Empowering Healthcare Through Data, Collaboration, and Innovation for Better Outcomes

A recent Straits Times article, referencing an industry-sponsored white paper, questioned why Singapore’s cancer outcomes lag behind those of Australia and South Korea (“More cancer patients in S’pore die compared with Australia, South Korea; screening could play a role”). Subsequent discussions particularly on social media such as LinkedIn hinged on whether to prioritise screening or next-generation sequencing (NGS) technologies. While both are valuable, we must ask, “Are we implementing isolated fixes, or building data-driven, system-level solutions that adapt as new insights and technologies emerge?”

Having transitioned from a cancer specialist to the CEO of a cancer data company six years ago, and having worked across healthcare systems in eight countries, one truth stands out to me: sustained progress in healthcare over the next decade demands broad, inclusive collaboration. Today’s healthcare ecosystem extends far beyond government agencies, hospitals, pharmaceutical companies, and insurers. It includes diagnostic innovators, med tech and med device companies, AI developers, and other emerging players—all of whom rely on timely, reliable, and clinically meaningful data to accelerate the development and deployment of their solutions. When these diverse stakeholders securely share and analyse information, healthcare can become more affordable, effective, and equitable for everyone.

Leveraging Infrastructure for a Data-Driven Future

Singapore has invested significantly in data infrastructure, establishing a robust foundation with the National Electronic Health Record (NEHR), an interoperable public-sector EMR with EPIC, and TRUST/HEALIX—a cloud-based data analytics platform for public institutes. However, at the output level, the country’s publicly available cancer insights remain anchored in data only up to 2022. The Singapore Cancer Registry Annual Report lacks the granular clinical, genomic, and biomarker details critical for modern oncology. Additionally, the absence of longitudinal outcomes in national datasets highlights a key limitation, as underscored by the industry white paper mentioned earlier that concluded poor cancer patient outcomes in Singapore. While the Ministry of Health later clarified inaccuracies in mortality figures in The Straits Times, it raises broader concerns about whether we are focusing on the right metrics, relying instead on inadequate surrogates.

Transforming static snapshots of incidence and mortality into dynamic, actionable intelligence requires enriching foundational datasets with measures such as real-world Progression-Free Survival (PFS) and Overall Survival (OS) across diagnoses and stages. These longitudinal metrics are vital for assessing whether cancer outcomes are truly improving over time. By integrating such enriched data, policymakers, clinicians, researchers, and payers can transition from waiting years for updated guidelines to responding to evolving evidence in near real-time—enhancing therapies, refining screening strategies, and optimizing resource allocation with far greater precision.

Integrating AI and Next-Generation Diagnostics

In cancer screening, AI-driven diagnostics and Multi-Cancer Early Detection (MCED) tests show great promise in identifying disease earlier. Several Singaporean diagnostic companies have developed their own technologies to also compete in this space. Yet without rigorous evaluation, we risk unnecessary testing, inflated costs, or lead-time bias that does not translate into genuine survival benefits. Incorporating real-world evidence (RWE) ensures that each new tool is judged not by theoretical potential, but by actual patient outcomes. This allows us to direct investments toward interventions that truly improve lives, rather than those that merely appear beneficial on paper.

Enhancing the Cancer Drug List Framework

Traditional evidence models—built on randomized controlled trials (RCTs) and international regulatory approvals—still guide local frameworks. Singapore’s Cancer Drug List (CDL) ensures equitable access to proven therapies while managing costs. The Agency for Care Effectiveness (ACE) informs subsidy decisions based on clinical and economic metrics, but its publicly available evaluation methods do not explicitly detail how local RWE might be integrated.

Embracing RWE would enable more agile adjustments to the CDL. As new data emerge, policymakers could swiftly subsidise effective treatments or scale back support for those found less beneficial in real-world settings. Recent moves to fund cell and gene therapies (“Government subsidies now available for cell, tissue and gene therapy in Singapore”) demonstrate responsiveness. With RWE, such decisions become more systematic, ensuring that subsidies align with interventions proven to help local patients.

