Singapore: the most efficient healthcare system in the world?

A French delegation went to this Nation-Island from 10th to 14th of June 2019 to try to answer this burning question. Composed of directors of Center Hospitalo-Universitaires, public hospitals, private non-profit and private health groups, the delegation took advantage of eleven site-visits to form an opinion.

Integration of care: Since 2017, hospitals, specialized healthcare centers, rehabilitation and community services and polyclinics have been merged into three regional Clusters. Our participants discovered the modalities of this integration into several structures of the SingHealth Cluster, including services co-managed by hospitals and community hospitals designed to facilitate rehabilitation and streamline the care pathways of elderly and poly-pathological patients. Beyond the vertical integration, the organization of some services promotes horizontal integration. For example, a one-stop consultation clinic for diabetic patients at Singapore General Hospital. A multidisciplinary team of endocrinologists, ophthalmologists, chiropodists, dieticians are consulting in the same floor, avoiding unnecessary travel and delays for patients.

New technologies: the Singaporean government is investing heavily in the modernization of its healthcare system, with some very targeted priorities: development of artificial intelligence, robotization, digital solutions, unique computerized patient record. All of these projects are underway and are being announced for years to come, such as the Tan Tock Seng Hospital Command and Control Center, from which all patients capacity and flow can be managed centrally.

Innovation: Singapore takes a pragmatic approach to innovation, identifying international best practices and adapting them to their national context. The Changi Hospital Innovation Center has deployed various patient experience solutions inspired by the United States' experience. Each Cluster combines clinical, teaching and research to foster translation research. Continuing education is a central element of their strategy, to enable health professionals to increase their skills and adapt themselves to the new challenges of the health system.

This intensive study mission allowed our French delegates to question the characteristics of an efficient healthcare system and to discover new perspectives on the solutions to be fostered in order to meet the challenges of an aging population and the development of chronic diseases.