National Medical Excellence Awards 2016

• Medical Advisor and Senior Consultant, National Skin Centre, National Healthcare Group

• Clinical Professor, Yong Loo Lin School of Medicine, National University of Singapore

• Adjunct Professor, Saw Swee Hock School of Public Health, National University of Singapore

• Adjunct Professor, Duke-NUS Graduate Medical School

• Adjunct Professor (Honorary), Lee Kong Chian School of Medicine, Nanyang Technological University

Professor Roy Chan was a President Scholar and graduated from University of Singapore with MBBS in 1978. After completing his Health Manpower Development Plan (HMDP) training overseas in 1988, he returned to Singapore as Consultant with National Skin Centre (NSC), a member of the National Healthcare Group.

Prof Chan served as the Director of NSC from 2004 to 2014. Under his leadership, numerous new services in medical, surgical and laser dermatology were introduced. Owing to that, NSC is now recognised as a global centre of excellence in dermatology. Prof Chan was also Chair of the Dermatology Specialist Training Committee/Residents Advisory Committee from 2008 to 2014.

Besides his work with NSC, Prof Chan was also a pioneer of AIDS Education and Awareness in Singapore. In 1988, he founded Action for AIDS (AfA), a non-governmental organisation and charity dedicated to fighting AIDS/HIV infection. His clinical expertise gave him a head start in designing treatment programmes for infected individuals in Singapore in the early days of the epidemic. He is the President of AfA since 1998.

At AfA, Prof Chan spearheaded numerous innovative educational and prevention campaigns. So far, 10 biannual Singapore AIDS conferences have been held which has increased the public’s awareness on HIV-related matters. He has introduced new testing paradigms and has been instrumental in bringing affordable and accessible medications to thousands of Singaporean patients. The projects target specifically the most-at-risk populations earning the lowest incidence and prevalence of the disease HIV in these groups in the world. In addition, Prof Chan advocates for the fair and humane treatment of HIV infected persons. AfA was awarded the 2010 World Health Organisation Dr Lee Jong-Wook Memorial Prize in Public Health, an accolade awarded to entities who have made an outstanding contribution to public health.

During his years of public service as a highly-respected dermato-venereologist, Prof Chan’s expertise has been extensively tapped by local, regional and international medical communities. Other than being a long serving member in the Governing Council of the International AIDS Society, he is also the Head of the National STI Control Programme from 1992 till today. During this period, innovative STI/HIV prevention programmes have been implemented and brought to scale. These programmes are central to the successful control of HIV and STI among sex workers, masseuses and their clients. These widely-acknowledged control and intervention programmes have been the major reasons for the relatively low level of HIV infection in Singapore.

In 2009, Prof Chan was nominated by the Ministry of Health and conferred the prestigious Queen Elizabeth II Gold Medal awarded by United Kingdom’s Royal Society for Public Health (RSPH). The medal is awarded to individuals for their outstanding contribution towards public health and health promotion within the Commonwealth. With over 100 peer-reviewed publications, Prof Chan continues to be involved in research activities. In 2013, he took on the role of the Skin Research Institute of Singapore’s Executive Director (Clinical).

For his outstanding work and dedication to HIV prevention and care that spans almost three decades, as well as his continued significant contributions to public health, Professor Roy Chan is awarded the National Outstanding Clinician Award 2016.

• Director & Senior Consultant, National University Cancer Institute, Singapore

• Professor, Yong Loo Lin School of Medicine, National University of Singapore

• Group Chief Physician Leadership & Organisational Development Officer, National University Health System

• National University Health System

• Deputy Director, Cancer Science Institute of Singapore, National University of Singapore

An accomplished haematologist, Professor Chng Wee Joo is an exceptional clinician-scientist. His research in blood cancers translates scientific discoveries into clinical applications, improving patient outcomes.

Prof Chng has made significant contributions to the use of genetics and genomics in understanding disease biology as well as their use in clinical applications in blood cancers, in particular myeloma, acute myeloid leukaemia and lymphoma. Some of these methods are already employed in routine clinical care today, such as the sequencing and analysis of myeloma patients’ DNA to stratify them into different risk groups which allow doctors to tailor their treatment accordingly.

