natural and man-made disasters companies locate their offices in spend on accommodation and hit her neighbours. As Singapore’s Singapore, but also because Singapore transport; dine and wine; and of healthcare services have been built is an excellent jump-off point for course, shopping! They also get to up through the years with the help business ventures in the region and visit the excellent tourist attractions. of the developed world, Singapore is China. In addition, Singapore’s long Even those who come to Singapore paying it forward in turn by sharing experience in healthcare quality primarily for other reasons, such as knowledge and expertise with the provides the consultants that JCI business, may ﬁnd time and occasion region. needs to serve its customers. Clinical to visit healthcare providers for the trials and research projects, often odd Botox injection. All in all, some 3. Medical Hub requiring many more subjects than 9% of the expenditure by tourists Beyond direct clinical services, Singapore alone can provide, are and other visitors to Singapore Singapore is a medical hub in the fuller nonetheless run out of Singapore, can be attributed to international sense of the phrase. The Economic in particular Biopolis, Singapore’s healthcare services. Development Board of Singapore purpose-built research hub. cultivates a biomedical cluster of 2. Medical Community related and mutually supporting 4. International City Approaching from the opposite end, industries in the life sciences. Many Beyond the life sciences, Singapore it is only natural for many patients healthcare and healthcare-related is also an international business to be referred to Singapore because multinational companies set up city for other industries e.g. media, doctors in their own country often their headquarters in Singapore. infocomm, financial services etc. come to Singapore for various These include the pharmaceutical There are many expatriates living in medical conferences and/or training. industry where six of the eight Singapore. Many business travellers These doctors then refer their cases biggest companies have ofﬁces and transit in Singapore to go to other to their counterparts in Singapore. manufacturing plants in Singapore. countries in the region indirectly. Knowing that some technologies and Similarly, many multinational Although not always explicitly services are available in Singapore healthcare consultancies operate in acknowledged, a key consideration and trusting in the competence Singapore. Interestingly, although for the choice of a regional or of their operators, conscientious all except singleton hospitals in world headquarters is the safety and doctors refer patients to Singapore Singapore have been accredited by healthcare services for the expatriate for better care. Doctors in Singapore the Joint Commission International, staff. The business needs must be often travel in the region to perform JCI nonetheless established its Asia pressing indeed for executives to and demonstrate surgery and to Pacific headquarters in Singapore deliberately choose to live in the train doctors. Singapore has also in 2006. It is not only because of more dangerous cities of the world.

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The quality of healthcare services National Imperative lists, usually because the healthcare in Singapore plays a significant role All in all, national imperative system is not able to match the in making Singapore the choice of is the last rationale that drives resources with the demand (e.g. in the 7000 multinational companies the SingaporeMedicine effort. If some developed countries). headquartered here. Singapore chooses to serve only its own people, the quality of care it is 2. Affordable Healthcare 5. Local Needs able to provide will not be the best In many cases, it is not the clinical The most critical motivation for possible. There is therefore no choice services that have fallen behind SingaporeMedicine is the health of its but to serve international patients. but the healthcare financing system own people, not just the expatriates that has fallen apart. Services may and travelers. The Ministry of Why Do Patients Seek be available but are inaccessible Health has a comprehensive Health International Healthcare? to particular population segments Manpower Development Program Conversely, why do patients seek because they are impossibly which sends doctors and other international healthcare services? expensive. Health insurance is healthcare professionals in Singapore Many Singaporeans think that available in many countries but their to be trained in the best centers of the international patients come to premiums may not be affordable. world, with large catchment zones Singapore because of her superior In some instances, the co-payment and high patient-volumes in their healthcare services. The reality is that alone are so expensive that it is subspeciality (or sub-subspeciality) rational people do not readily travel cheaper to travel to another country interests. On their return, they for healthcare, and will generally only for healthcare services. find a small population of only 4.5 seek international