getting a scan? - Parkway Pantai

MICA (P) 002/02/2012
THURSDAY / SEPTEMBER 20 2012
Your Life. Live it well.
GETTING A SCAN?
BE SOOTHED
BY THE SEA
THE NEWEST HOSPITAL HERE,
MOUNT ELIZABETH NOVENA HOSPITAL,
HAS PATIENT-FRIENDLY FEATURES
pages12-14
WIN!
Skincare products
and health supplements
worth more than $1,000
2
POOR DIABETES
CONTROL
One in two patients
misses medication
6
HEALTHIER BROWNIE
No yolk, no butter
and just half
the sugar
18
12
THE STRAITS TIMES
SEPTEMBER 20 2012
Cover Story
Scan spared patient from surgery
A new machine which provides
clearer scans of tumours is just
one of several firsts offered at
Mount Elizabeth Novena Hospital
NG WAN CHING
A
60-year-old woman
who had cancer in
her vagina was
spared from
disfiguring surgery
because of a new
type of scan that produces
clearer images of organs in the
pelvis.
Computed tomography (CT) scans did not show
any spread of her vaginal melanoma beyond the
pelvic area.
If this had been true, the cancer would be in
stage 1 and surgery would have been performed to
remove it.
But the new machine, the positron emission
tomography-magnetic resonance imaging (PET-MRI)
machine, picked up a 1cm-wide tumour outside the
patient’s pelvic area.
This meant that the cancer was in stage 4 and
surgery was no longer appropriate.
The woman’s doctor, Dr See Hui Ti, a consultant
medical oncologist at Parkway Cancer Centre, said:
“We used this information to decide not to send the
patient for the disfiguring surgery and started her on
immediate chemotherapy.
“This nodule was small and potentially could have
been missed using other imaging modalities.”
Singapore’s newest hospital, Mount Elizabeth
Novena Hospital (MNH), where Parkway Cancer
Centre has a clinic, is the first here to use the
PET-MRI machine to scan patients.
This is one of a few firsts that the new hospital,
which opened on July 1, has scored for the private
health-care sector.
The others include an advanced surgical system
for brain and spine surgery, and a purpose-built
hybrid operating theatre, where both open surgery
and minimally invasive procedures can be
performed.
Raffles Hospital, for example, does not have the
PET-MRI machine or the hybrid operating theatre.
These are fairly new introductions to the
health-care scene and the hospital management is
evaluating them at the moment, said a spokesman
for Raffles Hospital.
The Clinical Imaging Research Centre at National
University of Singapore is the only other owner of a
PET-MRI machine in Singapore, but uses it for
research only.
A spokesman for the National Cancer Institute,
Singapore said it does not currently offer PET-MRI
scans to patients as there is no established clinical
indication for it.
But the machine, which does a PET scan and
magnetic resonance imaging (MRI) at the same
time, was approved by the United States Food and
Drug Administration last year, based on performance
tests that compared it with the existing positron
emission tomography-computed tomography (PET-CT)
device.
In a PET-CT scan, patients are injected with
radioactive dye, which will be drawn to cancerous
Not the most expensive hospital
ST PHOTOS: AZIZ HUSSIN
Mount Elizabeth Novena Hospital is the first here to offer PET-MRI scans, which allow doctors to see better if there is any tumour present in the patient and if it has spread.
cells and will show these cells on the scan.
MRI uses a strong magnetic field to capture
detailed images of the internal structure of the body.
Doing an MRI scan and a PET scan
simultaneously, but without a CT scan, gives
pinpoint accuracy. The radiation level is also lower
than that of a PET-CT scan, doctors said.
The machine improves resolution of the images of
structures especially in the head, neck and pelvis,
allowing doctors to see better if there is any tumour
present and if it has spread, said Dr See.
“We look at every imaging modality as a welcome
addition to make better and more accurate clinical
judgements so that our patients need not be put
through potentially disfiguring surgery if there is no
chance of cure,” she said.
Conversely, it can also help doctors identify which
patients are suitable for surgery if it shows the
cancer is in its early stage, she said.
In addition, the significant reduction in radiation
dose – between 25 and 50 per cent – to the patient
is of great significance to those who need long-term
oncology follow-up, she added.
It costs $3,500 to do a PET-MRI scan of the
whole body. This is cheaper than an MRI scan of the
whole body, which costs $4,000. A whole-body
PET-CT scan costs $2,100.
