On 21 September, the Singapore Ministry of Health (MOH) announced the launch of the “one resident, one family doctor” scheme in Parliament. The programme aims to strengthen care continuity and increase care affordability. It will first be targeted at the nation’s older demographic – those aged 60 and above – starting in the second half of 2023.
The scheme is part of a larger nationwide healthcare transformation strategy, Healthier SG, which aims to address the challenges of an ageing population by putting a stronger focus on sustained preventive care.
In a press release in March this year, MOH detailed that one of the key aims of this overarching strategy is bringing healthcare closer to where citizens reside. This would entail larger healthcare institutions such as hospitals working in tandem with primary care providers in a closer way than before.
“Upon discharge, hospitals would refer patients to the family physicians they are enrolled with, to ensure continuity of care. There could also be shared care between family physicians and specialists or other allied health professionals to jointly support patients based on their care needs,” MOH said in the press release.
GovInsider speaks to the MOH Office for Healthcare Transformation (MOHT) and allied healthcare provider Speedoc, to find out more about the steps they are taking and the automation tools they are using to catalyse this nationwide decentralisation of healthcare.
Home-based care in a heartbeat
One of MOHT’s key ongoing initiatives is the home hospitalisation programme, Mobile Inpatient Care at Home (MIC@Home).
Since 2019, MOHT has used MIC@Home to provide alternative care models to inpatient delivery. These involve outpatient monitoring solutions, multidisciplinary care, and telehealth solutions – all of which have risen in popularity as a byproduct of the Covid-19 pandemic.
Community-anchored care has always been integral to MOHT’s strategy, according to Lai Yi Feng, Senior Manager and Project lead of MIC@Home. “Decentralised care is one of the trends we believe will power the next phase of healthcare innovation and development in Singapore – along with patient-centric care, value-driven care, data-driven care, and shared care,” Lai tells GovInsider.
As a natural extension of this strategy, partnerships are part of MOHT’s “organisational DNA”. “No organisation can accomplish care innovation and transformation alone. We need buy-in from different stakeholders end-to-end for the entire journey …so that we can design solutions that are relevant to the needs of our stakeholders,” Lai adds.
MOHT’s partnerships have ranged from hospitals to polyclinics, and even private healthcare solution providers. These include telemedicine provider Doctor Anywhere, which has quickly risen to become a household name as a result of the need for socially-distanced care provision during the Covid-19 pandemic.
Partnering with private healthtech solutions
But decentralised healthcare extends far beyond telemedicine. MOHT has also explored collaborations with technology solution providers such as Biofourmis and ConnectedLife, which utilise machine learning and data analytics to streamline connections between patients and their care providers.
“We think that everyone will stand to benefit from decentralised healthcare, but more so the housebound and the caregivers of the elderly. They would be able to avoid traveling to and from hospitals, as well as reduce the risk of community-acquired infections,” says Dr Shravan Verma, CEO and co-founder of Speedoc, another partner of MOHT.
“It is important to recognise that the patient is not the only stakeholder, but their family, caregivers, and friends are key beneficiaries from any care model improvement,” adds Lai.
Shravan explains that Speedoc’s aim to provide remote medical services began long before the pandemic. But since then, they have branched out into even more care modalities for patients at different stages of their health-seeking journeys. These range from telemedicine and remote patient monitoring, to ambulance booking and medicine delivery.
“During the pandemic, we worked with MOH and various public hospital partners and came up with a virtual ward programme, H-Ward®, which enables patients and caregivers to receive hospital-level care within the comfort of their homes,” Shravan says.
H-Ward provides blood tests, virtual screenings, on-call doctors, and medical equipment all to the comforts of patients’ homes. Since their pilot launch with the National University Health System, the programme has discharged more than 2600 patients and saved approximately more than 10,000 bed days for the public healthcare system at large.
“Speedoc is able to support the hospitals by providing a scalable and dynamic roster of healthcare professionals, who can provide distributed and decentralised medical care at very little additional cost. In effect, this means that Speedoc adds elastic bed capacity to our hospital partners,” says Shravan.
Building capacity with automation
The great migration to team-based care is very much powered by robotic process automation (RPA) and AI to eliminate repetitive workflows.
Case in point, public healthcare institutions like the Singapore General Hospital and the National University Hospital have partnered with AI-driven messaging tools such as BotMD or Dr COVID to automate the collection of patient details or the addressing of basic patient queries, address basic patient needs, and digitalise workflows.
Similarly, Speedoc promotes productivity in healthcare settings by using RPA software that mimic the way humans interact on digital platforms. These include the digitalising of form submissions for patients, which greatly increases productivity for healthcare workers by freeing up more time for them to focus on high-priority tasks.
“In the amount of time required for a form to be filled in manually, the end-user – our patients – enjoy the benefit of accuracy and efficiency as we can dedicate more time to solving their problems and helping them recover faster,” says Shravan.
Other uses include using RPA to enter patients’ test results – such as during Covid-19 mass tele-ART testing – and processing statistics related to patient experience. “The process of recording calls, logging patient wait times, and publishing these results on dashboards is now automated, and we no longer need to extract the data ourselves,” Shravan adds.
Moving forward, Speedoc has plans to explore more advanced automation that involve deeper system integration and AI to allow for more frictionless experience for its remote patients. The possibilities are endless, ranging from extracting text from images, to verifying patient identities through the camera, and more.
But for that to happen, Lai highlights the need to first secure data flows to ensure that patients’ information remain confidential and protected always. “The gap lies not in technology or devices, but in data flows and security. I think a lot more work needs to be done in this area to allow clinicians to harness the full potential of technology in care delivery,” he says.