Hacking Forward: CHI-FLYING Hackathon Shaping Tomorrow’s Solutions

The Centre for Healthcare Innovation’s Future Leaders and Young Innovators Guild (CHI-FLYING) developed a new hackathon model to drive system-level healthcare innovation, led and driven by healthcare professionals within the organisation. Targeting in-service healthcare professionals, it focuses on real-world problem validation, solution development and project sustainment. Case studies like the Healthcare Sustainability Innovation Challenge demonstrate its success in fostering ground-up, cross-sector collaboration and lasting change.

Key Points

• The CHI-FLYING Hackathon model drives system-level healthcare innovation.
• It targets in-service healthcare professionals to solve real-world problems.
• Participants validate challenges, develop solutions and test prototypes.
• Teams receive mentorship and support to sustain and expand their projects.
• A healthcare sustainability challenge demonstrated the model’s effectiveness.

An Imperative for System-Level Change

Healthcare organisations around the globe face a convergence of complex healthcare needs, arising from several factors such as a rapidly ageing population, an increase in non-communicable diseases and growing health inequities (OECD & WHO 2020; WHO 2019; WHO 2021). The challenges faced are becoming increasingly multifaceted, requiring a vast array of services across multiple levels, ranging from preventative care to acute specialist and long-term care (Figueroa et al. 2019).

Although there is an urgent need for change, these healthcare systems often struggle to adapt, especially in terms of reorientation necessary to address new challenges such as climate change and a declining workforce capable of caring for older, sicker patients (Braithwaite et al. 2018). This struggle has been attributed to ongoing fragmentation in the planning, investment and operation of healthcare systems, which hinders their ability to evolve to meet these needs (WHO 2021).

Some cases, such as the COVID-19 pandemic, demonstrated that healthcare systems can radically reorient in the face of crisis. However, it may be difficult to mobilise such an intense effort when faced with increased complexities necessitating new tools and solutions, like digital innovations. These innovations can help reduce the need for manpower while ensuring equitable resource distribution and compliance with regulations and protocols (Braithwaite et al. 2024; Cernega et al. 2024; Kasula 2023; Niaz et al. 2023; Thirumalai et al. 2024). To navigate these challenges, healthcare professionals will need to develop collaborative structures and behaviours. This approach can facilitate the creation of solutions through cross-disciplinary innovations, allowing successful tools and solutions from one setting to be adapted for use in another. This will help minimise duplication of efforts and reduce resource waste (Best et al. 2020; Borgwardt et al. 2019; Woiceshyn et al. 2022).

Re-engineering Hackathons for Healthcare Professionals through CHI-FLYING

Hackathons have been growing in prominence and interest as accessible channels for rapid, intense solutions to wide-ranging problems (Falk Olesen et al. 2020; Heller et al. 2023). While first conceptualised and delivered in the realm of computer science, bringing individuals together to create software solutions over a short time span, this concept of accelerated design and problem-solving has grown and demonstrated strong potential in the corporate, research, scientific and healthcare sector (Nolte et al. 2020; Rooholamini et al. 2024; Wang et al. 2018). Such hackathons are often organised to enhance an organisation’s innovation processes, develop and prototype new solutions and increase employee motivation to remain engaged and contribute to the organisation through collaborative problem-solving (Herala et al. 2019).

A recent literature review demonstrated hackathons’ potential in the healthcare sector, showing that they are providing opportunities for healthcare professionals to collaborate with non-healthcare experts, leading to innovative solutions in both public health and healthcare education (Leary et al. 2022; Muñoz-Leija et al. 2021; Rooholamini et al. 2024). However, the focus and value of hackathons in healthcare have often been limited to educational settings and higher education institutions as a means to engage students and improve their learning experience (Rooholamini et al. 2024). This demonstrates a gap and a potential for in-service healthcare staff to participate in and drive such short-term problem-solving efforts during hackathons.

In Singapore, we fill this gap through the Centre for Healthcare Innovation-Future Leaders and Young Innovators Guild (CHI-FLYING). A unique network of over 150 young leaders below 40 years of age in the health and social care sector across the nation, our ethos is to go “across professions and across siloes” to solve cross-cutting health issues. With such a wide-ranging group of individuals with unique experiences and skillsets, all driven by a common goal to solve pressing health challenges, we chose to harness the hackathon concept as a platform for a systematic, rapid validation of problems and the development of quick, iterative solutions to address them.

While healthcare students are willing to participate, our hackathons primarily target in-service healthcare professionals who are directly involved in patient care and operations. This is essential as these professionals possess the specific knowledge needed to address the real-world issues they encounter. They also have the opportunity to test and validate the problems they face.

