Models of care are often centred around healthcare infrastructure, such as an acute hospital. Alexandra Health System (AHS) is a young regional health system (RHS) in the north of Singapore looking after about 700,000 people. The cluster comprises an acute general hospital and a community hospital, and is rapidly growing by adding additional infrastructure to support the healthcare needs of an ageing and growing population. A new model of care is needed to guide AHS in transforming its service models to attain the triple aim for the population under its care.
A business process re-engineering (BPR) project was undertaken to stock take ongoing service model innovations in the RHS, map the current model of care, and determine root causes of existing service delivery gaps and issues. A series of design challenge workshops were then conducted that culminated in a new conceptual model of care for the RHS.
The new care model is divided into a "low control" lifelong care model, which requires the RHS to activate and empower its population and the community using an Asset Based Community Development approach, including developing the requisite shared care partnerships with healthcare and social care providers in the community; as well as a "high control" care model focusing on reorganising service delivery within the existing acute and community hospitals to deliver "better, safer, faster and cheaper" diagnostic and therapeutics for its patients. Both the "low control" and "high control" care models are intended to be fully integrated with each other.
AHS is currently implementing the model of care through a series of service delivery pilots. There are numerous challenges ahead as the journey has just started. Insight and experience gained through the testing and implementation of the new care model may be valuable to governments and other regional health systems to define their own care transformation policies and guide efforts in developing better regional healthcare systems for their populations.