Originally developed during the COVID-19 pandemic to support remote monitoring at Singapore’s community care facilities, Health Discovery (HD) has since evolved into HD+, a platform used to support remote monitoring for chronic conditions across Singapore’s polyclinics.
In this Q&A, Rino Tan, Senior Manager, Patient Empowerment at Synapxe, discusses why the organisation chose to develop its own remote monitoring platform, how the system evolved beyond its initial pandemic role, and the challenges of balancing standardisation, flexibility, and adoption as HD+ expanded nationally.
What made an off-the-shelf system insufficient for your initial COVID-era requirements?
At the onset of the COVID-19 pandemic, a large proportion of new cases in Singapore were detected across multiple migrant worker dormitories. With no vaccines available at the time, the Singapore government established the Singapore Expo as a community care facility (CCF) during the circuit breaker period to quarantine and monitor patients with mild symptoms. This allowed hospitals to focus their resources on patients who were more severely ill. The facility was transformed within 28 days, with Synapxe providing the technology infrastructure.
To protect healthcare workers and preserve limited medical manpower, we realised that the traditional model of care would not be appropriate in this environment. The proposed approach was a remote monitoring system that enabled patients to self-monitor their vital signs, reducing physical contact between infected patients and healthcare workers.
Synapxe initially considered deploying a commercial off-the-shelf solution for remote patient monitoring. However, we found that the available solutions at the time could not scale quickly and were not well suited to Singapore’s medical protocols. For example, the solution would have required each patient to be assigned a dedicated iPad, which was not practical given the volume of patients and migrant workers’ familiarity with the interfaces and instructions.
As a result, we decided in May 2020 to build our own remote monitoring solution, HD. This allowed us to design a system tailored to the needs of healthcare providers, enabling patients to self-monitor their vital signs and generate alerts when abnormalities were detected, while reducing the workload and exposure risk for healthcare teams managing large patient volumes.
Because HD was developed in-house by Synapxe, the team had greater flexibility to release new features more quickly, helping care teams work more efficiently.
What changed when the system evolved from COVID monitoring to chronic care?
In its early development, HD was designed as a remote monitoring solution for more than 100,000 migrant workers infected with COVID-19 who were housed at CCFs.
Patients could use remote monitoring kiosks or their own mobile devices to record vital signs such as temperature, blood pressure, and oxygen levels.
The HD dashboard flagged patients with abnormal readings or those who required attention. Care teams monitoring the dashboard could then respond accordingly.
This approach allowed patients to take a more active role in monitoring their health while enabling care teams to intervene only when necessary.
While HD was originally developed for use in CCFs, the team recognised the broader potential of the remote monitoring system. The same team later collaborated with the Singapore Ministry of Health’s Office for Healthcare Transformation to develop HD+, which was subsequently deployed across polyclinics.
Today, HD+ supports Primary Tech-Enhanced Care (PTEC), a program that enables patients with diabetes and hypertension to be monitored remotely from home, while the HD+ dashboards provide clinicians with automated alerts, enabling proactive intervention and early detection before conditions deteriorate.
What cloud and IT stack underpins HD+?
HD+ is hosted across both the Healthcare Commercial Cloud and the Healthcare Private Cloud.
Where do clinical requirements and system design have the most opportunities for alignment today?
The team adopted an agile methodology to develop HD+. Synapxe’s business analysts worked closely with the PTEC clinical team to understand care-team workflows and define the required medical protocols. At the end of each sprint, the team provided product demonstrations to gather feedback and incorporate clinical input into subsequent iterations.
Bridging the gap between clinical requirements and system design requires co-creation. Rather than adopting a plug-and-play model, we worked with healthcare partners to align operating procedures and workflows and develop the final solution. From the discovery stage, the team worked to understand requirements and define the necessary systems, operations, and workflows to ensure the solution was fit for purpose. Partners and users were also engaged throughout the process to refine and improve the system.
What have been the biggest trade-offs in running HD+ as a national platform?
As part of designing the system, we had the critical task of aligning and harmonising medical protocols and operation workflows across all polyclinics to ensure care consistency. This involved extensive engagement and close collaboration with the respective clinical and operational champions to build consensus and ensure that the proposed workflows were both practical and readily adoptable on the ground. A key challenge was finding the right balance between establishing a standardised national system and providing sufficient flexibility to accommodate local operational needs and adaptations where appropriate.
To scale HD+, we trained more than 100 nurses across 27 polyclinics. Ensuring a consistent understanding of the platform, as well as confidence in and adoption of its use across a broad user base, required sustained effort beyond system development. This included structured training, clear communication, and ongoing support.
These efforts required not only technical solutions, but also strong collaboration and active communication between the technical and healthcare teams.
What would you approach differently if you were starting again today?
If we were starting again today, we would place greater emphasis on achieving early alignment across clinical clusters to ensure consistency in workflows and expectations from the outset. We would also design with long-term national scale in mind from day one, anticipating broader adoption and integration requirements.
In addition, we would embed change management earlier and consider future platform consolidation from the beginning to support adoption and reduce the number of changes required later.