healthcare services million people and basically too few when they are unable to obtain the 3. Quality Healthcare patients in their areas of interest. In healthcare they need or want in Even where services are available, order to afford the more expensive their own country. There are some the quality of care in some countries technologies, to maintain the skills five types of healthcare that patients may be substandard. Capabilities and of doctors trained at great expense, travel for. competences vary between doctors and to retain these specialists in the within one healthcare facility, so country; it is critical to have patient Why International it is hardly surprising that there volumes commensurate with the Healthcare? should be differences between the level of sophistication of the medical very different healthcare systems technology. Such a rationale also • Essential across international borders. The means that international clientele • Affordable is not only needed by the private differences may be more perceived sector but by the public sector as • Quality than actual but are still important well. Singapore’s “public sector” reasons for patients to travel. Stories • Premium hospitals are all private limited of mistakes or misbehavior of a few companies (albeit government- • Incidental doctors or facilities in patient’s native owned), licensed under the private country can cause a general lack of hospitals and medical clinics act trust in the whole system. People are and operated as private entities 1. Essential Healthcare willing to travel for services that may but with a government subvention The development of healthcare make even a small difference when it that enables subsidies for the less services, and more pertinently comes to matters of health. affluent. A minimum patient volume healthcare systems, has not been the (and size of population served) same around the world. Currently, 4. Premium Healthcare is needed to maintain worldclass the entire economic structure of If there is a higher quality of services. Singapore finds itself in healthcare varies widely from country healthcare away from one’s own the apparently paradoxical position to country. Medical technologies and country, some services then naturally of needing to serve international services may not be available at all become regarded as of premium patients in order to serve its own in some countries (especially the quality, available only to the rich, people to the clinical standards developing countries) or they may sophisticated or enlightened. Patients desired. be available but with long waiting boast of the services they obtained at

www.asiabiotech.com Volume 11 > Numbers 23 & 24 > 2007 ■ 1527 1264 OVolume 11 > Number 19 > 2007 www.asiabiotech.com •[ Special Feature •] these high-end centers and may look but why do these patients choose from visa arrangements, to hotel on these services as luxuries available Singapore over the others? accommodations, to arrival and send- to only a few. off, to even leisure activities like visits for the family to the Night Safari. Why Singapore? 5. Incidental Healthcare Lastly, and overlapping the four • Singapore 3. Medical Hub reasons given above, many people Singapore, the multi-faceted medical • Patient Services consume healthcare while overseas hub, offers more to patients than other for other purposes. Certain healthcare • Medical Hub destinations that offer only clinical services may be sought simply • At Home Away From Home services. Beyond providing services because they are convenient where developed elsewhere, patients have the traveller is visiting, or because • Affordability access to cutting-edge procedures they are unavailable, unaffordable and technologies. Many South- or inadequate in the travellers’ own 1. Singapore east Asian, Asian and world “ﬁrsts” countries. Major examples are dental For many patients, it is simply because were developed and performed in and cosmetic services. it is Singapore. Through the years, Singapore. The supply of medical Singapore has built a reputation as devices and pharmaceuticals is more Needs, Wants and Gaps a country in which what’s promised assured at this medical hub. Where Ultimately, the decision to seek gets delivered. In 2006, PERC said there is a need for economies of healthcare outside one’s own country Singapore’s government has the scale across multinational ﬁrms, key is a function of one’s needs and wants, highest integrity in Asia and in 2007, resources tend to be centralized in and the gap in the delivery between the World Bank ranked Singapore Singapore. the healthcare systems at home as the world’s easiest place to do and in the preferred destination. business. Things work in Singapore 4. At Home Away From Home Historically, healthcare systems have and, when it comes to one’s health, The travelling patient needs not only been generally isolated from one that is critical. good clinical care but also a warm another. In today’s globalized world, and non-threatening environment. the gaps have become more obvious 2. Patient Services Singapore is multi-racial, multi- and also more bridgeable, hence the Singapore’s healthcare services are