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(5) Schemes to make healthcare affordable for all patients 

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(5) Schemes to make healthcare affordable for all patients 

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(1)  Higher subsidies for B2/C ward for patients who pass means test
(2) Medishield Life (revamp) -higher claims for B2/C wards
(3) Medisave - withdrawals allowed  for Chronic Disease Management Programe
(4) Careshield Life - higher claims for inability to do some activities of daily living
(4) new Medifund schemes - Medifund Silver and Medifund Junior

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(2d) Interactive Healthhub App on smartphones (for individuals) - which provides individuals with one-stop interactive health information and services

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(2d) Interactive Healthhub App on smartphones (for individuals) - which provides individuals with one-stop interactive health information and services

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Functions:
(1)  Access an individual's  personal hospital records, lab test results
(2) View medical appointments , dental health records
(3) Check vaccination status  (date, type of vaccination  example Covid-19 vaccination)
(4)  Record of  medical history and diagnosis  (from past doctors' consultations)
(5)  Record of  medication allergies
(6)  Individuals are able  to access their children's (dependents) vaccination records, medical records, allergies, appointment dates  with doctors and dentists, children's vaccination status
(7) With Caregiver Access Module, patients can grant caregivers access to their personal health and medical records, as well as medical appointments
(8)  Access an extensive directory of healthcare and lifestyle services available island wide (example in polyclinics, healthier eateries and sports facilities

Advantages:
(1)  Empowers individuals to monitor their health status as well as their dependents' health status
(2) Helps caregivers to be aware of their patients' health conditions and to monitor their patients' health status
(2)  Helps individuals and caregivers keep track of medication, allergies
(3) Facilitate viewing  of doctors' appointments
(4)  Facilitates integrative health care - because medical information from government HCI network  (polyclinics to hospitals, diagnostic services clinics ) are available on this APP

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This includes promotion of Covid-19 vaccinations, as well as the promotion of Human papillomavirus (HPV2 or HPV4) vaccination (among teenage girls) to prevent cervical cancer.

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(2d) Use of AI and robotics in surgery to reduce surgical errors and to improve surgical outcomes. 

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(2d) Use of AI and robotics in surgery to reduce surgical errors and to improve surgical outcomes. 

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(8b i) To encourage regular physical activities, the Health Promotion Board runs the National Steps Tracker Challenge, where completion of 10,000 steps during a certain period of time can be exchanged for rewards.

(8b ii) To encourage healthy diet, the Health Promotion has the Healthier Choice Symbols on food products (example : Higher in Whole Grains or Trans Fat Free symbol) written on these food products. Consumers are encouraged to buy these healthier products

Objectives:
To reduce the probability of obesity caused  by eating unhealthy food and a sedentary lifestyle, so as to reduce the probabililty of getting chronic diseases such as diabetes.

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Screen for Life programme - to encourage Singaporeans and PRs to go for regular screening and follow-up. Conditions that are being screened include cervical cancer for Singaporeans and PRs above 25 years old, chronic illness and cervical cancer abover 40 years old, colecteral cancer, breast cancer, chronic illness and cervical cancer above 50 years old.

For Pioneer Generation, screening is free.
For Merdeka Generation, screening is $2.
For CHAS card - Blue or Orange is $2
For Green CHAS card is $5

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(9b) Increase enrolment of healthcare courses such as nursing, allied health workers

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(9b) Increase enrolment of healthcare courses such as nursing, allied health workers

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(a) Increase enrolment of allied health students, such as nurses, physiotherapists, speech therapists, dieticians in tertiary courses in SIT
(b) Increase enrolment of medical students in local universities for training as doctors.

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(1) Pay increases for nurses and healthcare professionals
(2)Tertiary level scholarships nurses, allied healthcare workers
(3) Mid-career professional conversion programs to nursing and allied healthcare are targeted at mid-career workers who want to switch to healthcare

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(7b) Integrating care into the community with new housing concept

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(7b) Integrating care into the community with new housing concept

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In the new elderly housing concepts, elderly residents are able to visit polyclinic, kidney dialysis centre, all within walking distance from their homes.  These housing concepts also include elderly friendly features, such as being equipped with grab bars, non-slip tiles to reduce probability of falls. Example : Kampung Yew Tee.

