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Excellent primary care helps maintain population health. CGH complements this with expertise in complex conditions that require specialist treatment. Through education and research into better management, prevention and treatment of these conditions, we improve outcomes for patients and advance healthcare delivery across Singapore.
Our teams continue to ideate and implement new technologies and services that address the everyday needs of patients and colleagues, where each innovation reflects a commitment to transform concepts into concrete solutions. Across various departments and areas of care, a collaborative RIE ecosystem has taken root: an ethos that turns ideas into real-world solutions and sets new benchmarks in healthcare.
Ensuring continuity presents our next vital challenge. Through education, we seek to empower the next generation of healthcare professionals to advance today’s achievements and sustain the transformation of research discoveries for improved health for people across Singapore and the world.
One patient’s blood test may contribute to a study that shortens diagnostic waiting times for other patients, while a bedside conversation could spark a question that evolves into a multicentre trial.
This close interplay between inquiry and healthcare practice defines how research is conducted at CGH. Through coordinated support systems and innovation pathways, researchers and investigators are empowered to navigate complex studies, while assisting the translation of ideas into practical tools. Together, this creates a robust infrastructure designed to move ideas from bench to bedside.
Research and innovations at CGH are strategically geared towards three focus areas that address patients’ most pressing health concerns: cardiovascular, metabolic disorders, and ageing and mobility. Beyond treating hypertension (high blood pressure) and dyslipidaemia (abnormal levels of lipids in the bloodstream), our teams investigate how other interconnected conditions, such as sleep disorders, can impact cardiovascular health. The second focus area drives an understanding of the links between complex metabolic dysfunction and premature ageing to develop more effective, specialised approaches to managing metabolic disorders. Finally, as Singapore’s society ages, research into maintaining functional independence and quality of life is timely and essential – it ensures our longer lifespans are matched by sustained health and wellbeing.
Through these interconnected research priorities, we aim to ensure that research addresses real patient needs and that innovations improve care, while also cultivating the next generation of healthcare professionals who excel in both patient care and scientific inquiry.
CGH’s pioneering hypertension research exemplifies a milestone in translational medicine, demonstrating how research can translate into enhanced patient care outcomes.
In Singapore, hypertension is a major cause of heart disease and stroke. It affects about one in three adults, of whom 5 to 20% have primary aldosteronism, a common yet lesser-known form of high blood pressure. These patients are also at a higher risk of developing heart disease, stroke and kidney failure. Despite this higher prevalence, many patients with primary aldosteronism are not screened and treated.
To bridge this gap with a non-invasive alternative to adrenal vein sampling (AVS), CGH led Asia’s first – and the second largest ever –clinical trial of ¹¹C-Metomidate PET-CT imaging which identifies hormone-producing growths in the adrenal glands. The new scan takes less than an hour to complete, emits less radiation than a conventional CT scan, can detect functioning growths in the adrenal glands non-invasively, and can thus replace current invasive diagnostic tests.
Riding on this success, the next milestone aimed to translate advanced diagnostics into routine patient care, and in 2021, the Shimadzu-CGH Clinomics Centre (SC3) was established. A collaboration between CGH and Shimadzu Asia Pacific, the laboratory combines our clinical and research expertise with Shimadzu’s diagnostic and analytical capabilities. Harnessing the technology of liquid chromatography coupled with tandem mass spectrometry and powered by artificial intelligence, the new clinical tests at the SC3 are processed locally, reducing turnaround time for lab results to just three to five days. To date, more than 7,300 tests have been conducted, allowing doctors to identify cases of primary aldosteronism earlier and offer timely interventions for patients.
As a smart hospital and leader in leveraging advanced technology, CGH, through the SC3, has come a long way in providing crucial diagnostics for hypertension patients in Singapore.
For Mr Khoo Keow Pin, 68, the impact of accurate testing was significant on his health. After years of taking medication for hypertension, tests processed at the SC3 revealed his primary aldosteronism diagnosis, and he underwent surgery to remove his affected adrenal gland. Within two weeks, his blood pressure stabilised, and he now requires fewer medications.
Mr Khoo Keow Pin (right) undergoes the salt-loading drip test at CGH as part of testing for primary aldosteronism.