Real-World Evidence: A Transformative Opportunity

RWE complements traditional trial data by reflecting everyday clinical realities. It accounts for varied patient demographics and comorbidities that RCTs may not fully capture. By continuously integrating and analysing real-world data, we can identify which interventions consistently deliver meaningful value. This iterative feedback loop supports value-based pricing and coverage models, ensuring that high-cost therapies are funded commensurate with their demonstrated benefits.

RWE-driven decisions can also mitigate financial burdens on patients. Stories of individuals relying on goodwill for essential treatments when insurers decline coverage (“Good Samaritans step forward to pay cancer patient’s drug after insurer refused”) highlight the need for rational, evidence-based reimbursement policies. Insurers and policymakers, guided by RWE, can ensure coverage aligns with therapies that genuinely improve patient outcomes.

Empowering Stakeholders Through Federated Data

A federated data ecosystem can integrate clinical records, genomic data, biomarkers, and patient-reported outcomes while ensuring data remains under the custodianship of hospitals or ministries. Secure, on-site computation preserves privacy by sharing only aggregated insights. Leveraging existing infrastructure like NEHR, EPIC, and HEALIX, this model can track treatment efficacy, identify care gaps, and drive cost-effective, scalable healthcare innovations. Advanced security safeguards data, enabling insights to support clinical trials, real-world evidence (RWE) generation, and population health strategies.

This approach transforms cancer care by enabling proactive population health interventions. Its scalable design supports cross-border collaboration while adhering to privacy regulations—a vital capability during global challenges like the COVID-19 pandemic. By uniting healthcare stakeholders, federated data sharing shifts care from reactive to preventive, anticipating risks and tailoring interventions to prioritise prevention over late-stage treatments.

From Oncology to Population Health

The methods used to manage and interpret cancer data can serve as a blueprint for improving population health overall. Integrating diverse data streams and leveraging RWE-driven insights enable health systems to become more resilient, patient-centred, and forward-looking. Over time, this approach fosters continuous learning, ensuring care remains aligned with the best available evidence.

Such a system evolves with scientific discoveries and changing health patterns, continuously refining interventions as new information emerges. Every aspect—screening protocols, resource allocation, insurance coverage, and treatment options—can adapt swiftly to evolving realities, ensuring patients benefit from the latest, most relevant insights.

A Collaborative, Data-Driven Path Forward

Singapore is well-positioned to lead this transformation. The country’s strong digital infrastructure, progressive policies, and commitment to innovation create fertile ground for integrating RWE and federated data models. Instead of relying on piecemeal solutions, we can embrace a holistic, data-driven paradigm that continually updates and improves.

Patients would gain access to more effective, context-driven care. Clinicians would have better tools at their disposal. Insurers and policymakers could base decisions on robust evidence rather than guesswork. Collectively, this marks a pivotal shift in how we think about healthcare, both in oncology and beyond.

By prioritising data pipelines and enrichment, embracing RWE, and fostering collaboration across all stakeholders, Singapore can set a global precedent. The end result is a continuously improving healthcare system that learns and adapts, consistently delivering better outcomes, controlling costs, and ensuring equity for all.

Sources

1. The Straits Times: “More cancer patients in S’pore die compared with Australia, South Korea; screening could play a role” – https://www.straitstimes.com/singapore/more-cancer-patients-in-spore-die-compared-with-australia-south-korea-screening-could-play-a-role
2. Singapore Cancer Registry Annual Registry Report – https://www.nrdo.gov.sg/publications/cancer
3. The Straits Times: “Government subsidies now available for cell, tissue and gene therapy in Singapore” – https://www.straitstimes.com/singapore/health/government-subsidies-now-available-for-cell-tissue-and-gene-therapy-in-singapore
4. The Straits Times: “Good Samaritans step forward to pay cancer patient’s drug after insurer refused” – https://www.straitstimes.com/singapore/health/good-samaritans-step-forward-to-pay-cancer-patients-drug-after-insurer-refused
5. The Straits Times: “Forum: Ratio of cancer deaths to new cases of cancer in Singapore comparable to other countries" - https://www.straitstimes.com/opinion/forum/forum-ratio-of-cancer-deaths-to-new-cases-of-cancer-in-singapore-comparable-to-other-countries

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