Prof. Swee Chye Quek1, Jin Ye Yeo2
1Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; 2PM Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. PM Editorial Office, AME Publishing Company. Email: pm@amegroups.com
Expert introduction
Prof. Quek (Figure 1) is the Chairman of the Medical Board of National University Hospital. He is also a Senior Consultant and Head of Division of Cardiology, at the Department of Paediatrics. Prof. Quek has published extensively in peer-reviewed journals and participated in many international conferences as invited faculty. In recognition of his contributions to cardiology, he was awarded Fellowship of the American College of Cardiology. He is the first Singaporean to be invited to serve as a Council Member of the ACC Adult Congenital Heart and Pediatric Cardiology Chapter. He is also a Fellow of the Royal College of Paediatricians and Child Health (United Kingdom), Academy of Medicine and College of Paediatricians and Child Health, Singapore.
Of his many administrative duties at National University Hospital, Prof. Quek is the Director of the Healthcare Performance Office. He was instrumental in the JCI accreditation of NUH, making NUH the first hospital in Singapore to be accredited in 2004, with subsequent re-accreditations after, including raising the bar to the accreditation to an Academic Medical Center standard. Prof. Quek is a visiting Senior Consultant to the Ministry of Health, Singapore, and the Health Promotion Board's School Health Service. For his contributions to healthcare, he was awarded the inaugural NUHS-Mochtar Riady Pinnacle Award for Clinical Excellence, National Medical Excellence Award by the Ministry of Health, Singapore, in 2013, and the Public Administration Medal by the President of Singapore in 2022, and the Public Administration (COVID-19) and Covid Resilience Medal in 2023 for effectively leading the team, amidst all the unprecedented challenges arising from the pandemic.
Figure 1 Prof Swee Chye Quek
Interview
PM: Why did you choose to specialize in the field of pediatric cardiology?
Prof. Quek: At the time of choosing a specialty, every doctor would invariably be considering whether ‘medical’ or ‘surgical’. I was no different. Cardiology is special because it combines the best of both worlds. It is medical inasmuch as it is procedural (e.g. echocardiogram and interventions). Pediatrics is dealing with children, and that is delightful. There is a lifetime ahead of them, and being able to treat and help them grow into healthy adults is a multiplier effect indeed.
PM: Could you provide an overview of the current landscape of publications in pediatric cardiology?
Prof. Quek: Generally, pediatric cardiology is a smaller subset of adult cardiology because of publication volumes. As such, the impact factor for pediatric cardiology journals is lower than adult cardiology journals. However, children are more than just small adults, and pediatric cardiology, per se, encompasses a wide range of conditions. It is not anything simpler either, because the patients whom we deal with are much smaller and span a bigger spectrum and age range, from newborns (even pre-term newborns) to toddlers, children, and adolescents, as they mature into adults. The publications that we have currently in pediatric cardiology are mainly found in Pediatric Cardiology and Cardiology in the Young. These journals are dedicated mainly to pediatric cardiology, but of course, one can find articles published in other cardiology journals like Circulation, Journal of the American College of Cardiology (JACC), and other major European publications. There are also some articles published in the major pediatric journals, such as Pediatrics, Journal of Pediatrics, and Archives of Diseases in Childhood.
PM: What are your thoughts on how pediatric cardiology has evolved over the years? How has it impacted your practice?
Prof. Quek: We have evolved significantly over the years. The practice has been completely revolutionized in the way we treat our patients. This is because medicine as a whole has advanced by leaps and bounds. For example, in the past, surgery for congenital heart disease may not have had excellent outcomes, but today, it is so much better because we have improved the surgical skills of our congenital heart surgeons, and we also have better support from anesthesiologists and pediatric intensivists. Indeed, the multi-disciplinary team has been an essential asset to our patients. We have moved a lot beyond simple imaging procedures to very sophisticated imaging such as magnetic resonance imaging (MRI) and computed tomography (CT) of the heart, while echocardiology continues to be a mainstay because it is non-invasive. Imaging has now taken over the role of diagnostic cardiac catheterization which is invasive, and many of the techniques derived from cardiac catheter studies today are used as therapeutic options in lieu of surgery. We can now perform interventional catheterization to close holes in the heart and treat other heart defects.