religious and multi-cultural, and growing interest in medical travel. excellent, safe and trustworthy. It well used to accommodating people is well demonstrated by clinical of diverse cultures from around Why Do International indicators (e.g. intensive care the world. Singapore is linked by Patients Choose Singapore? ventilator-associated pneumonia 80 airlines to 180 cities in 157 In 2006, approximately 410 000 rates which are well below even the countries and was ranked first in visitors (out of the 9.7 million USA national rates) and accreditation 2006 by IMD World Competitive visitors to Singapore) declared (Singapore has one third of all JCI- Yearbook in the world for the that the primary reason they came accredited facilities in Asia). With quality of air transportation. Mercer to Singapore was for healthcare. modern buildings (e.g. Tan Tock Seng Human Resource Consulting ranked They brought along about 86 000 Hospital which won an international Singapore in 2002 as the world’s accompanying persons, who may be design award) and the latest medical second safest city. High security and parents, caregivers, family members technology (e.g. the BrainSuite, low crime provides for the travelling or friends. In addition, some 56 000 Singapore General Hospital’s patrat. Singapore is a major tourist visitors who came to Singapore neurosurgical operating theater with destination, receiving one visitor for for other reasons (e.g. business, ensuite MRI, CT and radiotherapy every local resident in 2006. The leisure, education, visiting friends and capabilities), the healthcare Global Country Brand Index ranked families) also availed themselves of infrastructure is well developed. Singapore as the world’s second some healthcare while in Singapore. Singapore’s healthcare providers country brands for shopping and for There are many places in the world operate international patient liaison nightlife/dining in 2006. For many that have styled themselves as services that look after the needs of patients and their companions, the “medical tourism destinations,” foreign patients, managing everything ability to travel to a country that is

1528 ■ Volume 11www.asiabiotech.com > Numbers 23 & 24 > 2007 www.asiabiotech.comVolume 11 > Number 19 > 2007 O1265 [• Special Best of Feature 2007 • ] comfortable, being free from concerns The SingaporeMedicine work to maximize returns in their for personal safety and psychological Initiative respective missions, it is MOH that stress is very important. In many countries, medical travel is provides balance between the many the preserve of private healthcare bipolar tensions (e.g. foreign or local 5. Affordability players. Governments may announce talent/patients/facilities etc.). Lastly, but to some most importantly, their support and national tourism the cost of healthcare in Singapore organizations may generate publicity 2. Economic Development is not exorbitant. There is a slight for the destination, but the real Board premium in the prices for many investment dollars come from the As mentioned earlier, the Economic procedures relative to the prices in private sector and the healthcare Development Board (EDB) manages Thailand and India, but this premium players are private sectors facilities. the biomedical/life sciences cluster. is happily borne by Singapore’s Singapore’s approach is very EDB promotes inbound investment current international patients. different. The entire healthcare not only of clinical service providers When compared with the prices of industry, including the restructured but also the other facets of the equivalent services in the developed public sector, welcomes international medical hub like the pharmaceutical world, the prices in Singapore are patients, and the government- and medical device industries. EDB low. For example, an angioplasty industry partnership that is complements MOH’s public sector in Singapore is list-priced at about SingaporeMedicine supports the capability and capacity development US$13 000, marginally higher than whole industry. The five components by assisting the private sector (and in India but very low compared to the of the SingaporeMedicine initiative to some extent the public sector as are as follows: US price of US$57 000. Interestingly, well) in like manner, and enables some referral services prefer to send Singapore to go beyond being a mere clinical service provider. their clients to Singapore because the The SingaporeMedicine final bill is smaller. It is also because Initiative 3. International Enterprise the more efficient facilities are able • Ministry of Health to discharge the patient sooner and Singapore • Economic Development let the patient return to work earlier. Another government agency, usually Board Also, in some other destinations, abbreviated as IE Singapore, assists local companies to internationalize the cost of the hotel stay for the • International Enterprise and to “help SMEs become MNCs”, companions surprisingly dwarfs the Singapore so to speak. IE Singapore promotes medical bills. List prices are not good • Singapore Tourism Board outbound investment by local indicators of true costs. • At Home Away From Home healthcare