Integrated General Hospital

Lim Cher Wee

Executive Director
Covering Head (Integrated General Hospital)

IGH’s work responds to persistent system-level challenges that, when left unaddressed, impede care delivery. These challenges include the growing strain on acute hospital beds, the overburdening of emergency departments, and the fragmented coordination of care—especially at the intersection of hospitals and community-based resources (and vice versa).

Initial IGH care model pilot implemented at Alexandra Hospital demonstrated effectiveness and acceptability among patients with multimorbidity and complex needs requiring holistic generalist hospital care. In extending the IGH care model for holistic non-subspecialist team-based care, MOHT and MOH share the view that community hospitals (CH) can help alleviate the demand for acute hospital beds. MOHT hence conducted a review of existing MOH policies and a community hospital environmental scan that eventually landed on the Community Hospital of the Future (CHoF) initiative. A series of design-thinking workshops was conducted to identify CH care redesign opportunities. A series of proof-of-concept pilots are currently underway to redefine the service boundaries of CHs by jointly developing and scaling redesigned CH care model(s) that could reduce acute hospital (AH) strain, and support CH care aspirations. Insights from these pilots will help inform national policy shifts for a more integrated and sustainable post-acute care ecosystem.

With the successful conclusion of the Mobile Inpatient Care@Home (MIC@Home) Regulatory and Financing Sandbox commissioned by MOH, we are co-executing the Sandbox-to-Mainstream transition of the care model in Singapore. MIC@Home, better known as Hospital-at-Home (HaH) overseas, is an alternative inpatient care delivery model that offers clinically-suitable patients the option of being hospitalised in their own homes, instead of a hospital ward. This model delivers inpatient-level care through the use of digital tools such as remote monitoring, and round-the-clock care by the professional care teams consisting of doctors, nurses, pharmacists, and allied health professionals from the public hospitals and community medical partners. Our longer term goal is to establish MIC@Home as a clinically viable, cost-neutral, and value-driven alternative to traditional inpatient care.

As more healthcare services move into the community, IGH is working with healthcare partners to reimagine Singapore’s Pre-Hospital and Emergency Care (PEC) ecosystem. The goal is to provide timely, appropriate care before a patient even reaches the hospital, while easing pressure on emergency departments. One example is NurseFirst, a nationwide trial that collaborates with the Singapore Civil Defence Force (SCDF) to divert selected non-life-threatening 995 calls to a dedicated helpline staffed by trained nurses. Patients are assessed and guided to suitable care options such as GP clinics, urgent care centres, mobile medical teams, or virtual consults. This upstream intervention ensures emergency resources are preserved for those who need them most, while enabling more responsive and right-sited care across the system.

Technology plays a crucial role in supporting hospital and community healthcare initiatives. The IGH programme augments ongoing clinical pilots with digital enablers to better facilitate healthcare delivery in Singapore. We support national care redesign pilots like One-Rehab across more than 100 sites in Singapore. Another project, the OCP (One-Care Plan) Application, supports patients in the community, by allowing community health and social care providers from different institutions to securely share patient information, enabling coordinated care planning.

Partners:

• Ministry of Health Singapore

• Agency for Integrated Care

• SingHealth and its institutions

• National Healthcare Group and its institutions

• National University Health System and its institutions

• Synapxe

• DesignSingapore Council

• Enterprise Singapore

• Economic Development Board Singapore

• Private technology and clinical solution providers including Speedoc, MinMed, Biofourmis, Masimo, etc.

• Academia such as the National University of Singapore

• Unit for Pre-Emergency Care (UPEC), MOH

• Singapore Civil Defence Force

Current initiatives

Community Hospital of the Future (CHoF)

Mobile Inpatient Care@Home (MIC@Home)

One Care Plan (OCP)