Singapore’s NTFGH gets successfully revalidated for EMRAM Stage 7

The revalidation was done over three days, along with the successful EMRAM Stage 6 revalidation of the co-located Jurong Community Hospital.
By Dean Koh
09:01 PM

Ng Teng Fong General Hospital (NTFGH), a 700-bed hospital located in Jurong East in Singapore under the National University Health System (NUHS) cluster, has recently successfully revalidated their EMRAM Stage 7 achievement by HIMSS.

The EMRAM, or Electronic Medical Record Adoption Model, is an international quality standard that recognizes the use of technology, data and analytics to support the delivery of high-quality inpatient care.

Notably, this is the first revalidation conducted virtually in the APAC region since the start of the COVID-19 pandemic. NTFGH is also the first facility in Singapore to be revalidated at Stage 7 under the revised EMRAM criteria, which was updated in 2018. 

The revalidation was done over three days, along with the successful EMRAM Stage 6 revalidation of the co-located Jurong Community Hospital, 400-bed community hospital which offers post-acute and rehabilitative care.


NTFGH was the first facility in Singapore to achieve EMRAM Stage 7 back in 2016 – it had already achieved EMRAM Stage 6 in late 2015, just two months after the hospital officially opened. Last year, Thailand’s Princ Paknampo Hospital became the first hospital in the country to achieve EMRAM Stage 7, Healthcare IT News reported


In 2016, the 30-day readmission rate of NTFGH was 13.2%, which was significantly higher than the national average of 10.5% among the public hospitals in Singapore. A multidisciplinary team of clinicians and other care providers who supported case management and community operations were assembled to tackle the problem of high readmissions. 

A risk score for real-time prediction of readmissions for hospitalized patients was developed using machine-learning models and deployed in its Electronic Medical Records (EMR) in 2017. Systematic prompts of high-risk patients in the EMR enabled healthcare workers to have a greater degree of prioritization on intervening patients in need. With the implementation of this risk score and targeted interventions on high-risk patients, the overall 30-day readmission rate of NTFGH significantly improved from 15.0% in April 2017 to 12.0% in February 2020 (p < 0.01).


“The HIMSS EMRAM Stage 7 process validates the hard work we have put into making our EMR a safe and efficient system for delivery of care, leveraging our data in a positive cycle of improvement. The feedback from the HIMSS validators are equally valuable as it points management to the areas of improvement, since staying in one place is the same as going backwards,” said Dr Gamaliel Tan, Group CMIO, NUHS.

John Rayner, Regional Director EMEA, HIMSS, said: “It was my absolute pleasure to revalidate NTFGH at EMRAM Stage 7 and Jurong Community Hospital at Stage 6. To maintain 'whole organization' commitment over several years is a real challenge – these two hospitals have achieved just that. It is now time to step back and applaud the whole organization as every member of staff has played a part in the process of transformation.”

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