Applicant: Bright Vision Hospital (implementation site at Sengkang Community Hospital)
Programme Name:BVH Integrated Primary Care for At Risk Elderly (iPCARE 2.0)
In Singapore’s current healthcare system, General Practitioners (GPs) usually encounter multiple challenges caring for patients with complex needs and inevitably lands up referring them to public or tertiary institutions (e.g. polyclinics, specialist outpatient clinics) where there are abundant resources. Moreover, these patients or their caregivers find it difficult to navigate and coordinate their care services across different healthcare settings.
From 2017 to 2020, iPCARE has been established as a proof-of-concept, supporting an alternative model of integrating primary and community care services. It showed that:
- Patients with complex needs were willing to be seen by their GP for medical care, with other care needs1 coordinated by the iPCARE team and supported by resources from the nearby community hospital;
- GPs were willing to accept such patients, and were receptive towards the iPCARE team providing support to both GPs and patients outside of the GPs’ scope of work or working hours.
iPCARE 2.0 aims to further explore how to improve the integration between primary and community care; and evaluate the costs and barriers of anchoring such patients with the GPs (instead of acute hospitals and specialist outpatient clinics) and in the community by answering the following questions:
- What are the patient archetypes that GPs are reluctant to manage today?
- What are the services and resources that the GPs would require to better manage these patient archetypes?
- What is the overall cost of such a service bundle?
The lessons learned from iPCARE 2.0 could also potentially help to develop the next phase of Primary Care Networks (PCN) so more GPs and patients could benefit from it.
Clinic-based and home-based care e.g. nursing, allied health and social care services provided by a community hospital’s outpatient clinic, major home and social providers.