Streamlining Digestive Health Services in Singapore

Introduction

The National University Hospital (NUH) in Singapore has officially inaugurated the National University Centre for Digestive Health (NUCD), a comprehensive facility designed to enhance digestive health services. This new center aims to streamline patient access to specialists across various digestive health disciplines.

Enhanced Patient Pathway

Since its conceptual launch in 2024, the NUCD has integrated multiple digestive health services, allowing patients to receive same-day access to specialists in upper gastrointestinal, hepatobiliary and pancreatic, and colorectal care. Additionally, it serves as a referral hub for complex cases from other hospitals within the National University Health System, such as Ng Teng Fong General Hospital and Alexandra Hospital.

Addressing Fragmentation

"Previously, patients often moved through separate clinic and diagnostics queues in a step-by-step manner—clinic first, then wait for tests, and return for review, sometimes with additional referrals in between," explained A/Prof Lee Guan Huei, director of NUCD. He noted that the bottleneck was not due to a lack of expertise but rather the fragmentation of services, which involved multiple handoffs, sequential scheduling, and limited endoscopy capacity.

"NUCD consolidates the pathway so patients receive faster clarity and fewer unnecessary loops," A/Prof Lee added.

Benefits for Clinicians

The streamlined process at NUCD has led to more integrated triage, reduced duplication of tests, and standardized procedures for clinicians.

"With a consolidated center, referrals can be reviewed through a common framework, allowing patients to be directed more efficiently to the appropriate pathway—be it general gastrointestinal, hepatology/liver, inflammatory bowel disease (IBD), functional disorders, or surgical assessment—without unnecessary intermediate steps. Clinicians can spend less time redirecting cases and more time making decisions that advance care," A/Prof Lee stated.

Tests are now ordered with downstream decisions in mind. "For instance, if a patient presents with alarm symptoms, the pathway ensures that the correct definitive test is prioritized rather than requiring repeated clinic visits without resolution," he explained.

In cases involving chronic liver disease risk, investigations can be grouped and sequenced logically, minimizing the need for repeat blood tests or backtracking. In IBD management, monitoring and escalation can be protocol-driven, reducing ad-hoc variations and unnecessary repeat testing.

Standardized Procedures

The consolidation of services has also facilitated a standard pre-procedure work-up, more consistent bowel preparation processes, clearer post-procedure instructions, and structured follow-up. A/Prof Lee noted, "Over time, this reduces cancellations and repeat procedures due to inadequate preparation, leading to fewer avoidable complications and a cleaner end-to-end process."

The Larger Context

The NUCD is implementing high-impact programs, including a chronic liver disease screening initiative in collaboration with the National University Polyclinics and GP clinics, which has screened over 12,000 high-risk patients to date.

The center has significantly improved its adenoma detection rate (ADR) for colorectal cancer, achieving 42.4%, well above the 25% guideline set by the American Society for Gastrointestinal Endoscopy. This has been made possible through the use of AI-enabled and image-enhanced colonoscopy techniques, an automated ADR calculation system, and a dashboard displaying critical quality indicators for endoscopists. Colorectal cancer remains a leading cause of cancer-related deaths in Singapore.

The IBD Centre of Excellence, a key component of NUCD, provides advanced care for patients of all ages, featuring innovations such as home administration of intravenous biologics, point-of-care intestinal ultrasound, and a translational precision medicine program.

"Our goal is simple: to detect problems early, treat them effectively, and help our patients lead healthier lives," A/Prof Lee remarked during the center's inauguration on January 16.

Conclusion

The launch of the National University Centre for Digestive Health marks a significant advancement in the delivery of digestive care in Singapore, aiming to improve patient outcomes through streamlined services and enhanced clinical efficiency.

Source: Digitally streamlining digestive care pathway in Singapore - HealthcareITNews