Background

The PAtient Care Enhancement System (PACES) is the Singapore Armed Forces (SAF)'s Electronic Medical Records (EMR) system that is used in all SAF medical and dental centres in Singapore. PACES was first introduced in the SAF in 1995. Back then, it was a decentralised system – each medical centre functioned with its independent database, and information was subsequently synced back to the Ministry of Defence (MINDEF)’s centralised database. In 2005, the system was upgraded to PACES 2 and could be hosted on the SAF intranet. This meant that medical centre users were connected to a centralised database, which enabled the SAF Medical Corps to analyse disease and injury trends, and perform epidemiological research for infectious diseases affecting SAF personnel.

The current version, PACES 3, was launched in April 2016 and now connects to healthcare infrastructure outside of MINDEF/SAF via the internet. An infographic of PACES 3's features can be found below at Annex A.

New Features in PACES 3

Integration with National Healthcare Applications. PACES 3 is connected to Singapore's healthcare infrastructure and interfaces in real-time with different systems to provide more holistic medical care for SAF servicemen, namely:

a.    National Electronic Health Record (NEHR). This is a data exchange system for healthcare professionals to retrieve and update records of patients across the national healthcare network, which includes SingHealth, National Healthcare Group, National University Health System and other medical service providers. Being connected to the NEHR enables SAF medical officers to have the latest information on a serviceman's medical history, clinical visits with our public healthcare institutions, hospitalisation history and medication history, so as to be able to provide them with the appropriate medical treatment.

 b.     Critical Medical Information Store (CMIS). This system allows two-way information sharing between the EMR systems of our national healthcare providers. Having PACES connected in real-time to CMIS provides SAF medical officers with the latest information on a serviceman's reported drug and food allergies, for example.

Encourage Personal Health Management. Servicemen are now able to access information on their health status, medical conditions, and better manage their personal health through PACES 3's new features:

a.    New eHealth Portal (www.safhealth.sg). The new PACES 3 eHealth portal was designed to be user-friendly for both desktop and mobile devices. The portal allows servicemen easy access via the internet to personal health records and military medical information, such as updates in a serviceman's PES status. Through eHealth, users can also make appointments with the SAF medical centres and check the results of their medical investigations. Pre-enlistees and servicemen can submit medical screening questionnaires online, as well as submit requests for medical reports. Additionally, the portal allows servicemen to download and print their medical documents from the system, so that they no longer need to retain paper copies of their important medical documents.

b.    SMS Reminder System. To help servicemen remember their medical appointments, a new Short Message Service (SMS) reminder system informs servicemen of their upcoming medical appointments. It also sends an SMS to servicemen when there are changes to their medical appointments, or if they have missed their appointments.

Improved Efficiency. PACES 3 has helped improve the efficiency of the SAF medical processes, with both manpower- and cost-savings.

a.    Manpower and Time Savings. PACES 3 introduced a self-registration kiosk, allowing patient registration to be done more quickly and reducing the administration workload for the medical centre. PACES 3 also features the automatic transfer of ECG images, laboratory test results and x-ray reports into the system. As such, medical centre staff no longer need to scan these paper records into the system.

b.    Going Green and Reducing Paper Print-outs. PACES 3 moved the SAF medical centres further towards being paperless. Information from medical consultations is directly entered into PACES 3, and laboratory tests and x-rays are ordered on PACES 3, no longer relying on paper forms. Test results are also sent electronically into the system, reducing the need for paper printouts and the scanning in of results.

Information Security. Information security and data confidentiality were important considerations in the design and implementation of PACES 3. To ensure a safe and secure information system, a defence-in-depth design approach was taken to address and mitigate risks of cyber threats, data leakage, etc. For servicemen accessing their medical information on eHealth, they are required to have a SingPass account and use the SingPass 2-Factor Authentication (2FA) for authentication.