How public healthcare bridges the evidence-to-care gap

Walking into Dr Rachel Cheong’s office, I was immediately struck by her resilience.  

Despite a recent injury requiring a walking boot, the Deputy Head of Geriatric Medicine and Consultant at Khoo Teck Puat Hospital (KTPH) was interacting with patients via telehealth. 

KTPH is a public hospital under one of Singapore's three healthcare clusters, the National Healthcare Group (NHG).

Trained in both medical science and public health, Dr Cheong believes that the public healthcare sector is well-positioned to make data-driven innovations truly accessible – improving patient care at scale.  

While she finds satisfaction in helping individual patients, she is most motivated by the potential to introduce systemic improvements in public healthcare.

One thing that is unique to the public healthcare sector is that it facilitates collaborations between multiple stakeholders – spanning regulators, public healthcare institutions, academic and research institutions, she notes.  

By pooling resources and partnering on opportunities, public healthcare institutions gain access to the latest interventions that can improve patient care, she adds. 

To subscribe to the GovInsider bulletin click here.

AI enables resource-smart healthcare 

Given her interests, it should not have come as a surprise that Dr Cheong sees value of double-hatting as both a clinician and a researcher.  

“When resources are finite, I want to know what [interventions are] truly effective when it comes to effective patient care,” she says, adding that these interventions are supported by data and health service evaluations.  

On the use of artificial intelligence (AI), she feels “hopeful” about its potential to be weaved across the entire healthcare value chain – from research and development (R&D), diagnosis to even outpatient care. 

GovInsider earlier covered the launch of Singapore’s first gerontechnology lab, which promotes the use of assistive tech that supports seniors and their caregivers. 

Apart from AI, Dr Cheong sees the use of more technology for care interventions, such as providing cognitive training for patients with dementia. 

Incidentally while in a walking boot herself, she spoke about how technology, specifically video consultations, have allowed her to continue to see her patients without disrupting their care. 

Proactive, personalised, and integrated care 

Innovations should not only be restricted to tech or data, but include healthcare service models. 

“[This revelation] comes along when we become more senior in the field, and when we look at the healthcare sector from a macro perspective rather than a single interaction with a patient,” Dr Cheong adds.  

While her primary role as a clinician is treating patients, she says that clinicians are embedded in a larger system of workflows.  

At KTPH, she led the Early Intervention for the Elderly (ELITE) programme, which focuses on optimising patient flow and outcomes, as well as enhancing resource utilisation. 

For acute or short stay patients (assessed to be dischargeable within five days), the geriatric department adopts a Collaborative Care Continuum Model to deliver proactive and holistic care for elderly patients.  

“We encourage our team to really get to know the patients in terms of their life history, interests, family interactions and relationships. In a sense, it’s not just the diagnosis,” she says. 

She cites an example where the behaviour symptoms of patients with dementia may not necessarily linked to their diagnosis, but through other psychosocial factors. 

At a value-based conference last year, her team shared that the patients in the ELITE intervention had a reduced length of stay and lowered healthcare costs per patient. 

Moving forward, her team is looking into early interventions and even prevention. “Hopefully we'll be able to leverage on more technology, then we can move into this direction even faster,” she says. 

Maintaining the humanity aspect

Dr Cheong emphasises on the need to engage in reflective practice.

“As a team, what we often need to do is to celebrate the small successes we have as we care for every single patient, and reflect on how the lives of the patients have changed or improved,” she says.

She adds that this practice helps her team to “stay on course” and “reminds [them] of the purpose of staying in the field.” 

She underlines the importance of “maintaining the humanity aspect” amidst the drudgery of routines. 

“Because it’s one patient in and one patient out, there’s no time for us to stop, think and reflect. After a while, we might lose the human touch,” she says. 

Concluding our conversation, she shares an observation about her experience working with patients with dementia. Despite cognitive impairment, they can still deeply perceive and respond to genuine care, Dr Cheong notes.