Through initiatives like the SC³, CGH demonstrates its unwavering commitment to translational medicine, consistently seeking to bridge the research-to-care gap, leading to meaningful improvements in patient care and outcomes.
LEARNING IS CARING FOR THIS CLINICIAN-SCIENTIST
Clinical Assistant Professor Troy Puar
Head and Senior Consultant, Department of Endocrinology
In his clinic, Clin Asst Prof Troy Puar cares for patients with hypertension and metabolic diseases. He specialises in adrenal hypertension, including primary aldosteronism. Clinical research allows him to look beyond the surface of diseases and bridge the gap between discovery and patient care.
Clin Asst Prof Troy Puar (left) and Annabel Choo, Clinical Research Coordinator, Clinical Trials & Research Unit (standing) conduct a consultation as part of a clinical study recruitment.
As a clinician-scientist, Dr Puar balances patient care with research leadership. He is the Principal Investigator at the SC³ and a member of the hospital’s research strategy committee, helping ensure that studies not only translate into direct patient care, but also lead to enhanced care outcomes.
His influence extends beyond CGH: he founded the ASEAN Network for Adrenal Hypertension (ANAH), the first collaborative research network in Southeast Asia. Dr Puar also led an international study involving more than 860 patients across 15 countries that revealed that current gaps in AVS testing and surgical services left patients waiting over a year before receiving curative surgery. These insights led to the development of new approaches to expedite treatment and potentially eliminate reliance on invasive diagnostic procedures.
Dr Puar acknowledges that research brings its own challenges, but he sees them as part of the excitement. In 2025, he became CGH’s first recipient of the Clinician Scientist Award, which recognises his work in advancing precision medicine.
Mentorship remains central to his role. Rather than prescribing a set path, he focuses on “clearing roadblocks” – helping young clinicians and allied health colleagues refine ideas, navigate organisational processes, and move forward confidently in their research and clinical work.
Looking ahead, Dr Puar is collaborating with partners in Asia, Europe and Australia to test new diagnostic markers and artificial intelligence driven tools for hypertension, with the aim of making diagnosis simpler and more accessible both in Singapore and abroad.
CGH’s innovation team focuses on digital health, artificial intelligence (AI), product design and medical devices, sometimes managing up to a hundred projects at a time. When community nurses found their existing bags challenging for home visits, the team designed a solution – a mobile workstation with modular shelves, glove dispensers and a deployable table. The bag enables community nurses to travel more efficiently and carry out duties, such as minor procedures and counselling, while maintaining optimal hygiene levels and ease-of-movement in patients’ homes.
Serena Koh, Senior Nurse Clinician (Advanced Practice Nurse), Karen Hay, and Shelin Chee, Senior Manager, OOI, conduct testing of the pre-MRI VR simulation.
Another example is a virtual reality (VR) simulator, developed in collaboration with Temasek Polytechnic’s School of Engineering to prepare patients before their Magnetic Resonance Imaging (MRI) tests. Using immersive VR to simulate the process and environment of MRI tests, the simulator eases anxiety and claustrophobia that make patients fidget, which invalidates the scan. The simulator also helps nurses systematically identify patients who may require further preparations. It reduces the need for patients to reschedule scans, enhancing operational efficiency.
Karen is heartened that such inventions have inspired more colleagues to adopt a problem-solving mindset. “I think we’ve done a good job over the years promoting innovation, such that people just knock on our doors if they have an idea. Our people are eager to innovate!”
SIMULATING SOLUTIONS FOR INNOVATIVE CARE
The Emergency Department (ED) at CGH is one of the busiest in Singapore, with spaces sometimes divided for multiple functions and events happening at any one time, making it challenging to view holistically. To address this, CGH collaborated with FARM, a multidisciplinary design agency, and Vouse, a cross-technology company, to build Singapore’s first-of-its-kind digital twin of the ED.
Interface of the digital twin for the CGH ED.
The digital twin is a highly dynamic and interactive model of the ED environment, seamlessly integrating spaces, people, workflows, activities and time. This enables healthcare professionals to gain holistic perspectives for decision-making to address complex challenges and support patient care. Healthcare professionals can test ‘what if’ scenarios, anticipate opportunities to optimise workflows, and explore new configurations without disrupting patient care.