PM: Are there specific areas or aspects of pediatric cardiology research that you believe have been overlooked or received insufficient attention?
Prof. Quek: There are many areas in pediatric cardiology that I firmly believe research can and will make a major impact. Even in the areas that we think we know a lot about - such as interventions, echocardiography, and Kawasaki disease - in all of these aspects, there is so much more that needs to be done and can be revealed through research. Then, there is personalized medicine, for example, how genes and the environment interact in certain heart conditions, and how treatment outcomes may be impacted. Particularly in pediatric conditions, where the volumes are small, it calls for multi-center trials so that we will be better off collaborating and sharing results instead of trying to do things individually in small numbers.
PM: At the Hospital Management Asia 2023 Conference, you presented an overview of your hospital’s digitalization journey in the past few years, where you shared about the transition into using personalized medicine and 3D-printing (1). Besides personalized medicine and 3D-printing, could you share the significance of applying artificial intelligence (AI) and other digital technologies in pediatric healthcare?
Prof. Quek: Clearly, AI and technology are here to stay, and they will evolve more in the future as we become better at these new approaches. I am sure that we can use AI in a way that is beneficial in healthcare. In fact, we are already doing some of these things. For example, instead of having a nurse regularly monitor our patients and take their vital signs, we can in future use a device (wearables) to check and continuously monitor many of these in real time. If there are any deviations, there can be alerts to ensure timely treatment. We can use digital technology to involve patients and their families in their own care. AI can also generate predictions and analyze data to better predict risk and manage our patients’ conditions. Currently, some of these technologies are being tested, and some would need time to be developed. I am certain that over time, this will morph in a very significant and dynamic fashion, certainly much more than what it is now, and clearly moving forward with advances in technology that we have.
PM: Over the years, the healthcare cluster you are part of rolled out various digital initiatives with the aim of transforming the delivery of care and services at its institutions (2). How have these digital initiatives improved patient care in a sustainable manner?
Prof. Quek: A few years back, we started an electronic medical records system that allows us to share patient information and store data across multiple institutions caring for the same patients. This has improved communication which is vital for good patient care. We have been able to use our data, for example, to channel analytics looking into how our patients’ conditions can be risk-stratified and to reduce errors in treatment. Many of these digital initiatives can be applied on a grander scale and in a more complex form than what manual work can ever do.
PM: Could you share with us a memorable moment or event from your professional journey?
Prof. Quek: There have been many memorable moments and some of these are occasions when patients are cured of their conditions. For example, a sick baby with congestive heart failure from a large hole-in-heart is treated, goes home completely well, and grows up into a normal child, adolescent, and adult, then sets up his or her own family and brings his/her own children back for a visit. These are some of the most memorable and treasured parts of my professional career.
PM: How has your experience been as an Editorial Board Member of PM?
Prof. Quek: I joined the editorial board because of Prof. Huang Guoying who is an established researcher and exemplary clinician administrator. I felt that if he could contribute so much despite his busy schedule, I should try too. Although the editorial board members do not meet regularly in person, the journey has been a pleasant one, with a palpable enthusiasm in the team. I am being asked to opine on clinical scenarios, management issues, and healthcare challenges which are clearly important because they help me think and prepare myself for a better clinician.
PM: As an Editorial Board Member, what are your expectations for PM?
Prof. Quek: My greatest wish for PM, as much as the other the journals of AME, is to hope for continuous improvement and achievement. To continue to publish articles of high quality and impact for our healthcare professionals, and to be a platform where useful information can be shared and complex cases discussed. This would ultimately translate to better patient care, which is why we all are here to begin.
Reference
- Asia HM. Embracing change for better, more efficient care: Recap of HMA 2023. HMA. Available online: https://www.hospitalmanagementasia.com/patient-safety/embracing-change-for-better-more-efficient-care-recap-of-hma-2023/
- Asia HM. How NUHS’ digital front door strategy is transforming its delivery of care. HMA. Available online: https://www.hospitalmanagementasia.com/patient-experience/how-nuhs-digital-front-door-strategy-is-transforming-its-delivery-of-care/