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SPOTLIGHTS
Singapore Asia's Best Healthcare System in the Making?
Leaders from global institutions, academia, healthcare and government organisations come together at a Seminar on Precision Medicine organised by BC Platforms. They discuss about the challenges, innovations and future policy and business directions needed to harness the power of big data and genomics in Healthcare and Life Science.

Dr. Kathleen C. Barnes, Director of the Colorado Center for Personalised Medicine in the School of Medicine at the University of Colorado, Prof. Tai E Shyong, clinician scientist and director of the centre for precision health at the National University Health System, Dr. Kenneth Park, leader of Offering Development at IQVIA, Dr. Minna Hendolin, Senior Director of Health and Wellbeing thematic area at Business Finland, and Mr. Tero Silvola, Board member and CEO of BC Platforms were gathered at Seminar on Precision Medicine on 13th November 2019 to mark BC Platforms’ launch in Singapore.

The Ambassador of Finland started off by sharing about the similarities between Singapore and Finland, Finland having one of the best healthcare systems in the world. Both countries place huge investment in human capital—especially human innovation in the technology aspect and high-standard education—and have an increasing life expectancy. With such similarities, Singapore has the potential to become the country with the most effective healthcare system in Asia. The multiracial society in Singapore has a wide range of genetic diversity in ethnic groups which makes up approximately 80 percent of the entire Asian population, so it can fill the knowledge gaps in genomic medicine—it has the Asian gene pool that Western countries do not have.

According to Prof. Tai E Shyong, this allows research to be done on diseases that cannot be found anywhere else or endemic in this region, such as citrin deficiency, which affect Asians disproportionately.

Furthermore, Singapore has many competitive advantages. Firstly, Singapore’s government plays the largest role in our healthcare sector, allowing the sector to be able to implement multi-agency programmes country wide. Next, Singapore is also a trusted location for data security, integrity and high-standard healthcare—we currently have an advanced healthcare system with one of the best healthcare outcomes globally. Singapore has a strong capability in leading biomedical research, engineering and analytics and has the ability to forge strong international links with other national population-scale programmes. These all enable Singapore to become a powerful leader in healthcare and a key player in precision medicine.

Singapore has also put in place the National Precision Medicine Program (PRISM), which is a discipline where patients have personalised medical treatments designed based on their detailed genetic, molecular and clinical profiles. PRISM incorporates genomic medicine that leverages an individual’s genomic (the complete set of genes in an organism) information as part of their clinical care. It enables more accurate and quicker clinical diagnosis, more effective treatments and better healthcare, which can help patients save money by reducing cost-defective treatments. It can even help with developing measures to prevent certain diseases and illnesses. With the furtherance of genomic medication and the integration of Life Science and Healthcare, it can ensure that each individual receives personalised medication that is effective and efficiently developed. So far, genomic medicine has already benefited fields of oncology, pharmacology, rare and undiagnosed diseases, and infectious diseases, and the leaders present at the seminar are confident that it has the potential to do much more for the clinical care of every individual. Thus, PRISM is a step to enable Singapore to become a leader in the healthcare field.

PRISM is divided into the following workgroups:

  1. Regulation and Ethics, where the workers develop legal framework and identify and address regulatory, ethical and social issues surrounding precision medicine.

  2. Public and Community Trust, where the workers engage the public and scientific, medical and healthcare communities to survey and address their concerns for precision medicine.

  3. Enabling Platforms, where the workers develop technology or data infrastructure for data generation, analytics, storage and linkage as well as formulate data sharing policies.

  4. Clinical Adoption, where workers demonstrate clinical use cases for precision medicine and produce cost-effective clinical applications in a sustainable manner.

  5. Industry Development, where workers gain industry traction to produce economic and health outcomes.

  6. Workforce Development, where the workers build the healthcare workforce to support precision medicine research and clinical applications.

  7. These groups work together to aid in the success of precision medicine being implemented in Singapore.

Next, PRISM is also divided into different phases. Phase 1 of PRISM which started in 2017 was when project SG10K was initiated. The aim of the project was to sequence and project 10,000 genomes from 10,000 Singaporeans so that they could be used for research. This was so that healthcare companies could characterise genetic variation in Singapore population comprehensively. This aided in the creation of Whole Genome Sequence reference panel, which was to be used for accurate genotype imputation in Asian population and as a large control dataset for genetic association study of diseases.

For phase 2 of PRISM to be completed from 2021-2024, the first aim is to sequence 100,000 genomes of Singapore’s and then link them up to electronic health records. This makes the information relevant not just to patients and the public who provide samples of data, but also to the healthcare system where there are about 50,000 diseased people. The second aim is to get healthcare institutions to embark on training people to deploy clinical workforce, and the third is to begin to add more data types into the system. The third and final phase deploying island-wide solutions by scaling cost-effective clinical workflows.

In order for Singapore to improve its healthcare system Prof. Tai E Shyong said that it requires a nation-wide effort.

“People have to agree to deposit their data and agree to a common data governance framework, which is challenging in dealing with academic investigators,” said Prof. Tai E Shyong.

“We have to try to convince the hospitals to give us access to electronic medical records of patients who have given consent for such access.” This is so that patients can receive the correct treatment at any medical institute instead of just one, so as to make medical more convenient and more readily available.

References:

Genomics and Medicine. (2019, April 30). Retrieved November 19, 2019, from https://www.genome.gov/health/Genomics-and-Medicine.

SG10K: Insights into the genetic architecture of Singaporeans. (2017, October 20). Retrieved November 19, 2019, from https://www.a-star.edu.sg/Portals/100/4. BELLIS C et al_ASHG 2017_poster.pdf?ver=2018-08-01-113217-870.

This article was derived from the attendance at the Seminar on Precision Medicine, Transforming Healthcare and Life Science using Genomic Data organised by BC Platforms.

 

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