The key shift in population health is expanding our scope from patients to residents. As people value different outcomes at different stages of their life, this requires us to adopt a life course approach with a stronger focus on primary prevention. The next shift is for patient care to be anchored in primary care with trusting relationships between family doctors and patients. We should see individuals as a whole person and not just as a patient, and to address wider determinants of health such as social, lifestyle and environmental factors. We must work collaboratively with partners across the various sectors to develop an integrated ecosystem.
Healthier SG (HSG) places strong emphasis on preventive care, and assigns SingHealth as the regional health manager for Eastern Singapore. With this, we have moved towards a whole-of-life approach to promote health and improve quality of life of our patients and the community across the different stages of life and disease complexities. We pay attention not only to health, but also the social determinants of health – factors such as the conditions under which people are born, where they grow up, work, live, and where they age – all of which contribute to overall health and well-being.
SingHealth has adopted a two-pronged population health approach. The first prong is to develop
next-generation primary care that adopts a multi-disciplinary 'modular' approach that extends care beyond the clinic. The key 'modules', such as the primary care providers, community nurses, care coordinators and community partners, can be activated based on patients' needs. The second prong is the
"Health-Up!" programme to expand our community outreach. This programme encourages residents to adopt a healthier lifestyle through an integrated personalised care plan and create a health promoting environment.
GPs play a critical role in HSG, and SingHealth has been working with MOH and AIC to reach out to them, through the
Primary Care Networks (PCN) scheme to meaningfully engage them in caring for patients. By partnering with PCNs, we foster closer partnerships with GPs to co-create solutions to better integrate care.
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