One key benefit of this approach is that participants are encouraged to actively solve the problems they encounter, promoting a culture of innovation within the healthcare organisation. In addition, this method ensures the development of concrete and effective solutions, as they are created by individuals who can implement them in their specific setting and environments (Huppenkothen et al. 2018). Participants are grouped into teams of three to six members to ensure that everyone has a voice and can contribute actively (Day et al. 2018).

Unlike technology-oriented hackathons aiming on the development of new software or technological products to improve patient outcomes, our hackathons are issue-oriented, addressing broader issues and social problems (Briscoe 2014; Wang et al. 2018). For example, one hackathon we conducted in 2023 focused on the needs of older adults, specifically on solutions to either maintain their level of independence, such as an innovative ‘buddying’ system among aged neighbours, or to assist families of seniors approaching the end of life. By accommodating both technology-focused solutions, such as mobile health apps, and social-focused solutions, such as resident networks, we enable participants to apply their full range of professional and technical skills and knowledge to generate appropriate solutions.

Our Hackathon Model

Our approach and flow of hackathons are adapted from the Massachusetts Institute of Technology (MIT)’s Hackathon model, a proven, scalable and practical approach to hackathons, integrating the principles of interdisciplinary collaboration and rapid innovation techniques (Gubin et al. 2017). We have split it into five components:

1. Defining the problem,
2. Validating the problem,
3. Development of testing of a solution,
4. Presentation and judging of findings,
5. Support and sustainment of the project.

Based on the scope of the hackathon and the intended ‘end-product’, we have organised one-day hackathons intended to rapidly identify solutions akin to ‘traditional’ weekend-based hackathons, as well as three-month hackathons to allow sufficient time for validating the problem and developing and testing the proposed solution (Falk Olesen et al. 2020). Throughout each step of the process, teams are mentored by both CHI-FLYING members, who have expertise in hackathons, and relevant subject matter experts from the Centre for Healthcare Innovation (CHI). This ensures that at each step of the process, teams are facilitated through their brainstorming, ideation and execution process, encouraging the flow of ideas and the tolerance of potentially radical solutions that can lead to impactful outcomes (Wilson 2013). The timeframe guide of our hackathon model, which illustrates our journey from identifying problem themes to developing solutions and final judging within a five-month timeframe, is shown in Figure 1.

Throughout the hackathon, teams are evaluated based on the following criteria to determine their readiness to progress to the next stage:

1. If their solution effectively addresses the identified problem,
2. If their solution clearly demonstrates benefits to public healthcare and aligns with the challenge statement,
3. If the solution shows potential for sustainability and longevity, with the capacity to continue beyond the hackathon,
4. If the solution can be scaled to other locations.

The judging process consists of four phases: one for “Validating the Problem,” one for “Developing and Testing the Solution,” and two for “Presentation of Findings.” The specific aspects that will be assessed are illustrated in Figure 2.

Defining the Problem

Our initial Problem theme focuses on an area of interest to CHI, ensuring alignment with the organisation’s strategic needs while providing resources, capacity and access to expert advice. By collaborating with subject matter experts from CHI and its associate partners in relevant industries and academia, we establish clearly defined themes with sufficient latitude for teams to develop appropriate problem statements that are both precise and realistic (Heller et al. 2023). This collaboration also allows us to identify suitable subject matter experts to serve as mentors, offering specific technical skillsets and expertise to properly advise the team (Franco et al. 2022).

Next, we organise an information session open to all potential participants in order to communicate the theme and its relevance to the current and future healthcare landscape. A deliberate in-person gathering at CHI facilitates clear communication of the objective and focus of the hackathon, while also providing networking opportunities for potential participants to connect with mentors and experts. This interaction allows them to brainstorm ideas and explore potential approaches to their problem statements (Nolte et al. 2018). Afterwards, potential participants proceed to identify potential problem statements aligned with the theme and validate them appropriately.

Validating the Problem

Teams return to their workplace to collect data around the identified problem statement, examining whether the problem is relevant to public healthcare institutions in Singapore. This step allows teams to confirm that their proposed problem is pressing and aligns with the goals of their organisation. This is typically achieved through rapid focus groups with peers and staff surveys, demonstrating the extent of the issue and the need for action (Gubin et al. 2017).

Following this, teams submit their problem statement and associated data to CHI-FLYING and a panel of external judges assembled for the hackathon. This marks the first-cut review of the applications (Judging Phase 1). During this phase, the judges evaluate whether the teams’ proposed problems are suitable for the hackathon and if they meet the goals of the Problem theme (Kitsios et al. 2019).

