The COVID-19 pandemic, declared in March 2020, challenged healthcare systems globally. To successfully manage and plan resources, there was an immediate need to gather high-quality data to understand the disease’s characteristics and epidemiology. Singapore Health Services, commonly known as SingHealth, responded to this need by developing a comprehensive COVID-19 registry serving clinical, operational, and research requirements.
The SingHealth COVID-19 registry encompassed patients managed by SingHealth, Singapore’s largest cluster of public healthcare facilities. Identifying patients was performed using a combination of laboratory test results and nationally administered electronic disease tags. The registry leans on the Electronic Health Intelligence System (eHIntS), SingHealth’s data repository, to create a dashboard. This dashboard consolidates patient identifiers with variables from a minimum data set (MDS). This framework has allowed for hospital resource management to be mapped out, and for deriving and coding 19 comorbidities and 14 complications amongst hospitalized patients.
To offer a comprehensive insight, the registry catalogs over 100 variables across 15 data domains. It captures both raw data, like problem lists and intra-hospital movement, and derived variables such as comorbidities, complications, and outcomes. As of end 2023, the registry had captured data for 156,262 unique patients, of whom 27,630 had been admitted for COVID-19 at least once in a SingHealth facility. Recognized for its efficient low-cost development during a rapidly evolving pandemic situation, the registry serves as a model for automated databases. It has utilized standardized clinical workflows enforced by the pandemic to inform operations, clinical management, and research efforts.
The registry has contributed significantly to our understanding of COVID-19, filling gaps in knowledge related to emerging variants, vaccine regimens, and long COVID-19 syndromes. For instance, the Omicron variant posed additional threats due to its increased transmission rates and superior ability for immune evasion. The registry also shed light on the impacts of vaccination programs, identifying a reduction in vaccine effectiveness against the Omicron variant, which triggered discussions on the necessity of booster doses. Furthermore, the registry enabled the understanding of long COVID-19 syndromes, which were affecting more than 65 million individuals globally, yet remained a relatively unexplored territory. The SingHealth COVID-19 registry showcases the power of systematic data collection and stands as a crucial instrument for future outbreak management.