AI chatbot PEACH to save Singapore General Hospital over 600 junior doctor hours annually

Key Takeaways: 

• Clinicians at Singapore General Hospital (SGH) have created an AI-powered chatbot, PEACH, to streamline preoperative assessments and support surgical preparation.
• In validation studies, the tool achieved 98% accuracy in making recommendations and reduced documentation time by nearly six minutes per patient.
• Deployment of PEACH is projected to save more than 600 junior doctor hours and about 60 senior doctor hours each year.
  

Development of the PEACH chatbot

Clinicians at Singapore General Hospital (SGH) have designed an AI-powered chatbot to assist with preoperative assessments and surgery preparation. The tool, named PEACH (Perioperative AI Chatbot), was created specifically for the hospital’s Preoperative Assessment Clinic.

The development process was a collaboration between SGH and Open Government Products, a team within the Singaporean government that brings together engineers, designers, and product managers to build technology solutions. Together, they integrated SGH’s extensive perioperative guidelines into a large language model-based AI assistant, making these guidelines more accessible and easier to apply in daily clinical practice.

How PEACH works

Doctors using PEACH input relevant patient data drawn from electronic health records. The chatbot can then:

• Answer perioperative anaesthesia-related questions.
• Draft referral letters and patient instructions.
• Summarise key anaesthesia issues.
• Generate comprehensive perioperative care plans.
  

Beyond these core functions, PEACH can also triage patients scheduled for surgery, advising whether they should be assessed over the phone, in person at the clinic, or on the day of surgery itself.

Findings from validation studies

The research team at SGH conducted two studies between November and February to evaluate PEACH’s performance. The results have been published in npj Digital Medicine and were presented at Euroanesthesia, the annual anaesthesiology and intensive care congress in Portugal.

• First study – accuracy and reliability
  In 240 chatbot interactions, PEACH achieved 98% accuracy in making preoperative recommendations. The rate of AI hallucination (false or fabricated information) was less than 2 per cent, while guideline deviation was under 1 per cent.
• Second study – clinical application
  Over 270 actual patient assessments were examined. Clinicians primarily used PEACH for more complex cases and gave the tool high ratings for safety, clarity, and explainability. Independent human reviewers confirmed the accuracy of its outputs.
  

In medium-complexity cases, PEACH reduced documentation time by nearly six minutes per patient. Researchers estimated this would save over 600 hours of junior doctors’ time and around 60 hours of senior doctors’ time every year.

Following these results, Singapore’s Health Sciences Authority approved the deployment of PEACH in clinical practice.

Why this innovation matters

SGH’s preoperative clinic manages approximately 25,000 patients each year. For each case, doctors must review more than 400 pages of perioperative guidelines, which are frequently updated. SGH noted that “consistent adherence” to these evolving guidelines is challenging and can lead to suboptimal preparation or even postponements of surgeries.

By streamlining this process, PEACH not only reduces administrative burden but also improves consistency in patient preparation. Another key advantage is its ability to triage patients effectively, helping the hospital reduce waiting times and allocate resources more efficiently.

Dr Hairil Rizal, Associate Professor at SGH’s Department of Anaesthesiology and senior author of the PEACH papers, explained:

“[The] system’s ability to triage patients effectively means we can better allocate our resources where they’re needed most. This is about working smarter to deliver better care.”

Part of a wider trend in AI at SGH

PEACH builds on SGH’s earlier work with artificial intelligence. Two years ago, the hospital implemented a predictive AI tool to assess patients’ fitness for surgery, based on its Combined Assessment of Risk Encountered in Surgery (CARES) calculator, enhanced through machine learning.

More recently, SGH researchers collaborated with the A*STAR Institute of Molecular and Cell Biology to create an AI system capable of predicting liver cancer recurrence. These initiatives reflect SGH’s broader strategy of incorporating AI technologies into clinical workflows to improve efficiency and patient outcomes.

Voices from the team

Dr Ke Yuhe, Associate Consultant in Anaesthesiology at SGH and lead on the PEACH project, stated:

“PEACH represents a significant step forward in how we manage preoperative assessments. By integrating our comprehensive perioperative guidelines with AI technology, we’ve created a tool that not only enhances patient safety but also helps doctors make more efficient and consistent decisions.”

Dr Rizal added:

“What excites me most about PEACH is how it’s transforming our clinical workflow at [the preoperative clinic]. When you’re seeing thousands of pre-surgery patients annually, every minute saved on administrative tasks is a minute gained for patient care.”