Visualising the ED as an interconnected system enables a more holistic redesign of processes, making sure that every adjustment maintains the delivery of safe, efficient and patient-centred care. Ultimately, the goal is to enhance the approach to healthcare design and planning as well as to improve experiences for patients, family members and healthcare workers.
CGH’s partnership with Vouse also created an innovative smart positioning assistance system that creates real-time visual feedback for optimal X-ray positioning.
The CGH radiography department performs about 21,000 X-rays monthly, with about 10% needing retakes. Two-thirds of these result from sub-optimal positioning of patients, which may extend waiting times due to repeated scans. The X-ray positioning solution uses real-time visual models to provide immediate feedback for radiographers to make adjustments and position patients, potentially cutting retakes by 50%.
This innovation proves especially valuable for newly trained radiographers, those returning to practice, and smaller clinics where supervision may be limited. By further reducing potential radiation risks and streamlining workflows, the X-ray positioning solution could set a new standard in patient experience and radiography training at CGH and beyond.
Karen Hay and the Radiography project team test the X-ray positioning solution.
Over time, bedside teaching evolved into structured programmes with simulation training, integrated curricula and evidence-based frameworks. This ensures every healthcare professional – in medicine, nursing and allied health – develops the competencies essential forexceptional patient care.
Today, learners join ward rounds, assist in clinics, and participate in assessments that strengthen critical thinking and reasoning. Residency, specialty training and fellowships integrate theory with practice, while nursing and allied health programmes nurture technical and leadership skills. We also support practising professionals through workshops and continuing education, helping them stay current with new medical treatments and standards.
PURPOSE-BUILT CENTRES TO SUPPORT HEALTHCARE LEARNING
Our commitment to educational excellence comes to life in world-class facilities. The Changi Simulation Institute (CSI),opened in 2012 by former President Dr Tony Tan, provides safe environments for practising emergency procedures before working with real patients. As part of the SingHealth Duke-NUS Institute of Medical Simulation network, CSI serves as a dedicated home for interprofessional simulation training of scenarios ranging from critical care procedures to emergency resuscitation.
In 2018, CGH comprehensively upgraded the Centre for Advanced Clinical & Surgical Skills (CACS). Today, it facilitates specialised training across surgical and procedural fields for healthcare professionals from around the region.
At CGH’s Changi Simulation Institute and Nursing Education Institute, team-based simulations and trainings are frequently conducted to keep our healthcare professionals’ skills relevant and top-notch.
In 2023, CGH launched the Nursing Education Institute (NEI), a hub with flexible spaces that shift between lectures and simulated ward environments. It prepares nurses for both clinical and leadership roles, with training aligned to Singapore’s healthcare priorities and international standards.
BUILDING TEACHING EXPERTISE BEYOND CLINICAL SKILLS
Faculty development is key. High-quality teaching requires more than clinical expertise; it also calls for strong pedagogical skills. Faculty members undergo training in methodology, curriculum design and assessment techniques. They also go for workshops with innovative strategies such as problem-based and case-based learning, while senior clinicians receive leadership training to design curricula that respond to evolving healthcare needs. This systematic approach creates a multiplier effect, producing graduates with stronger clinical judgement, better teamwork skills, and a commitment to patient safety.
At the Nursing Education Institute, senior and junior nurses come together to train in a range of procedures and skills.
Placing a strong emphasis on interprofessional learning, medical, nursing and allied health students participate in joint experiences that mirror real-world teams. Through collaborative simulation exercises, learners build communication, teamwork and shared decision-making skills that directly enhance patient safety and care quality.
Watch the below to learn more about RIE at CGH!
Looking ahead, CGH is advancing education with emerging technologies such as virtual reality platforms, AI-enabled adaptive learning, and immersive virtual environments. These innovations personalise learning, allow repeated practice of complex procedures, and provide real-time feedback to refine skills.
Through research, innovation, enterprise and education embedded within daily patient care, CGH is poised to continue to build comprehensive workforce capabilities – developing skilled, compassionate healthcare professionals who meet today’s healthcare demands while advancing tomorrow’s healthcare transformation.
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