System outages reported in some public hospitals, health facilities in Singapore

Over the past six weeks, system interruptions have been reported in some public hospitals and healthcare facilities under the National Healthcare Group and the National University Health System, leading to delays in appointments and longer wait times.

The first reported outage occurred on 27 August; 26 IT applications, including EMR, appointment, pharmacy and laboratory systems, were down across 17 government-run health facilities.

A second, longer interruption happened on 5 September, affecting eight public healthcare institutions and two polyclinic groups.

Three weeks later on 29 September, another system failure was reported in some NHG and NUHS facilities, including Woodlands Polyclinic and Yishun Polyclinic, according to a news report by CNA.

Why it matters
The central cluster NHG and the western cluster NUHS serve a combined population of around two million. The system outages had caused “significant impacts on operations,” said Senior Minister of State for Health Dr Janil Puthucheary in a reply to a recent parliament inquiry.

“Patients experienced longer wait times ranging up to one hour at the affected institutions. Some had their outpatient appointments rescheduled. There were delays in dispensing medications to patients,” he explained.

“Fortunately, there was no compromise to urgent care services across the institutions during the IT disruptions. Nobody was turned away from the emergency departments, or denied urgent care,” he added.

The larger context
The two earlier incidents were blamed on bugs found in hardware devices in data centres.

According to Dr Puthucheary, in the days leading to the first outage, two nodes in firewall zones of data centres failed due to bugs in the firmware. The manufacturer, CISCO, was then contacted to identify the bugs and patch the devices.

However, the two nodes failed again a week later causing the second IT interruption. An assessment found that the failure was different from the first event.

In any case, NHG and NUHS had activated business continuity measures and downtime procedures, and in some cases resorted to manual documentation, following the system failures.

“Fixes for some of the issues have been made available and have been deployed. For the others, we continue to work with the manufacturer,” the senior state minister said.

“In the meantime, we have increased capacity in the network for more operational buffer to increase resilience,” he added.

Moreover, Dr Puthucheary did not attribute the first two system outages to the lack of manpower.

He also assured the parliament that there were no indications of security compromises to the affected systems.

The Integrated Health Information Systems (iHIS), which implements, maintains and manages the IT systems of all public healthcare facilities and institutions in Singapore, has yet to provide details about the third and recent system interruption, which had been resolved within the day.

“System services have been restored from 1 pm. We are monitoring the situation in support of our healthcare partners in serving their patients,” the health tech agency said in a Facebook post on 29 September. Healthcare IT News