29th Apr 2022
Good afternoon everyone.
Professor Lee Chien Earn, Deputy Group CEO (Regional Health System), SingHealth
Associate Professor Ding Yew Yoong, Executive Director, Geriatric Education & Research Institute
Distinguished Guests
Ladies and Gentlemen
1. It is my pleasure to join you this afternoon at this inaugural Singapore Population Health Symposium. We have many colleagues and attendees from the health and social care sectors. Colleagues also from the infrastructure sector agencies: Ministry of National Development, Urban Redevelopment Authority, Housing & Development Board, and Land Transport Authority. It highlights the fact that doing population health and doing it well, requires a whole-of-society effort and I am glad that we have so many representatives across our public sector.
Moving healthcare upstream for population health
2. Recently, the Ministry of Health (MOH) announced our Healthier SG strategy at the Committee of Supply Debate. And adopting a healthy lifestyle, we should start early, to keep us as healthy as possible for as long as possible. It is the best prevention against the development of diseases and ill health. The implementation details of Healthier SG are still being worked out, but we need the support of many different agencies to go further upstream to tackle ill health at its root causes.
3. National level initiatives that encourage citizens to stay active and make healthier choices, especially around food, like the Health Promotion Board ’s National Steps Challenge and Healthier Choice Symbol - these efforts have seen good progress. At the regional level, our public healthcare clusters have also developed innovative population programmes to encourage early detection and management of chronic diseases in the community. And these are important efforts to address preventable risk factors early, do so on a location and a way that patients and clients find easy to access and comply with and drive good health outcomes through the use of research, innovation and technology. There are some recent examples that SingHealth has put in place, and these draw out some key lessons. Allow me to highlight just a few of these examples and these lessons.
(a) I will start with oral health, which is a precursor for good nutrition and health outcomes among the elderly. the National Dental Centre Singapore has started its ‘Oral Health Movement (OHM) 8020’ and this has seen good progress. The programme includes oral health screening at various platforms in the community, as well as a preventive intervention programme to improve the oral health of what they call the orally pre-frail or frail individuals. And this might account for 30% of our population above the age of 40 on the basis of an initial survey that was done. That shows the need to strengthen our preventive oral health efforts. The OHM 8020 initiative complements Project Silver Screen, which is a nation-wide programme implemented since 2018, which offers screening for oral health, hearing and vision and as well as intervention for seniors aged 60 years and above.
(b) A second example is the partnership between SingHealth and the National University of Singapore’s School of Computing. There is a mobile app called EMPOWER, which helps residents better manage chronic diseases. And this delivers personalised nudges and reminders on exercise, taking medication, monitoring of diet, as well as health coaching for clients and patients with chronic conditions through their smartwatch, of an Artificial Intelligence engine. The pilot started with 1,000 patients with diabetes. These were recruited through the SingHealth Polyclinics and there are plans to roll out to this effort to go to those with hypertension and high cholesterol levels subsequently.
(c) The third example, SCREENii, an automated frailty screening device which measures gait speed, the speed of walking and grip strength – how strong your hands are, has been developed to make frailty assessment and screening simple, accurate and most importantly, fuss-free. The device captures the walking speed of an individual without the need for an elaborate setup nor trained human assessors. And so there is good potential to scale its application in the community.
4. Keeping healthy is influenced by social and environmental factors, including the community in which we live, work and play. And so SingHealth Community Hospitals has started a social prescribing pilot in 2019 to address patients’ social needs and link them up with other community partners to support their care and wellbeing. Social prescribing is where a clinical care provider tells you, the patient, not these are the medications that you can take but these are the activities and behaviours, especially the social behaviours, that you need to take in order to influence your health outcomes. To date, more than 600 patients have benefitted, and the programme has also been extended to the SingHealth Polyclinics patients. Now, today’s theme of the symposium is Life Space.
Life Space in Population Health
5. This is a key measure of community mobility and it encompasses a person’s travel and activity patterns, how they achieve self-care, employment, social and their recreational needs. When community mobility is diminished, this is associated with poorer quality of life and the risk of increased mortality. So we need to develop early interventions aimed at preventing or delaying disability in seniors, and most importantly, enhancing their ability to meet their basic needs, build and maintain relationships, continue contributing to society, and improving their quality of life.
6. This is a new concept, the science of Life Space is nascent in Singapore and in the region. So the development of the “Elderly Life Activity-Space Envelopes” Project, is important because this project is led by SingHealth and is a collaborative effort, between the government, academic partners, community partners and industry partners coming together, will systematically study Life Space amongst community-dwelling seniors. It will involve 900 participants and is the largest Life Space project in Singapore so far.
7. And it’s important, is that this will give us interdisciplinary learning points which will be very valuable to understand the impact of environmental, health, and social determinants on Life Space. Our urban planners will also be able to use these and these insights especially on seniors’ perceptions of what facilitates and what obstructs urban mobility. I am confident that this project will serve as a springboard for future population health interventions, and it will improve the quality of life for our seniors and future generations.
8. To achieve these goals, everyone’s got to work hand-in-hand to develop the population health ecosystem that will drive the overall objective of a healthier population. We have to look beyond healthcare and start engaging partners in other sectors such as urban planning, technology, and education as we embark on this Healthier SG.
Launch of SingHealth Centre for Population Health Research and Implementation (CPHRI)
9. So today, I am delighted to launch the SingHealth Centre for Population Health Research and Implementation (CPHRI). Today, this is an essential foundation that we need to start building as part of our Healthier SG effort in order to look at innovative approaches to population health.
10. It takes a long time to move research evidence into “real-world” practice. By some measures, an average of 17 years. An organisation like CPHRI will help to narrow this ‘research to service’ gap. It is strategically sited in the SingHealth’s Regional Health System. It has access to an extensive network of community partners and research agencies.
11. And functioning as the nexus for population health – both research and implementation in Singapore, CPHRI will be able to develop thought leadership in population health research across the life stages, and accelerate the translation of research findings to care delivery, improving and scaling services on the basis of evidence-based programmes.
12. To achieve these aims, CPHRI will leverage data and technology, and work together with research and academic institutions, as well as community and industry partners. This is all part of MOH’s continued commitment to research and support for our healthcare clusters and institutions’ efforts to innovate better population health outcomes. The Ministry will support the work of CPHRI through the National Medical Research Council (NMRC) Centre grant and other mechanisms.
13. I am also pleased to share that MOH will be launching a new NMRC Population Health Research Grant under the Research, Innovation and Enterprise 2025 Plan for Human Health and Potential Framework. A total of $90 million would be made available to encourage research and innovation on population health, particularly in the areas of Health Promotion, Preventive Health, and Health Services Research. With this new Grant scheme, we hope to support a larger pool of researchers on innovative population health research as part of this Healthier SG effort, going beyond conventional ways of delivering health promotion, preventive health and health services. Over the next few weeks, our colleagues from NMRC will share more details.
14. SingHealth has partnered the Geriatric Education and Research Institute (GERI) to organise this symposium. GERI’s mission is very much aligned with CPHRI’s: to extend the healthy years of older adults, promote healthy ageing and to drive care integration in Singapore. So I encourage all of you to seek out like-minded partners to advance population health research and implementation in Singapore.
Closing
15. Thank you very much to SingHealth and all the participating institutions for your continued efforts to look after us and drive good population health outcomes in Singapore and the region.
16. Wishing all of you fruitful and stimulating learning experiences this afternoon and I hope that you will benefit from the opportunity to network, collaborate, and exchange ideas from the different sectors that are represented by the attendees and participants and panellists of today’s session.
17. Thank you very much for inviting me to join you here today. Thank you.