Development and Testing of a Solution

Shortlisted teams are invited to CHI for a workshop designed to guide them on the fundamentals of solution development. During this workshop, teams learn how to identify the most valuable aspects of their intervention, which helps to improve outcomes for patients and the general population while reducing environmental, social and financial impacts. This approach ensures that both the solution they developed and the processes established to create the solution will build a cycle of positive change (Gubin et al. 2017; Senge 2006).

After the workshop, teams submit the first draft of their proposal for review by CHI-FLYING. An external panel of judges is then assembled to review the proposals for their relevance to the problem statement and their feasibility for completion during the hackathon (Judging Phase 2). Successful teams are awarded a start-up sum to proceed with the prototype of their solution.

Teams receive guidance throughout their prototyping process and are informed about the expected prototype necessary for testing their ideas. They collaborate with a suitable mentor who has expertise in the relevant field, such as a software engineer for digital solutions or a manufacturing expert for new fabric production. This ensures the prototype developed can be effectively produced for testing purposes (Heller et al. 2023).

Once the teams have developed their solutions, they test them within their specific settings. Due to the time constraints of the hackathon, the testing is limited to Proof of Concept (POC) demonstrations. During this phase, teams evaluate their solution’s feasibility, effectiveness and overall value proposition in comparison to existing approaches. Over a brief testing period, the team assess whether their solutions adequately address the identified problem, are capable of being operationalised in their setting and have the potential for making a meaningful impact (Rabinowitz et al. 2013). With their solutions developed and tested, the teams are now ready for judging.

Presentation and Judgement of Findings

The teams present their findings from the POC and their recommendations for adaptation and expansion of their prototyped solutions to a panel of expert judges selected by CHI-FLYING and CHI. We aim to include judges from both the healthcare sector and beyond, ensuring they have the necessary subject matter expertise related to the topics addressed during the Hackathon. This approach guarantees that the judges possess the appropriate knowledge and experience to assess the solutions and their applicability in healthcare settings (De Winne et al. 2020; Kitsios et al. 2019). Through this judging process, we aim to identify the highest quality solutions, which will subsequently receive institutional support to help them mature and move forward.

Although the Hackathon is designed to foster collaboration, we chose to include a competitive atmosphere towards the end to encourage teams to present unique solutions and innovative findings to their judges (Nolte et al. 2020). Each team is allocated five minutes to present their solution, explain how they validated the need for it and share the findings of their POC before the judging panel (Judging Phases 3 and 4 represent semi-finals and finals, respectively). The top three teams are awarded funding to support the continued development of their solutions and are partnered with their home institutions to further refine and mature their solutions before wider implementation. An overview of the judging phases throughout the project is summarised in Figure 3.

Support and Sustainment of the Project

Once the best solutions are identified and funding is awarded, we proceed to ensure the project teams receive the organisational support to continue and expand their solution within their healthcare organisation. To achieve this, we partner the teams with relevant subject matter experts from CHI, including the CHI Academies Office, which provides expertise in areas such as healthcare sustainability and socially-focused healthcare.

We hope to deliver some of the key ingredients needed for the successful continuation of Hackathon projects. This includes access to expertise-focused learning through CHI, as well as funds and resources from the prize money to further enhance or develop their solutions. Additionally, this support may be supplemented through further start-up grants from CHI (Nolte et al. 2020).

In addition, throughout the entire coaching and development process, we aim to identify and bring out team members who demonstrate the drive, motivation and commitment to see their project through. These qualities have been recognised as strong predictors of a team’s ability to sustain their project after the hackathon (Cobham et al., 2017a; Cobham et al. 2017b; Nolte et al. 2018).

Hence, the CHI-FLYING Hackathon approach has a structured, logical flow. It effectively guides teams to focus on a designated problem, validate it and develop solutions to address it. Teams then test their effect, present their findings and, if successful, seek a potential ‘home’ to further refine and develop their ideas before deploying them in a healthcare setting.

Case Study: Healthcare Sustainability Hackathon

We applied the CHI-FLYING Hackathon model to raise sustainability efforts across the healthcare settings through the Centre for Healthcare Innovation-Singapore Institute of Technology (CHI x SIT) Healthcare Sustainability Innovation Challenge. Our focus was on environmental sustainability in healthcare, as climate change poses a growing concern for the Singaporean healthcare system. A recent systematic review by Aik et al. (2023) found a positive correlation between rising temperatures and heat-related as well as enteric illnesses. This indicates an increased risk for Singaporeans facing heatwaves and heatstroke as temperatures rise. While national measures are being implemented to reduce carbon emissions, with a net-zero target set for 2050, we sought to initiate local initiatives within the public healthcare sector (National Climate Change Secretariat 2023).