players internationally. Through such projects, Singapore Peace of mind • Medical Travel Industry companies have been setting up The above five reasons for Singapore (healthcare providers, healthcare facilities in countries like as the medical destination of choice medical travel agencies) Vietnam, China and India. come together in the peace of mind that patients and their families get. 1. Ministry of Health 4. Singapore Tourism Board A time of illness is already in itself The ultimate purpose of the While medical travel is more a part a time of high stress, and worrying SingaporeMedicine effort is to serve of the healthcare industry than about possible coups, bombs, riots, Singapore’s residents. The Ministry the tourist industry (since leisure muggings and the like is something of Health (MOH) provides overall is generally not a high priority for best avoided. An American visiting leadership. As regulator and policy people who are sick), the Singapore Singapore for the first time remarked maker, it is also responsible for Tourism Board (STB) has the that Singapore is just like a particular the long-term development of the expertise to facilitate the inbound American city, to which an American healthcare industry and manpower travel of patients and therefore takes living in Singapore retorted that capabilities. While individual charge of international branding and Singapore does not have the crime. facilities and government agencies marketing, and the development of

1266 OVolume 11www.asiabiotech.com > Number 19 > 2007 Volumewww.asiabiotech.com 11 > Numbers 23 & 24 > 2007 ■ 1529 •[ SpecialSpecial FeatureFeature •] associated people-oriented services effects that other destinations often constrained in many countries and like local transport, accommodation, suffer from. care has to be taken to stay within and international patient liaison acceptable practices. services. Singapore was voted The SingaporeMedicine best Medical Travel Destination Approach 2. Channel Development by Travel Weekly in 2007, an Judging from the number of After patients decide that they want acknowledgment of STB’s work in delegations and enquiries we receive to travel to Singapore for healthcare, international marketing. STB also from organizations in other countries they may need assistance. This is helps the industry collaborate and seeking to develop their own medical done by medical travel agencies cooperate through platforms like the travel industry, SingaporeMedicine that are similar to other travel SingaporeMedicine Industry Forum has been the model for many. Through agencies except that they specialize and the SingaporeMedicine Industry open sharing of our methodologies in patients’ travel. Doctors often refer Roundtable. STB also encourages and approaches, SingaporeMedicine their patients to specific medical medical conferences in Singapore. hopes to support the development specialists in Singapore and are The International Congress and of the whole medical travel industry, channels in their own right. Lastly, Convention Association has ranked which would develop medical insurance companies and other payors Singapore as the top convention destinations and, more importantly, for healthcare services seek the best city in Asia and second in the world give patients around the world more possible care at reasonable costs for for many years, and more than a choices for their healthcare needs. their insured and employees. These third of events held in Singapore are What does SingaporeMedicine include government departments in healthcare-related. actually do? There are five focus some countries and corporations in areas. the developed world. Singapore has 5. Industry been a traditional referral destination The most important component of for expatriates working in the region, the strategic alliance is naturally the The SingaporeMedicine but the payors are increasingly hospitals and healthcare networks Approach looking at sending patients from that serve the patients and the medical • Brand development their home countries for services travel agencies that facilitate their otherwise unavailable or simply for visits to Singapore. The healthcare • Channel development better cost control. facilities are diverse and range from • Product development multi-hospital healthcare networks 3. Product Development • Singapore Tourism Board complete with general practice clinic Because Singapore’s primary driver networks, to singleton hospitals to • Industry development for medical travel is to obtain even individual medical and dental sufficient patient volumes to • Outbound services clinics. The medical travel agencies maintain its hard-won excellent provide both ground-handling as medical quality, the main focus for well as international marketing for 1. Brand Development SingaporeMedicine is high-tech their local healthcare partners. For patients to decide to visit and high-complexity services. These Singapore for healthcare, they must include cancer treatment, cardiac Government-industry ﬁrst be informed and then persuaded services, neurosurgery and orthopedic partnership that the healthcare services in surgery. As an industry however, To make