The Straits Times says

Towards integrated healthcare model

The Woodlands Health Campus, when it takes in patients from 2022, will be the first here designed to have acute and community hospitals, a nursing home and specialist clinics all within a single complex. This is an innovative leap. However, those who bemoan the current shortage of hospital beds might just focus on the 1,800 beds the campus will deliver and wonder if this number, plus more to be offered at Sengkang General and Community Hospital and other upcoming hospitals will prove to be sufficient. The catch-up programme has to contend with a growing pool of elders seeking hospital care, reflected in the rising median age of patients, now at 57 years. Further, older patients tend to stay longer and are likely to be rehospitalised. How will the system cope when there are 900,000 seniors by 2030?

Waiting periods of over eight hours for a public hospital bed now occur from time to time at Tan Tock Seng Hospital, which has the busiest emergency department here. Other hospitals also come under pressure when demand for inpatient treatment peaks, but all are coping better than three years ago when some patients had to wait more than two days for a bed - leading to temporary measures like beds in corridors and tents.

Emergency admissions might spike when communicable diseases sprout or there's a major accident. A bed crunch might be exacerbated when patients take longer to recover. With fast-ageing populations, longer lifespans, and more chronic illnesses, can hospitals of tomorrow continue to function in the same way as they do now, especially when skilled professionals will be in high demand and in short supply? Acute hospitals will remain indispensable to handle emergency cases and complex needs, with their concentration of specialists straddling all key areas, their advanced equipment and highly skilled teams. But to keep loading acute hospitals with a broad mix of other cases too will not be sustainable.

Singapore needs to reduce its dependency on a hospital-centric model of care. For non-serious cases, one might turn to a general practitioner in the neighbourhood, a day rehabilitation centre, a nursing home, or a community hospital. In certain situations, technology could be harnessed to offer a home-centric model of care. Telehealth is already being attempted in some places like KK Women's and Children's Hospital. At Woodlands, there are plans for more online hospital services accessible from home. Robots will do housekeeping, and data analytics and artificial intelligence will be used to crunch vast numbers of records to pinpoint options and to quantify risks. With sophisticated tools, patients can be cared for in the community and at home as well, while being watched over by acute hospitals serving as command centres. For this integrated healthcare model to take root, public acceptance is crucial.

A version of this article appeared in the print edition of The Straits Times on April 27, 2017, with the headline 'Towards integrated healthcare model'. Print Edition | Subscribe