Earlier research has shown that even slight changes can have both environmental and clinical impact. For example, raising the temperature in the operating theatre to a still clinically appropriate level has led to a significant reduction in electricity consumption, while also reducing the risk of patient hypothermia and related complications (Tee et al. 2024). However, with so many departments and areas needing to initiate such change, we sought to use the Healthcare Sustainability Innovation Challenge as a single unifying platform for the ideation and prototyping of sustainability efforts across institutions and departments.

Working alongside sustainability experts at SIT, we defined our hackathon into clear, actionable areas. We developed five problems that participants could use to frame their problem statements:

1. Points of Care: examining how healthcare services are assessed, accessed, consumed and delivered.
2. Rethinking Efficiency: analysing how processes, infrastructure and environment are designed and used.
3. Rethinking Impact in Supply Chain: ensuring that we receive what we need when it is needed.
4. Rethinking Pharmaceuticals: evaluating how medications are produced, delivered and managed.
5. Rethinking What We Throw: investigating how we manage our waste.

This framework allowed participating teams to examine sustainability efforts across the entire healthcare delivery process, from re-evaluating the coordination and procurement of healthcare products to the consumption of electricity needed for department operations and waste disposal. With this comprehensive range of opportunities, 34 teams submitted their problem statements in April 2024, with the majority (14) being centred around Rethinking What We Throw.

Using our assessment criteria, we narrowed down the problem statements to select 11 teams of 50 participants who had the most appropriate problem statements. We invited them to our workshop in May 2024 to introduce them to context-based problem-solving skills, which would help them better analyse their problems and generate solutions. Teams received guidance on the application of Sustainability in Quality Improvement (SusQI) and the principles of Sustainable Clinical Practice – prevention, patient-empowerment and self-care, lean clinical pathways and low carbon alternatives – developed at the Centre for Sustainable Healthcare (CSH) (Mortimer 2010). This instruction provided valuable ideation support for enhancing and sustainably delivering healthcare.

Throughout the workshop, two teams identified a shared challenge regarding the recycling of unused medications and the redistribution of these medications to underserved patients in the community, which led to their merger. 10 teams were formed, each of which received €1,318 (SGD1,500) in seed funding to prototype and test their solutions. Additionally, they were matched with suitable experts from SIT, including specialists in materials development and engineering for teams focused on reusing plastics.

In July 2024, nine teams presented their solutions and findings during the semi-finals. The judging panel consisted of Chief Sustainability Officers from Singapore’s three public healthcare clusters, who had the expertise and knowledge to evaluate whether the proposed solutions could be implemented in their institutions (Kitsios & Kamariotou 2019). In addition, as the judges were leaders in sustainability efforts across the three major public healthcare groups in Singapore, the presenting teams had the opportunity to demonstrate their problem-solving skills and their ability to establish effective solutions. This could potentially open the door to more opportunities for collaboration with their home public healthcare institutions following the event (Nolte et al. 2020).

Using the judging criteria outlined above in Figure 3, we selected five teams of 30 participants to compete in the finals, which took place on the following day. They presented their solutions and findings to a panel of sustainability experts who further assessed the solutions and plans based on their experience of implementing and supporting sustainability initiatives in their own settings. Through this process, three winning teams were identified, each awarded €2,636 (SGD3,000) to continue developing and refining their solution. In addition, these teams are now receiving expert coaching and guidance from professionals in innovation and sustainability at the CHI Sustainability Academy. This support will assist them in redesigning their solutions and delivery models to improve the quality and longevity of their projects.

Overall, the Challenge provided comprehensive support for ideation, prototyping and solution testing through the CHI-FLYING Hackathon model. A summary of the nine teams that reached the semi-finals is provided in Table 1, with the top three winners highlighted.

FLYING into a Hackable Future

Our Hackathon model offers an end-to-end framework for guiding the ideation, prototyping and solution testing of innovative ideas and processes. This approach has demonstrated its effectiveness through case studies, such as the CHI x SIT Healthcare Sustainability Innovation Challenge. We demonstrated how this model allows healthcare professionals ‘in the trenches’ to better manage the complexities of healthcare systems and develop multifaceted solutions together. It has the potential to connect and unite a fragmented healthcare ecosystem to better solve various interconnected challenges across sectors.

