Updated: Dec 9, 2021
✦ One of Singapore’s public healthcare groups (known locally as “clusters”) has chosen to use an artificial intelligence (AI) system with real-time streaming capabilities to deliver better patient care and treatment across its network of hospitals, polyclinics, specialist centres, medical centre and academic health science institutions.
National University Health System (NUHS) is one of three public healthcare clusters in Singapore equipped with an integrated academic health system and regional health system that delivers value-driven, innovative and sustainable healthcare. Its network covers an extensive 19 hospitals, polyclinics, specialist centres, medical centre and academic health science institutions.
NUHS has built an AI production platform known as Endeavour AI based on an NVIDIA DGX A100 system, a system for AI infrastructure, to become the first healthcare group in Singapore with real-time streaming capabilities to deliver better patient care and treatment, collaborate on biomedical research and transform how illnesses are managed and treated.
With this newly-launched Endeavour AI platform, NUHS can make real-time predictions on diagnosis, progression of diseases, readmissions, risk of falls, and others. This new system will be integrated with NUHS’ Discovery AI training platform to form a complete training and inference system as part of the group’s digital transformation.
Endeavour AI is a software and hardware stack that features streaming data as well as AI tools running micro services. With the capacity to be able to manage up to 150 projects, Endeavour AI will start off with dozens of projects initially before increasing them.
Among the first projects are those that impact the whole cluster, ranging from predictions on how a patient with a certain condition will fare when admitted to a hospital to analysing magnetic resonance imaging (MRI) images. The projects will involve everything from structured medical data to text-based medical data that form the basis for generating chatbots that are conversational in nature.
Dr Kee Yuan Ngiam, group chief technology officer of NUHS and deputy chief medical informatics officer of National University Hospital (NUH), explains that the organisation is undertaking a digital transformation throughout the cluster, with AI as the centre of its digital transformation.
Dr Ngiam’s team has strategised, planned and built in NVIDIA DGXA100 from day one upon the deployment of Endeavour AI. The organisation will be using it for high speed and large volume inference processed by their AI tools.
For example, for every patient who turns up at its hospitals and polyclinics, every time a doctor clicks, saves or free texts, or when a new lab test results are out, an AI tool runs in the background. All the data gets processed by the AI tools and each tool runs about 100-200 inferences per second. This is done hundreds of times per second throughout the whole cluster at a large volume.
NUHS produces between 20 and 30GB of structured data and text daily, or between 1,800 and 2,500 messages per second for each of its hospitals, which translates to about 10,000 to 15,000 messages per second at peak for all of its cluster. The AI tools need to run quickly in the background to absorb all the data on a day-to-day basis.
“We are building a platform that enables multiple projects to run at a time. We have multiple uses for GPUs, largely in training at this point, but certainly we are well underway in operationalising the production use cases. Without the GPU, we cannot do a lot of these things,” said Dr Ngiam.
With Endeavour AI, NUHS has become the first healthcare group in Singapore to achieve stream capability by operationalising AI tools in real time for the entire cluster.
Patients interacting with AI-powered chatbots will experience improvement in appointment booking services, reduction in waiting time, and optimised care due to some of the work on patient trajectories. Radiologists and clinicians benefit from improved accuracy and speed of processing of images, X rays and scans. In day-to-day hospital operations, a number of predictions are computed automatically without needing to click a button. Data that streams out of the electronic medical record system are processed and the doctor is alerted if a patient meets a certain set of weights for high risk.
“These are tangible realities and outcomes that we expected when Endeavour AI went live,” said Dr Ngiam.
NUHS is already looking forward to the next generation of the system to tackle the expected growth in datasets and speed needed to process those data in the next few years.
“We have invested in programmes that look at genomics. When this genomic data hits us, we are not talking about gigabytes but one terabyte of data per day. The amount of compute required to run genomic type processing going forward is going to be exponentially larger. Until then, our next step is to look at how to optimally use our GPUs for the next few years,” said Dr Ngiam.
Singapore’s public healthcare system
In Singapore, the government manages the public healthcare system through the Ministry of Health (MOH). The MOH ensures that good and affordable basic medical services are available to all Singaporeans. It achieves this by providing subsidised medical services while promoting individual responsibility for the costs of healthcare services.
The public healthcare delivery system is geographically structured into three vertically integrated delivery networks based on geographical regions:
These networks are also known as “integrated clusters''. Each integrated cluster has a full range of facilities, capabilities, services and networks across different care settings including primary care, acute and long term care, among others to deliver comprehensive and person-centred health promotion, disease prevention, curative and rehabilitative care for the population in their respective regions.
Information about Singapore's integrated clusters have been taken from the MOH press statement issued in 2017 here.
Contact National University Health System Address: NUHS Tower Block
1E Kent Ridge Road, Singapore 119228
Tel: +65 6779 5555
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