Big 2+1 Change Management (NBS, NHIPS, eFC)

Year Submitted: 2025
Published Date: 11 December 2025

Tags: Applied/Translational Research, Care Continuum, Intensive Care

About this Content

Aims

To facilitate the seamless change transition and adoption of the Big 2+1 systems at TTSH, ensuring people readiness and workflow integration.

Background

To enhance care delivery for patients, NHG embarked on a National Health IT Transformation of their pharmacy, billing and financial counselling systems through the implementation of the Big 2+1 Systems: National Billing System (NBS), National Harmonised Integrated Pharmacy System (NHIPS), and Electronic Financial Counselling (eFC).
As the largest NHG institution to implement these systems, TTSH's transformation spanned all service areas, impacting patients and over 2,000 staff / end-users.
This necessitated a robust change management strategy to ensure people readiness and workflow integration for a successful go-live at TTSH on 30 June 2025, with minimal operational disruption.

Methods

The team adopted the S.T.E.P. Change Management Strategy Framework to guide a consistent and comprehensive approach to change adoption.
The following key change activities were implemented to ensure a seamless change transition of the Big 2+1 Systems at TTSH -
For 'Sharing Information': Sharing of Change Narrative via EDMs, Go-Live Communications at specific milestones of the project, Established Communication Structure and Platforms for dissemination of information (e.g Teams Channels), Communications Repository (Sharepoint), NBS and eFC Digests (during/post go-live).
For 'Training': Identification of Change Agents and Trainers (TTTs), Systematic training approach for training (Train-the-Trainer and End-User Training), Tip Sheets and Quick Reference Guides.
For 'Engagement': Pulse Surveys at specific milestones of the project, Deployment Readiness Day, Daily Pulse Checks, Leadership Walkabouts during Go-Live, Morale Boosters and Energisers (to ensure welfare and well-being of staff).
For 'Possibility Thinking aka Risk Mitigation': Process of developing options and actions, optimising opportunities and managing risks, Workflow Gallery, Integrated Workflow Conversations, Risk Matrix and risk mitigation strategies.

Results

Interventions were carried out at the department levels to further prepare ground staff for the change, leading to an overall increase in the confidence and readiness levels of end-users before go-live.
Inter-Workflow Conversations across all five care settings were completed, ensuring end-to-end synergies across departments; mitigating measures were implemented for all risks identified, culminating in the successful Go-Live of the Big 2+1 Systems on 28 June 2025.

Lessons Learnt

Key ingredients for a successful change management:
1. Go deep: Understand and address real stakeholder concerns
2. Decentralise Change Ownership and activate unit/dept level ownership towards change
3. Design communication channels thoughtfully: Set up clear communication structures and tailor communication mediums to staff levels/roles for effective reach
4. Leverage middle management: Partner closely with them as they are vital bridges who can make or break ground perception and adoption
5. Acknowledge, celebrate and re-energise

Keywords

Change, IT System Change, NBS, NHIPS, eFC

Innovators' Details

Connect with this contributor!

Ho Wai Ling - wai.ling.ho@nhghealth.com.sg

Deborah Lee - DEBORAH.LEE.SY@nhghealth.com.sg

Project Attachment