CUTTING-EDGE TECHNOLOGY
Another first for the private sector at MNH is the
O-arm surgical imaging system integrated with a
surgical navigation system, which is used for spine,
orthopaedic and trauma-related surgery.
The O-arm surgical imaging system provides
real-time images of a patient’s anatomy with
high-quality images and a large field-of-view in both
two and three dimensions during surgery.
By integrating the O-arm with a surgical navigation
system, surgeons are able to perform less invasive,
safer and more accurate procedures.
The same navigational system is integrated with
the operating microscope that neurosurgeons use
for brain surgery.
It also helps surgeons perform surgery on the
brain more smoothly, accurately and safely.
MNH is the first private hospital here to have a
purpose-built hybrid operating theatre, where both
open surgery and minimally invasive ones done
using catheters threaded along blood vessels can
be carried out.
Traditionally, catheter-based interventions are
done in a cardiac catheterisation suite while surgical
procedures are done separately in a conventional
operating theatre.
The use of the hybrid operating theatre benefits
patients with complex conditions. For example, an
elderly heart patient with multiple blocked arteries,
heart failure, long-standing diabetes and maybe a
previous stroke could be treated in the hybrid
operating theatre without the need for open heart
surgery.
If his most important heart artery – the left
anterior descending artery – is blocked along with
other lesser arteries, the hybrid operating theatre,
with its X-ray imaging system, will allow the heart
surgeon to bypass the block using minimally
invasive surgery.
It will also allow an interventional cardiologist to
clear the other smaller blocks by inflating a balloon
attached to a catheter and deploying stents to prop
the blood vessel open.
“The patient would not have the increased risk of
stroke due to being hooked up to a heart-lung
machine in open heart surgery,” said Dr Peter Yan,
medical director of the Parkway Heart and Vascular
Centre, which is located at MNH.
The time taken to do the procedure would also be
shorter than that for open heart surgery and the
The newest hospital in Singapore may have the
latest technology and the most expensive room at
$12,000 a night, but Mount Elizabeth Novena
Hospital (MNH, above) is not the most expensive
one here, said its chief executive officer.
Most of its charges are comparable with Mount
Elizabeth Hospital off Orchard Road, said Dr Lee
Hong Huei.
Currently, regular room rates and hospital fees
are pegged to Mount Elizabeth Hospital, its sister
hospital under private health-care company
Parkway Pantai, he said.
For example, a day’s stay in a single room at
MNH costs $578 while doing so at Mount
Elizabeth Hospital costs the same.
In hospitals, the final bill size of any surgical
procedure depends on a few key factors.
These include the duration of surgery, the
equipment and consumables used, and whether
the patient has any other underlying condition such
as diabetes and suffers from complications.
Dr Lee noted: “When bill sizes are off the norm,
anaesthesia levels would be lower.
This would result in a faster recovery with a
shorter stay in the hospital.
The usual length of hospital stay for open
coronary artery bypass surgery is between seven and
10 days, but patients who have had a hybrid
procedure can be discharged within four to five days,
said Dr Yan.
They are seven times more likely to return to work
within one month instead of the usual three months
for a standard coronary bypass surgery, he said.
The hybrid operating theatre will allow the doctor
to quickly convert from a catheter-based intervention
to an open-heart bypass surgery if the need arises.
PROVIDING ADVANCED MEDICAL CARE
The investment in cutting-edge technology is in line
with MNH chief executive Lee Hong Huei’s vision for
the hospital to focus on advanced surgical and
medical care.
Such care will be more expensive but it offers
patients more choices, he said.
So, doctors at MNH – there are currently more
than 120 of them – are encouraged to move towards
further specialisation and to practise in speciality
groups.
those are normally associated with some
complications.”
For example, a patient could have an underlying
illness such as diabetes, which goes out of control
either during or after surgery.
But so far, the bill sizes for the same procedure
performed by the same surgeon in the two private
hospitals have been about the same, Dr Lee said.
For example, a procedure to remove a gall
bladder costs between $11,274 and $12,274 at
MNH.
This is comparable with the median of $13,771
for the same procedure at Mount Elizabeth
Hospital.
At another private hospital here, Raffles
Hospital, the median is $12,887.
In comparison, patients who stayed in A class
wards in public hospitals and did not receive any
subsidies from the Government paid less.
The median at National University Hospital was
$4,666, while that at Singapore General Hospital
was $5,717.
Dr Lee said: “With the rapid advancements in the
medical field, it is inevitable that we would have to
progress towards sub-specialisation (further
specialisation). We are essentially providing active
support to facilitate the process.”