Objectives: Enable the elderly to lead an independent life, and at the same time, be near to medical facilities (convenience).

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(4c) Other subvention schemes such as global subventions, casemix

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(4c) Other subvention schemes such as global subventions, casemix

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(7a) Agency for Integrated Service co-ordinates service providers' delivery of Intermediate to long term care services to patients and caregivers. This includes providing names of providers in home nursing, home rehabilitation services, and Day Care Centres

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(7a) Agency for Integrated Service co-ordinates service providers' delivery of Intermediate to long term care services to patients and caregivers. This includes providing names of providers in home nursing, home rehabilitation services, and Day Care Centres

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(8a i) Day Care, Eldercare and Day rehabilitation Centres

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(8a i) Day Care, Eldercare and Day rehabilitation Centres

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Patients are able to attend for their rehabilitation, example dementia patients could attend Day Care centre.

Referrals to these centres are made by hospitals, or polyclinics, or family service centres, or could be by patient contacting the AIC for list of service providers.

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(7) Promotion of community care  and home care

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(7) Promotion of community care  and home care

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(5b) Silver industry standards to ensure that nutritional products for elderly, healthcare and eldercare, technology for elderly are regulated. Silver Industry standards also sets guidelines for day care, eldercare and day rehabilitation centres

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(5b) Silver industry standards to ensure that nutritional products for elderly, healthcare and eldercare, technology for elderly are regulated. Silver Industry standards also sets guidelines for day care, eldercare and day rehabilitation centres

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Objectives
(1) Ensure quality and safety of products and services for elderly
(2) Ensure there is an age-friendly physical environment (example to reduce falls by elderly)

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(5a) Making consultation fees more affordable for elderly for Chronic Disease Management Program (CDMP) in GPs

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(5a) Making consultation fees more affordable for elderly for Chronic Disease Management Program (CDMP) in GPs

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(1) Pioneer Generation package (for Singapore citizens born on or before 31 December 1949) was introduced in 2014. Under CDMP program (for simple chronic diseases,) they receive up to $90 subsidy per visit, capped at $360 yearly. For complex chronic diseases, subsidy is up to $540 yearly.

(2) Mederka Generation package (for Singapore citizens born between 1950 and 1959) was introduced in 2018.  Under CDMP prgram (for simple chronic disease) they receive $85 subsidy per visit, capped at $340 yearly.. For complex chronic diseases, subsidy is up to $130 per visit, and $520 per year.

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(5) Schemes to make healthcare more affordable for elderly, and to improve health outcome (eg safety) for them

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(5) Schemes to make healthcare more affordable for elderly, and to improve health outcome (eg safety) for them

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(1) National Electronic Health Records (NEHR)

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(1) National Electronic Health Records (NEHR)

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Objective : With NEHR (one patient, one record), seamless integrated care is enhanced

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Patients consult doctors remotely, such as tele-consultations.  (Benefits: Saves time and cost for patients. Patients gets care without leaving home)

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Patients' vital signs (such as blood pressure, pulse rates, blood glucose level) are tracked and monitored remotely by HCI. Patients' conditions are monitored regularly and If there are abnormal deviations detected, patients will go for more extensive medical examinations
.

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(2a) Use of AI and IOT in store and forward telemedicine

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(2a) Use of AI and IOT in store and forward telemedicine

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Patients' diagnostic reports (eg X-rays, CT scans, MRI scans) are done at the diagnostic tests clinics in hospitals are shared remotely with the doctors at another clinic (example GP clinics)

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(2) Use of Artificial Intelligence (AI) and Internet of Things (IOT) in telemedicine

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(2) Use of Artificial Intelligence (AI) and Internet of Things (IOT) in telemedicine

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Objectives : (1) to enhance patient care in remote settings
(2) to provide the infrastructure to integrate healthcare providers across the Integrated Care pathway

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This financing scheme empowers institutions to improve clinical outcomes in a cost-effective way. The 3 regional clusters are financially incentivised to perform well in key priority areas.