With a clear focus on seeking innovations, Prof Chng has also pioneered new ways to deliver cancer treatment. Prof Chng played a pivotal role in the introduction of the first outpatient autologous stem cell transplant for myeloma, which was performed at the National University Cancer Institute, Singapore (NCIS) in 2011. He also headed the Bortezomib@Home programme, where myeloma patients can choose to have their injections for Bortezomib, a chemotherapy drug, administered by a nurse outside the NCIS specialist outpatient clinics.

Prof Chng has been instrumental in establishing key infrastructure and building research in haematology at NCIS and the Cancer Science Institute of Singapore. This includes providing training and mentorship to students and doctors, expanding the capacity, scale and scope of trial activities in haematology, and building an environment and culture that is conducive to research. Through the efforts of Prof Chng and his team, NCIS was one of the top recruiters in a global randomised controlled trial for a new chemotherapy drug called Carfilzomib for myeloma, results of which has led to the approval of the drug for clinical use.

Thanks to Prof Chng’s contributions, drive and passion, NCIS is now a world-renowned centre for haematology; sought after by doctors, both local and overseas, for training; companies for clinical trials and by patients seeking the best care in Singapore.

In addition, as Prof Chng has established an international standing, he currently leads international efforts in various research areas, especially for myeloma. He became the first Asian member in the International Myeloma Working Group to lead a consensus guideline project. Besides setting up the Asian Myeloma Network (AMN), he spearheaded its clinical trial efforts. In particular, he completed the first AMN clinical trial, recruiting 100 relapsed myeloma patients across Korea, Singapore, Taiwan and Hong Kong over a relatively short 15 months, which is a significant achievement.

For his outstanding contributions and achievements in research in the field of blood cancers that have led to improved patient outcomes and better understanding of the diseases, Professor Chng Wee Joo is awarded the 2016 National Outstanding Clinician Scientist Award.

• Chairman, Medical Board, Yishun Community Hospital, Alexandra Health System

• Vice-Dean, Clinical Affairs, Lee Kong Chian School of Medicine, Nanyang Technological University

Associate Professor Pang Weng Sun has dedicated his career to developing medical education to meet the needs of Singapore’s ageing society. A caring clinician, whom colleagues describe as “one-in-a-million”, A/Prof Pang is a passionate teacher who nurtures the human touch in those he teaches.

His passion for teaching and his compassion for patients make him an impeccable mentor for medical students and senior doctors alike.

A pioneer in the fields of geriatric and palliative medicine, he is one of the founding practitioners who built, shaped and developed the training of both specialties and services, in which he instilled a teaching culture that remains to-date.

A/Prof Pang was Chairman of the Geriatric Medicine Specialist Training Committee, now called the Geriatric Medicine Resident Advisory Committee, a role he holds until today.

He was actively involved in setting up the Graduate Diploma in Geriatric Medicine in the NUS Division of Graduate Medical Studies in the 90s, which has evolved into two programmes, the Graduate Diploma in Geriatric Medicine and the Graduate Diploma in Geriatric Medicine Staff Residency Scheme.

A/Prof Pang assisted in teaching the doctors’ course in Palliative Medicine initially organised by Hospice Care Association and later taken over by Singapore Hospice Council; as well as in developing hospital-based palliative care services at Tan Tock Seng Hospital.

Besides impacting service development in the community, especially community hospitals and nursing homes, A/Prof Pang also taught extensively in both geriatric and palliative medicine for community hospitals and nursing staff, including doctors and nurses.

As the Vice-Dean for Clinical Affairs, A/Prof Pang played a pivotal role in the establishment of the Lee Kong Chian School of Medicine (LKCMedicine), a partnership between Nanyang Technological University (NTU Singapore) and Imperial College London, including curriculum development. He continues to be involved in teaching and engaging the clinicians from the School’s healthcare partners.

