SINGAPORE (Aug 6): A greying population, coupled with the rising incidence of “rich-world” health problems such as heart disease and diabetes, is a looming headache for policymakers and a burden on a public healthcare system that is already running at full capacity... unless one is in Singapore, where the government, cognisant of these challenges, has embarked on a plan to focus on preventive healthcare and community care. And, to make it work on a national scale, a large part of it will be powered by technology.

The initiatives, from stretching resources to improving the work processes of healthcare workers and identifying healthcare issues, are led by Integrated Health Information Systems. IHiS was set up in 2008 to digitise, connect and analyse Singapore’s health ecosystem.

 “We’re no longer looking at one patient. We’re now looking at the population and how we run things at scale,” says Chua Chee Yong, director of planning at IHiS. “The only way to do that is to use technology to harness the power of what we do individually, and maximise the benefits translated for our patients.”

However, it is not a straightforward task. Convincing people of the merits of a tech solution, for one, is proving a challenge. “It’s difficult... getting a consumer to download an app and trust it. Who is going to pay for the app and the service and administer care for the patient?” Chee notes.

Another issue is encouraging tech development in the preventive care and post-treatment space. About three-quarters of the innovations that come up in the public healthcare sector are focused on hospital and clinical care.

To help address this, IHiS launched the National HealthTech Challenge, which paired healthcare professionals and tech providers to create solutions for the public healthcare service. The event in March had nearly 80 teams, both local and foreign, participating in the challenge. The top 20 finalists offered a range of solutions such as smart motion sensors to alert and prevent falls, and a self-administered triage kiosk. However, the majority of the solutions were still aimed at the treatment space.

“It’s natural because the seekers are in the public healthcare space,” says Chee. “But it’s the repurposing [of the solutions] that is important. For example, the anxiety reduction innovation for pre-surgery patients — you don’t have to come to the hospital because you can do it at home,” he adds.

Tech teams can get funding from partner agencies such as SGInnovate, NTUitive, the National University of Singapore and even the Ministry of Health. The teams will also have to conduct a proof of concept, and viable solutions will be further evaluated in a proof-of-value study, to determine the potential for deployment in public healthcare. IHiS says some of the solutions from the recent challenge are set to be implemented at home rather than at the hospital or clinics.

While an efficient and effective healthcare services infrastructure is essential, one issue that warrants policymakers’ attention is the escalating cost of healthcare. One way to resolve this is to look at how doctors and patients can be incentivised towards beneficial outcomes.

“With the right incentives, you can drive the right behaviours,” observes Jeremy Lim, partner at management consultancy Oliver Wyman’s health and life sciences practice. “To me, the most interesting thing that the government needs to do but hasn’t looked at in a serious way is how to structure the healthcare financing model so that we get the right behaviours. How should hospitals and doctors be paid? Should Singaporeans be incentivised to be healthy?”

Lim argues that what is required is a right framework of incentives and disincentives to change behaviour, and therefore alleviate the strain on resources. A population that is incentivised to stay healthy, whether through diet or active lifestyles, would mean lower public spending on healthcare, for instance.

“I think from the government’s point of view, everything should be on the cards: selective taxes on sugar; the use of differential payments of income tax; the number of steps walked and so on,” Lim adds. “This is an area with a lot of [scope] for creativity.”

Lim also believes that research projects have to be differentiated according to strengths and needs, given that costs here will not be lower than other countries in the region. “For Singapore, the right guiding principle is the diseases that will affect Singaporeans. It should be diseases where a lot of innovation and R&D is happening, in areas such as cancers and stem cell [therapy],” he says. “We have to pick the areas we want to be good at and [direct] appropriate resources there.”

Ultimately, given the right resources and backed by political will, Singapore’s healthcare system will be in good shape. “We’re at the inflection point,” Lim says. “What we do in the next five years will probably determine whether we will be a highly regarded healthcare system 25 years from now. These are exciting times and I personally hope we don’t screw up.”

This article appears in this week's issue of The Edge Singapore (Issue 842, week of Aug 6), which is available on newsstands now. Subscribe here