The FPC programme aims to enable patients to effectively self-manage their chronic diseases in partnership with their primary care providers. This involves the development of a national telehealth platform and the incorporation of technologies that enable effective and sustainable home management.

Various pilots are ongoing. The Primary Technology Enhanced Care (PTEC) project began in partnership with National Healthcare Group Polyclinics. The Home BP Monitoring programme trialled the use of a home monitoring kit for hypertensive patients, within an integrated care delivery system including a chatbot that brings about better management and outcomes. Patients are empowered to manage their conditions independently, while building a trusted relationship with their care team. The initial pilot was successful and is now being scaled across the three healthcare clusters. The programme is currently available in more than half of polyclinics across Singapore, and will be available in every polyclinic by 2023.

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PTEC has been extended to diabetes and the testing of a home HbA1c diagnostic kit. Pilots with SingHealth Polyclinics have commenced to assess a diabetes coaching solution and better linkages between primary care and community-based services.  

Another initiative is an open call to local General Practitioners (GPs) to develop solutions around new primary care technologies, care redesign & process improvement and new private-public partnership business models. The challenge statement, developed by FPC, centres on chronic disease patients with the aim of achieving good disease control while ensuring financial stability and scalability.

Partners:

• National Healthcare Group Polyclinics

• National University Polyclinics

• SingHealth Polyclinics

• Integrated Health Information Systems

• Private GPs

  • Frontier Medical Associates/Frontier PCN

  • Lee & Tan Family Clinic and Surgery / Frontier PCN and NUHS PCN

  • Northeast Medical Group / Class PCN and United PCN

 

Current Initiatives:

• Tele-health pilots for hypertension and diabetes

• General Practitioner Innovation (GPI) Initiative