A Digital Leap to Accelerate Urgent Cardiac Care

By Valissa Yap

Every minute counts when a patient is required to undergo an urgent cardiac catheterisation procedure. Take for example, a heart attack patient that comes through the Emergency Department. The procedure is typically arranged within hours or even minutes following an urgent medical review. Therefore, the window period to contact patients’ family members and facilitate complex financial decisions is usually narrow.

Timely financial counselling is essential for timely treatment. The manual paper-based system which once worked well, had become increasingly ill-equipped to keep pace with rising case volumes. Team ReLight, a cross-functional team from the Nursing and Administrative departments, came together to revolutionise the workflow, ensuring that patients receive seamless care.

Why Financial Counselling Matters

Financial counselling (FC) in healthcare helps patients and their families understand treatment costs, insurance coverage, potential out-of-pocket expenses, and available payment options. Beyond providing families with a peace of mind, it ensures cost transparency and allows the Business Office to assess financial eligibility, facilitate smooth post-procedure billing process, and more importantly, ensure timely treatment.

The team found that the paper-based workflow for ad-hoc cardiac procedures has resulted in several bottlenecks such as hardcopy forms running out at critical moments, illegible handwriting leading to confusion, and missing information requiring multiple follow-ups. At times, key information such as contact details of patients or their families were found to be outdated or incomplete.

Legacy hardcopy forms which staff were required to retrieve and manually fill out during time sensitive demands.

Furthermore, communication between wards, Business Office, and the Cardiac Catheterisation Lab (Cath Lab) relied on manual faxing and repeated phone calls. These legacy methods were labour and time-intensive, provided no visibility across departments in real-time, and led to delayed procedures.

Building a Digital Bridge

Driven by extensive stakeholder feedback and detailed workflow analysis, Team ReLight developed an in-house Electronic Financial Counselling (eFC) portal. The centralised digital hub was tailored specifically to the demands of urgent cardiac care, seamlessly connecting the wards, Business Office, and the Cath Lab with a streamlined workflow to eliminate physical paperwork.

“We set up the portal in a way that enables real-time electronic referrals and instant status tracking. This eliminates the need for manual faxing and follow-ups via phone calls,” shared Senior Staff Nurse (Clinical) Rosalie Lite Lacasandile from Cardiac Catheterisation Lab and a team member of Team ReLight. The team carefully refined the system through rigorous pilot testing, ensuring the interface was intuitive for both nursing staff and the Business Office before full-scale implementation.

The updated workflow following the implementation of the eFC portal to allow visibility across all wards, Business Office and Cath Lab.

Feedback during the pilot was overwhelmingly positive. The Ward and Cath Lab nurses appreciated the transparency of the streamlined workflow while Business Office could conduct FC more quickly, significantly reducing the turnaround time. The Cath Lab nurses were able to ensure the ad-hoc procedures could begin on-time since the implementation of the portal. “The eFC portal has been a game-changer for our daily ward workflow. We no longer waste precious time hunting down physical forms or making phone calls, giving us more resources to focus on preparing our patients for the procedures,” Acting Senior Nurse Manager (SNM) Low Huiling from Ward 44 and leader of Team ReLight shares.

Streamlined for Success

The transition to eFC exceeded the team’s expectations, reducing processing time by almost half, which translates to a staggering 1,422 hours saved annually. Beyond clinical time savings, the improvement initiative eliminated the need for more than 3,000 hardcopy forms, saving 180 hours of manual filing time each year. These results represent a significant leap in both cost efficiency and environmental sustainability.

More importantly, patients experienced shorter waiting times and reduced stress when making financial decisions. Procedures moved forward more smoothly, and staff satisfaction improved as administrative burden decreased.

“By removing the tedious paperwork and manual tracking, the eFC system has given us greater clarity and allowed us to conduct financial counselling with patients and NOK more efficiently,” said Josephine Koh, Manager from Business Office and member of Team Relight. “It is rewarding to see how a digital shift can speed up processes to improve the patients’ experience and ensure they receive care when they need it most,” she adds.

A Model for Digital Transformation

By encouraging open communication, sharing sessions and proactive support, Team ReLight transformed a high-pressure administrative bottleneck into a seamless digital experience. Following the success of its initial implementation, the eFC workflow has been expanded to the Cardiothoracic Intensive Care Unit (CTICU) for patient referrals to Financial Counselling Services.

This initiative proves that the most impactful digital transformations in healthcare are not merely about adopting new technology. Instead, they are about removing the systemic obstacles that hinder daily productivity, ultimately allowing us to focus on what truly matters – our patients.

Members of Team ReLight (from L-R): Josephine Koh, Manager, Business Office; Victor Effendie, Senior Assistant Director, Digital Heart; Nurse Clinician (NC) Alias Bin Osman, Ward 56; NC Aidila Binte Ismail, Nursing Specialty Care Unit; Acting SNM Low Huiling, Ward 44/47B; Senior Staff Nurse (Clinical) Rosalie Lite Lacasandile, Cath Lab; Advanced Practice Nurse (Intern) Soh Yanly, Nursing Specialty Care Unit; Melody Teo, Assistant Manager, Nursing Administration and Assistant Director Chua Lee Kheng, Nursing Development Unit.