The heart and vascular centre is one such
example. It has 12 heart specialists with different
further specialisations.
This will eliminate the need for the patient,
especially one with a complex issue, to go from
clinic to clinic seeking multiple opinions, said
Dr Yan.
Other sub-speciality group practices within the
hospital include those for neurosurgery, colorectal
surgery, hand surgery, spine surgery and ear, nose
and throat surgery.
MNH also provides facility services to doctors
located nearby, such as Novena Medical Centre,
Novena Specialist Centre, Thomson Medical Centre
and Mount Alvernia Hospital, as long as they have
admitting privileges with the hospital.
[email protected]
Designed for patients’ well-being: page 14
14
THE STRAITS TIMES
SEPTEMBER 20 2012
Designed for patients’ well-being
ST PHOTOS: AZIZ HUSSIN
(Photos 1 and 2) The lighting
in the intensive care units at
Mount Elizabeth Novena
Hospital have been designed
to be in sync with the body’s
body clock and will dim
automatically when night
falls.
(Photo 3) All rooms are
canted, with the bed angled
towards the windows, which
makes it easier for the
patient to look out of the
window.
E
ven the lighting in the latest hospital in
Singapore has been designed to help
speed up patients’ recovery.
The ambient lighting in the intensive
care units at Mount Elizabeth Novena
Hospital (MNH) works in sync with the
body’s normal circadian rhythm, often called the
body clock.
Instead of having the lights set at a fixed level
of intensity all day and night, the lights dim when
night falls.
They can be programmed to do so automatically
or they can be dimmed manually.
A study published in 2009 in the British Journal
of Anaesthesia said light levels reflecting a
circadian rhythm are beneficial and that reducing
light intensity at night will help to promote sleep.
Another study published in the Critical Care
Nurse journal in 2010 showed that night-time
lighting and a good night’s sleep are critical to
overall health, and healing cannot occur without it.
The study also recommended that light should
not be mounted on the ceiling directly above the
bed as doing so will cause patients to suffer from
the glare.
All the rooms in the new hospital have been
designed to optimise both medical care as well as
comfort.
For instance, all the rooms for patients are
canted, with the bed angled towards the windows.
This gives greater access to natural light, which
may hasten the recovery process.
It also means the patient can look out of the
window without turning his head.
The rooms have also been designed such that
the distance between the bed and bathroom
requires the patient to take the least number of
steps.
This is to minimise the risk of falls.
Every room has the patient bed, caregiver space,
bathroom and other equipment in the same
location.
This minimises the possibility of error, said the
hospital, as doctors and nurses immediately know
exactly where everything is.
MNH is the first hospital in Singapore to offer
only single-bedded patient rooms, which its parent
company, Parkway Pantai, says are in high demand
in their other hospitals.
The single-room setting provides space for
patients’ family members or caregivers to stay
over.
Keeping patients in separate rooms may also
help to reduce the risk of cross-infections.
So far, 180 of the 333 rooms are in use.
MNH’s guiding principle in designing the
hospital was to create a “stress-less” healing
environment by making it not look or feel like a
hospital where possible, said its chief executive
officer, Dr Lee Hong Huei.
The hospital building uses design features
commonly found in hotels, such as high-ceiling
lifts, spacious public spaces and a
double-storey-high ceiling in the lobby.
The colour and texture of materials used in the
fixtures also aim to create a warm and comforting
overtone.
In addition, the scan rooms have soothing
pictures mounted on the ceilings to calm patients.
To facilitate speed and connectivity, the hospital
was built with separate lobbies and movement
paths for doctors, staff, patients and the public.
This ensures that the medical team can
respond quickly during emergencies and the
patients are kept away from the public area when
being moved from one spot to another within the
hospital.
The MNH building design incorporated green
elements, such as the optimal use of natural light,
aerial gardens and landscaping, private gardens in
selected patient rooms and the use of
noise-reducing materials.
It is also the first private hospital in Singapore
to implement paper-less, fully electronic medical
records.
One patient was impressed by the quality of
service during his stay at the hospital.
Mr Chia Sze Tong, 47, a sales director, was
admitted on Sept 2 for suspected gastritis and
discharged three days later.
He said he chose MNH as his doctor said it
would be able to admit him immediately.
His total bill was $5,500, before claims from
Medisave and insurance.
He said: “The single-bed room was spacious
and soundproof. It let in a lot of natural light and
had many modern gadgets. I was very impressed
by the butler service and food.
“The excellent service and comfortable
environment was worth the amount I paid.”
Ng Wan Ching