Associate Professor Wayne Morriss, President, World Federation of Societies of Anaesthesiologists (WFSA)
Associate Professor Sophia Chew, President, Singapore Society of Anaesthesiologists (SSA)
Associate Professor Chan Yew Weng, Local Organising Committee Chair
Distinguished guests
Ladies and Gentlemen
A very warm welcome to Singapore. I am so delighted that post-COVID, Singapore has become a choice location for many congresses and concerts, and we have a few going on. I was really surprised that we have a 3,000-participant strong Congress happening in Singapore. This is held once every four years, the last one being virtual, so we are also very honoured that we have this physical Congress, post-COVID.
2. As we gather here today as a global community, I would like to talk about two key global healthcare developments which are acutely felt in Singapore.
Ageing Population and Preventive Care
3. First, an ageing population. Other than Africa and some parts of Asia, almost the whole world is ageing. The number of people aged 65 and older around the world is rising very fast, estimated to double from now to 1.6 billion people within 30 years. Singapore too, is on the path to becoming a super aged society by 2026. We are not far from there. By then, over a fifth of our population will be aged 65 years and above.
4. As every clinician will know, an ageing population makes for a significant healthcare challenge. Healthcare systems around the world are all feeling the impact, as patient load goes up, the number of older patients with complex conditions increases, and they have longer stays in hospital when they fall sick.
5. Even as national healthcare systems grapple with the rising patient load, we need to go upstream as a longer term solution, to practise stronger preventive care and population health. Hence in July last year, Singapore launched our national preventive care programme called Healthier SG. It encourages Singaporeans to take proactive steps in managing their health, by adopting better lifestyles and health-seeking behaviour, to prevent the onset of chronic diseases.
6. But at the heart of Healthier SG lies the belief that primary care matters greatly in population health, and the trusted and continuity of care from a consistent family doctor delivers positive health outcomes. As I was speaking to some of the leaders before this Congress, we spend a lot of effort and money to keep people alive. But actually, we should also be spending the resources and knowhow to keep people healthy, and not just alive.
AI and Disease Burden
7. The second big trend is the advancement of medical technology. There is a confluence of rapid advancements here. One is precision medicine. While nascent and uncertain, it holds promise to revolutionise healthcare. However, I do not believe any country in the world has figured out how to finance expensive cell and genetic therapies of the future, should they become mainstream treatments of tomorrow.
8. Two is the emergence of Artificial Intelligence (AI). Because healthcare is a highly regulated sector, AI applications can be rolled out methodically, judiciously, in a way that benefits patients, with improved productivity, while minimising the downsides. In that sense, there is a great opportunity to adopt AI in healthcare. Furthermore, in a sector like healthcare, physical care is so important. I do not think we are at great risk of AI replacing clinicians or nurses. In fact, what we want are clinicians, nurses and medical personnel who can use AI to improve their work and the quality of care.
9. In Singapore, we need to be proactive in the use of AI in healthcare where it is proven to be safe, clinically efficacious and cost-effective. We need to embrace this exciting new technology. I look forward to a proliferation of use cases in the coming years.
10. We have laid some groundwork to facilitate this in Singapore. For example, we have developed and issued the AI in Healthcare Guidelines to guide developers and implementers in the safe development and rollout of AI-related healthcare products and services. We are closely watching other jurisdictions’ regulatory approaches, and stand ready to learn from best practices. I hope to update everyone with a comprehensive strategy to implementing AI in healthcare sometime later this year.
A Global Imperative
11. Given these two major trends – ageing and the advancement of medical technology – healthcare systems around the world are faced with a global imperative, which is how do we leverage all the knowhow we available to us, to keep our population as healthy as possible?
12. The conversation today has gone way beyond just value-based care, but to make full use of technological advancement to revolutionise healthcare, to move upstream and drive the social determinants of health to prevent, and not just cure sickness. There will be a re-direction of our focus of the healthcare agenda beyond hospitals to communities, beyond sickness to health.
13. I believe every healthcare professional, every social activist, every educator and every caregiver can play a direct role in this transformation of healthcare. Likewise, I believe anaesthesiologists can play a big role.
The Role of Anaesthesiologists
14. In an ageing population, as the perioperative experts, anaesthesiologists will be familiar with the increased risk profile of an elderly patient. Many elderly will be classified as moderate to high-risk sedation patients. Anaesthesiologists will therefore be motivated to improve patient pre-morbidity and thereafter, patient outcomes.
15. In this regard, anaesthesiologists can play a very active role in advocacy, in educating people to be healthier and practise preventive care, and in the context of Singapore, play a decisive role in our Healthier SG strategy. Before an operation, I believe a patient may be most receptive of health advice.
16. Every pre-operative counselling session is therefore a valuable opportunity for teaching, for education and for screening. Patients can be educated on smoking cessation. For example, if you go through a successful surgery, once you come out of the operating theatre, quit smoking. They are more likely to listen to you then. You can also advise them on their Body Mass Index or apnoea risk. They can also be assessed and treated for anaemia or poor glucose readings. Some are even assessed for sarcopenia. So I hope the community can carry on and even step up, the current good work.
17. The anaesthesiologist community has also been innovative in the way it has embraced technology and AI. For example, Singapore has assisted in developing an AI-powered ultrasound guidance system, called uSine. This has been implemented in our biggest Obstetrics and Gynaecology (O&G) hospital, KK Women’s and Children’s Hospital, to deliver spinal anaesthesia to women, by assisting in locating landmarks for the insertion of the spinal needle.
18. This AI-guided needle has improved success rates of spinal anaesthesia delivery by 22%, especially amongst those with challenging spinal anaesthesia landmarks.
19. As ageing and inflation raise healthcare costs, anaesthesiologists can also play a part in facilitating conversations about healthcare financing. Your expertise, such as effective inter-discipline communication and holistic approach to care, contributes to the reduction of surgical complications. It enhances recovery and minimises unnecessary interventions.
Closing
20. As many of you may remind me, anaesthesiology covers every stage of life, every part of the body. At the opening of this Congress, I had merely talked about two major trends in healthcare and linked your work and influence to these trends. But I believe during the Congress, your discussion topics will extend far beyond what I have just laid out.
21. Finally, I would like to extend my heartfelt congratulations to the recipients of the Distinguished Service Awards and the inaugural Rising Star Award. I wish you good discussions, a fulfilling time in Singapore, and a successful 18th World Congress of Anaesthesiologists. Thank you very much.