A/Prof Pang’s wisdom and ability to inspire and engage his clinical colleagues has been critical to the progress of LKCMedicine. His personal engagement with medical students, particularly those who are finding the path difficult to navigate, exemplifies his quiet and effective manner of providing pastoral care.

For his tireless dedication and unwavering commitment to improving patient care, A/Prof Pang has been recognised with a number of awards, including Outstanding Doctor of the Year Award from Tan Tock Seng Hospital in 1998, a Healthcare Humanity Award in 2005, Public Administration Silver Medal in 2012 and Singapore Medical Association Merit Award in 2014.

A/Prof Pang has also been a great role model to many clinicians, during his previous appointments as Head of the Department of Geriatrics and the Chairman of Medical Board at Alexandra Hospital. Currently Chairman of the Medical Board at Yishun Community Hospital, A/Prof Pang continues to be a mentor to many. He spends time and effort to teach, advise, coach and counsel individual doctors, inspiring many to become better doctors, exemplary in both clinical capabilities and character.

For his outstanding contributions and exemplary dedication to advancing medical education and training to address the needs of ageing societies in Singapore and beyond, Associate Professor Pang Weng Sun is awarded the National Outstanding Clinical Educator Award 2016.

• Deputy Director and Head, Department of Pharmacy, National University Hospital, National University Health System

Mr Wu Tuck Seng is a steadfast champion for quality who has an illustrious career in hospital pharmacy over the past 29 years. A keen advocate for safety, quality and productivity, he has led numerous multi-disciplinary and multi-institutional programmes and initiatives.

Mr Wu conceptualised and led the development of the Outpatient Pharmacy Automation System (OPAS), a joint initiative by NUH, Tan Tock Seng Hospital, National Healthcare Group Pharmacy and Integrated Health Information Systems (IHiS). The pharmacy at National University Hospital’s (NUH) Medical Centre operates on this system that is regarded as a world-class innovation for its ability to incorporate automation in box picking, loose tablet picking, packing, capping and labelling, as well as RFID technology. OPAS integrates locally developed software with internationally sourced robots for the fully automated system to function seamlessly. It reduces wait time, improves patient safety and enables work redesign for staff. The initiative won numerous awards including the Ministry of Health (MOH) Health IT Excellence Award 2014, 1st Runner Up of the National Infocomm Award 2014 and HIMSS Asia-Pacific Elsevier Digital Healthcare Award 2015.

Mr Wu also played a vital role in successfully implementing the Closed Loop Medication Management System(CLMMS) in NUH wards in 2009 to reduce human errors, enhance patient safety and improve operational efficiency. A first in the Asia-Pacific, the CLMMS won two national awards - National Infocomm Awards 2010 and PS21 Gold Award 2011.

Under Mr Wu’s leadership, NUH Department of Pharmacy received 38 NUH quality improvement project awards since 2010, many of which were for multi-disciplinary projects involving other departments. Significant programmes introduced by the department include:

• NUH’s first Outpatient Anticoagulant Clinic in 1996, which has since developed into a hospital-wide anticoagulant service led by pharmacists, supported by haematologists, for both inpatients and outpatients;

• The NUH Antibiotic Stewardship Programme in 2009 to ensure appropriate and cost-effective use of antibiotics;

• Implementation of a 24/7 Pharmacist Service in 2011 to provide comprehensive and safe patient service after hours;

• Inpatient Diabetes Mellitus(DM) Management Programme in 2013 to reduce hypoglycaemic incidents in DM patients.

A firm believer in the quality development of future generations of pharmacists, Mr Wu is responsible for many key changes in the training of pharmacists. He was instrumental for the introduction of Singapore’s first part-time post-graduate Masters in Clinical Pharmacy with the University of South Australia which focuses on advancing practicing pharmacists’ pharmacotherapy knowledge and skills. In 2012, he established Singapore’s first Post Graduate Year 1(PGY1) Pharmacy Residency programme at NUH, a foundation training programme for aspiring clinical pharmacists.