Reference:  Mr Masagos Zulkifli, 2nd Minister of Health, at Singapore Healthcare Management Congress 3 August 2021, in https://www.moh.gov.sg/news-highlights/details/opening-address-by-mr-masagas-zulkifli-2nd-minister-for-health-at-the-singapore-healthcare-management-congress-2021)

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4(a) Bundled payment (promote integration of care)

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4(a) Bundled payment (promote integration of care)

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Funding is tied to a patient's entire care process, acrross multiple health settings.  This encourages providers to optimise care, reduce costs, and pass on savings to patients. Such models are best suited for medical conditions where clinical care pathways are defined.

Reference:  Mr Masagos Zulkifli, 2nd Minister of Health, at Singapore Healthcare Management Congress 3 August 2021, in https://www.moh.gov.sg/news-highlights/details/opening-address-by-mr-masagas-zulkifli-2nd-minister-for-health-at-the-singapore-healthcare-management-congress-2021)

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(10) Increase hospital beds by building new hospitals for example Woodlands Health Campus which increase hospitals by 1800

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(10) Increase hospital beds by building new hospitals for example Woodlands Health Campus which increase hospitals by 1800

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Woodlands Health Campus will open in 2022. It comprises an Acute Hospital, Community Hospital, a nursing home and specialist clinics.

Special feature: Acute and community hospitals are in the same building, so that patients can seamlessly move from acute to step-down care with the same doctor-in-charge.

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(9) Increase in number of healthcare staff 

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(9) Increase in number of healthcare staff 

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Objectives:  (1) To care for an anticipated increase in number of patients who would be getting chronic diseases (especially increase in number of elderly, given Singapore's ageing population)
(2) To replace staff who left

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(6) Promote primary care by GP clinics by encouraging them to join integrated care networks to provide quality care for chronic diseases (under Chronic Diseases Management Program)

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(6) Promote primary care by GP clinics by encouraging them to join integrated care networks to provide quality care for chronic diseases (under Chronic Diseases Management Program)

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GPs are encouraged to join networks such as
(1) Family Medicine Clinics - GPs who are supported by a term of nurses and allied health professionals to provide holistic care services. Acute care hospitals also partner with these FMCs to refer patients for primary care, in the same Regional Health Centres

(1) Primary Care Network - consists of multi-disciplinary teams  to provide patients with more effective management of chronic diseases, through dietary counselling,  screening tests such as diabetic foot screening. GP is able to refer patients for diagnostic tests and counselling, and the GP follows up with the treatment.

Objectives
(1) GP are able to provide holistic patient care
(1) Co-ordination of care  by GP
(2) Convenience for patients

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(3) Promote seamless integrated care , example through 3 Regional Healthcare Clusters

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(3) Promote seamless integrated care , example through 3 Regional Healthcare Clusters

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In 2017, clusters are divided into (1) Central region (2) Eastern region (3) Western region
Each cluster has full suite of healthcare services, from Primary care (Polyclinics) to Acute care hospitals and Community hospitals to Nursing homes, and each has a medical school.

Objectives: (1) Promote integration of healthcare services across the Integrated Care Pathway
(2) Provide comprehensive and patient-centred care, because patients get suite of medical care from different HCI in the clusters, depending on their conditions
(3) Optimise use of resources within the cluster because different HCI will be able to focus on its core medical capabilities

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Improvements in Healthcare Systems after Mr. Khaw. Boon Wan's video (after 2011)

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Improvements in Healthcare Systems after Mr. Khaw. Boon Wan's video (after 2011)

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These improvements include -  initiatives to enhance care delivery through the use of AI, new financing innovations , integration of care pathways,  preventive health promotion,  enhancing primary care services, enhancing intermediate and long term care services , providing more support to caregivers

Objectives :  These new measures increase the responsiveness of our healthcare system, improve fair financial distribution,  reduce diagnostic and medical errors, increase the patients' life expectancy, as well as their quality of life.