things work, there needs Singapore meet their needs and individual healthcare providers to be more collaboration than wants, and that the gap that they offer everything from simple health competition. The different players in perceive in their own healthcare screening and wellness program to the SingaporeMedicine partnership system is adequately met. This is done quaternary cancer chemotherapy. have their different roles under the through public relations work with SingaporeMedicine does not overall charge of the Ministry of the media and through appropriate explicitly drive the new trend for Health. They collectively develop the advertising and promotions. The aesthetic medicine/surgery but many national medical travel industry to its provision of information regarding patients also come to medical spas fullest potential but avoiding the side healthcare services is regulated and and dental services that focus more

1530 ■ Volume 11www.asiabiotech.com > Numbers 23 & 24 > 2007 www.asiabiotech.comVolume 11 > Number 19 > 2007 O1267 [• Special Best of Feature 2007 • ] on aesthetics than on curative or consumers make their own decisions. preventive services. As remarked earlier, patients travel for healthcare because of a real or 4. Industry Development perceived deficiency in the healthcare The international patient is not of theirown country, hence the seeking just excellent healthcare but value proposition that needs to be a total experience. Too many patients presented varies by market and by have discovered that their surgery market segment. A single marketing was successful and they are back approach throughout the world on their feet but the whole trip left is likely to fail in at least some a bad taste because of other things markets, and may be outright illegal that went wrong — rude customer in others. service, insensitive dietary offerings, unsafe city streets, heart-rending beggars etc. The industry, however accustomed to serving international patients, has to continually learn how to better serve their cross-cultural clients. SingaporeMedicine operates rose every year to 210 230 (despite and/or supports several platforms it being the SARS year), 320, 352 for such local knowledge sharing, and 410 thousands in the succeeding including conferences focused on years until 2006. A measure of the medical travel. STB also supported economic contribution is the total the establishment of the International tourism receipts generated by the Medical Travel Association, the healthcare services, which comprises world’s first international society the total spending by healthcare for medical travel which seeks to visitors and their accompanying protect the interests of the medical persons on accommodation, travel traveller. (on local carriers), medical services, dining, leisure, anything else during 5. Outbound Services their stay, and the spending on Beyond seeking to bring patients to SingaporeMedicine — medical services by visitors for Singapore, there is the larger effort to Targets and Progress other purposes. In 2004, that came internationalize Singapore’s clinical When the original Economic Review to some S$906 million and rose to services, consultancy and medical Committee published its findings S$1295 million in 2006, which was technology. Besides joint participa- in 2001, the targets set for 2012 an increase of 43% over two years. tion in international exhibitions, was 1 million healthcare visitors Compared to the 28% increase in the organizations in Singapore (including and S$2.6 billion in value added number of visitors, this suggests that those beyond the SingaporeMedicine to the economy. These numbers Singapore is increasingly providing initiative like the Singapore Business represent rough targets rather than more complex, and more expensive Federation and the Singapore Manu- hard objectives. In a sense, they were services. In 2006, the total tourism facturers Federation) also cooperate “stretch targets” where the stretching receipts attributable to international in joint trade missions and events. was far more important than the healthcare services was a significant targets themselves. 9% of the national tourism receipts. Matching the Market Through the years since the Data comparison with other countries The above is naturally just a menu official launch of SingaporeMedicine, is very difficult because of the of activities from which appropriate the industry has expanded tre- different bases and methodologies combinations are used depending on mendously. From the initial 180 used. Many countries collect and the market. Not every market has thousand visitors in 2001, the number collate statistics directly from well developed channels, nor do all of visitors specifically for healthcare hospitals, which may report the