Mr Wu’s contributions to the field of pharmacy span beyond the grounds of the National University Health System (NUHS). He is the President of the Singapore Pharmacy Council and Chairperson of the MOH National Medication Safety Committee. As Vice-Chairman of the National Pharmacy Landscape Steering Committee, Mr Wu played a significant role in the development of the National Pharmacy Strategy 2015 – a 10-year plan, endorsed by MOH, to transform pharmacy practice and the provision of pharmacy services in Singapore.

For his outstanding contributions and extraordinary dedication to innovation and leadership in providing the highest level of safety, quality and productivity in pharmaceutical services to public healthcare in Singapore, Mr Wu Tuck Seng is awarded the National Outstanding Clinical Quality Champion Award 2016.

Diabetic Kidney Disease (DKD) is the leading complication that arises from poorly controlled diabetes. Nearly one in two diabetic patients evaluated between 2006 and 2009 at the National Healthcare Group Polyclinics (NHGP) had DKD. More worryingly, DKD is the leading cause of end stage kidney failure in Singapore. Nevertheless, optimal control of diabetes, early detection and management of its complications, including DKD, at primary care can avert the progression of the disease. Previous studies have also shown that the progression of DKD can be slowed down by keeping blood pressure under control and treating albuminuria, which is elevated levels of protein in the urine, with full or maximally tolerated doses of medications such as Angiotensin Converting Enzyme Inhibitors (ACEi) or Angiotensin II Receptor Blockers (ARB).

Recognizing this, a team from the National University Health System (NUHS) and NHGP, the primary healthcare arm of the National Healthcare Group, set up a kidney disease work group in 2010 to devise a strategy to manage albuminuria and blood pressure in DKD patients and to reduce the rate of progression of DKD at primary care. With funding from the Ministry of Health, a strategy for Nephrology Evaluation, Management and Optimization (NEMO) of DKD among patients on follow-up at the NHGP was implemented in 2011.

In preparation for NEMO, the National University Hospital (NUH), the tertiary care hospital of NUHS, and NHGP leveraged on good teamwork and identified key obstacles to optimizing drug doses in patients, established drug protocols to achieve target blood pressure, to reduce albuminuria and to deal with complications of treatment, and developed tailored solutions for individual polyclinics. In addition, the team shared valuable knowledge on kidney disease management with stakeholders by holding talks on DKD and its management for physicians at all nine polyclinics under NHGP. Through its efforts, selected polyclinic doctors became designated renal champions in each polyclinic to help drive NEMO.

10 Allied Health personnel, known as NEMO Coordinators, were also trained and a Coordinator deployed to each of the polyclinics under NHGP to help coordinate care. With the help of Information Technology, the NEMO Coordinators screened and identified patients with early DKD for recruitment into the NEMO programme; counseled the recruited patients on DKD, its risks and the need for the treatment to prevent progression; assisted doctors at NHGP in coordinating the drug optimization and tracked the results and outcomes.

As a result of these efforts, 54% of the 9,015 patients who had enrolled since 2011, have undergone drug optimization. Of these, 20% saw normalization of urine albumin levels while 10% saw an improvement and went from having late to early stage DKD.

Overall, the NEMO programme has demonstrated that medications such as ACEi or ARBs can be used safely in primary care to delay progression of DKD and significant proportions of DKD patients may be averted from the ravages of kidney failure requiring dialysis or kidney transplantation. More importantly, the programme has demonstrated that by focusing on goals and by developing a management plan, a team comprised of doctors and coordinators can implement changes in patient care to improve outcomes.

Following this success, plans are underway to roll out NEMO beyond polyclinics under NHGP to those which are under the SingHealth Group. In early 2016, NEMO was rolled out to Queenstown Polyclinic under the SingHealth Group. The team also hopes to expand the strategy to other healthcare institutions subsequently.

For their outstanding contributions and achievements in developing a collaborative approach to providing optimal care for Diabetic Kidney Disease patients at the primary care level and finding ways to slow down the progression of the disease to end stage kidney failure, the team from NUHS and NHGP is awarded the National Clinical Excellence Team Award 2016.