Setting up a regional health system database for seamless population health management in Singapore

Abstract

Objective: Understanding the health and health service utilization of the population is critical for Regional Health System’s (RHS) population health management (PHM) initiatives in Singapore. The RHS database is a collaborative effort toward developing a national architecture for healthcare utilization data across diverse clinical systems with disparate data models. This manuscript describes the setup of an RHS database which would facilitate big data analytics for proactive population health management and health services research. Materials and methods: The RHS database is a conglomeration of four isolated databases from the three RHSs. It contains linked National Healthcare Group (NHG) polyclinic visit records, specialist outpatient clinic visit records, hospital discharge records from Tan Tock Seng Hospital (TTSH), National University Hospital (NUH) and Alexandra Hospital (AH), chronic disease management system (CDMS) records and mortality records from local registries. The data linkage process was conducted using the unique identification number (NRIC) as the linking variable. The final anonymized database has multiple interconnected tables that includes patient demographics, chronic disease and healthcare utilization information. Results: Over 2.8 million patients had contact with the three RHSs from 2008 to 2013. The database facilitated risk stratification of patients based on their past healthcare utilization and chronic disease information. This database aids in understanding the cross-utilization of healthcare services across the three RHSs and can help address the challenges of setting up a distinct geographical boundary for individual RHSs. Conclusions: The RHS database has been established with the intention to support the secondary use of administrative health data in health services research and proactive PHM in Singapore.