1268 OVolume 11www.asiabiotech.com > Number 19 > 2007 Volumewww.asiabiotech.com 11 > Numbers 23 & 24 > 2007 ■ 1531 •[ SpecialSpecial FeatureFeature •] number of persons seen each year, or the number of separate visits to their There is a fear in the United States and in Australia premises, or (anecdotally rumored) even the number of counters seen that patients traveling abroad means reduced during a single visit (e.g. clinic, revenues for the local healthcare providers, laboratory, pharmacy). Singapore’s visitorship numbers are for trips though the relative sizes of the healthcare that may include any number of healthcare encounters. Some do not economies suggest that the impact is minimal distinguish clearly between visitors and possibly smaller than the US year-on-year coming for healthcare and their local expatriate population. Assuming inflationary increase. that the bases for the numbers do not change from year to year, India, Malaysia and Thailand have all been to be earned, and without the latter when there are so few JCI-accredited experiencing double digit growth in there would be no such hospitals for facilities in the world. the medical travel industry. anyone. In other words, the alternate For Singapore, there is also the use of the investment in private need to consider a greater emphasis Future Trends hospitals for foreign and affluent on outbound services. Today, there So healthcare is changing but what patients is not in services for the poor are nearly half a million visitors for shape will it take? That is hard to but some other industry with better healthcare a year and the nominal predict, just as few would have returns. There are complaints in target is one million by 2012. By predicted the extent to which Thailand that doctor staffing in rural then, there would be one incoming manufacturing and software Thailand is below 50% because of the patient for every five locals. How engineering have shifted to China movement of doctors towards the far can this number grow? The true and India respectively. The realization more lucrative cities and hospitals. future of Singapore healthcare could that more affordable, accessible There is a fear in the United be outbound serving the world, or better healthcare is available States and in Australia that patients although that is not without its elsewhere will encourage many traveling abroad means reduced problems. For example, if Singapore’s to travel for healthcare. In turn, revenues for the local healthcare healthcare providers send current healthcare facilities are considering providers, though the relative staff to overseas services, they run planting services in other countries. sizes of the healthcare economies the risk of depleting their local talent. Singapore has the interesting situation suggest that the impact is minimal On the other hand, foreign talent of American patients flying to see an and possibly smaller than the US can be recruited to fill the gaps, and American doctor in an American year-on-year inflationary increase. that provide Singapore’s local talent facility in Singapore — so will such When one considers that the entire with a leavening of international scenarios become more common? Singapore healthcare economy is experience and wisdom. There will be some disruptive only US$4 billion and the total The world is flat and getting impacts to many healthcare systems. medical travel trade for Singapore, increasingly flatter. Patients, pro- Today, there are grouses that the India, Malaysia and Thailand cannot fessionals and providers are seeing private sector hospitals in India are be very much greater than that value, farther and traveling more frequently. catering to the rich international and contrasting these numbers with From being one of the most protected patient while leaving untended the US healthcare economy which and least international of industry their local poor. It can be argued is US$2000 billion a year, there is a sectors, healthcare is globalizing and that such investment in healthcare distinct possibility of a major supply rapidly becoming a very different services there is precisely because crunch when Americans start to world. Our only choice, it seems, is of the foreign and affluent dollars travel in larger numbers, especially what role we will play. ®

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is a medical doctor Dr Yapand public health physician with more than eighteen years of operational and management experience. Currently director (Healthcare Services) in the Singapore Tourism Board, he is part of the multi-agency SingaporeMedicine initiative to promote, develop and maintain Singapore as an international medical hub. Formally trained and accredited as a public health physician and health administrator, he also trained in business management and information technology. His broad-based experience includes positions in medical informatics and healthcare e-portals, public health policy, healthcare facility operations, and a stint as Press Secretary to a Minister. He also played key roles in major healthcare changes in past decade, including the licensing for healthcare establishments, the introduction of casemix, the consolidation of IT in public sector healthcare institutions, the SARS outbreak, the Electronic Medical Record eXchange and now SingaporeMedicine.

Contact Details: Dr Jason Yap SingaporeMedicine Address: Singapore Tourism Board Healthcare Services Tourism Court 1 Orchard Spring Lane Singapore 247729 Email: [email protected]

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