While this method will not resolve all issues, especially deep-seated problems like poor health outcomes stemming from generational poverty, hackathons using our model have the potential to kick-start solutions that could address immediate, pressing problems.

Now we are exporting the model to various settings and environments to showcase its versatility. One example is a Research Hackathon held within Singapore’s National Healthcare Group, focusing on its nursing workforce. It intends to both initiate new research in identified priority areas and to identify the next generation of clinician-scientist talents. Through this model, we hope to encourage and inspire healthcare leaders to build more platforms for ground-up innovation and pilot projects, allowing the clinicians and administrators to have a stake in shaping the future of their organisations.

Acknowledgements

We would like to thank the following individuals and teams whose support has been critical for the development and delivery of our Hackathon Model and the CHI x SIT Healthcare Sustainability Challenge.

We would want to extend our gratitude to the many individuals who volunteered to participate in our Challenge.

We are grateful for our co-organisers of the CHI Innovation Challenge 2024 – representatives from both Centre for Healthcare Innovation (CHI) and Singapore Institute of Technology (SIT): A/Prof. Ethan Chong, Head of Sustainability (Education & Research), Provost Office, Singapore Institute of Technology; A/Prof. Jenson Goh, Associate Professor, Engineering, Singapore Institute of Technology; Casper Ng Chong Kee, Deputy Director, Grants & Innovation Office, Centre for Healthcare Innovation.

We wish to thank the expert coaches from Singapore Institute of Technology (SIT) and Merck Sharp & Dohme (MSD) who brought with them industrial knowledge that guided the teams in understanding information outside healthcare and ideate solutions to reduce carbon footprints: Asst. Prof. Aileen Scully, Associate Professor, Health and Social Sciences, Singapore Institute of Technology; A/Prof. Alfred Tan, Programme Leader, SIT-UofG BEng (Hons) Mechanical Engineering, Singapore Institute of Technology; A/Prof. Adison Wong, Teaching & Learning (T&L) Lead, Food, Chemical & Biotechnology Cluster, Singapore Institute of Technology; A/Prof. David Lin, Programme Leader, Bachelor of Science with Honours in Digital Supply Chain, Singapore Institute of Technology; Asst. Prof. Hu Chengcheng, Assistant Professor, Engineering, Singapore Institute of Technology; Asst. Prof. Howard Tang, Assistant Professor, Engineering, Singapore Institute of Technology; A/Prof. Malcolm Loke, Associate Professor, Infocomm Technology, Singapore Institute of Technology; Asst. Prof. Mark Teo, Lead, Sustainability-related Continuous Education and Training, Singapore Institute of Technology; Prof. Paul Sharratt, Professor, Food, Chemical and Biotechnology, Singapore Institute of Technology; Asst. Prof. Ricci Loh, Assistant Professor, Business, Communication and Design, Singapore Institute of Technology; A/Prof. Steve Kardinal, Engineering, Singapore Institute of Technology; Asst. Prof. Thomas Goh, Business, Communication and Design, Singapore Institute of Technology; Cindy Chng, Associate Director and Head of Strategic Partnerships for MSD Singapore, Malaysia and Brunei; Shanisca Yee, Market Access Manager, MSD.

We are also grateful for the generous sponsors from Merck Sharp & Dohme (MSD) and National Youth Council Singapore (NYCs), represented by the following: Isabell Chew, Assistant Director (Ground-Up), Partnership Lab, National Youth Council Singapore; Alex Goh, Young ChangeMaker (YCM) Curator, National Youth Council Singapore; Jaslyn Pang, Youth Leadership/ Engagement, National Youth Council Singapore.

Finally, we are grateful for the judges who provided valuable input to the teams on how to improve on their projects – Dr. Tan Tai Kiat, Chief Operating Officer (Environmental Sustainability), SingHealth; Dr. Jeannie Tey, Head of Sustainability, Tan Tock Seng Hospital and Co-Lead, Sustainability Academy, Centre for Healthcare Innovation; Prof. Eugene Liu, Head of Sustainability Office, National University Health System; Dr. Amanda Zain, Assistant Dean (Enterprise and Sustainability), Dean’s Office, Yong Lin School of Medicine, National University of Singapore; Sonia Roschnik, Executive Director, Geneva Sustainability Centre; Lau Lu Ching, Director, External Affairs, Policy and Communications, MSD Singapore, Malaysia and Brunei; Karen Lee, Director (Partnership Lab), National Youth Council Singapore.

Conflict of Interests

None.