SPEECH BY DR KOH POH KOON, SENIOR MINISTER OF STATE, MOH, AND MOM, AT THE 2025 SINGAPORE HEALTH AND BIOMEDICAL CONGRESS

Dr Louise Heyzer, Chair of Singapore Health and Biomedical Congress Organising Committee 2025

CEOs

Healthcare leaders

Colleagues from the various healthcare institutions

Distinguished guests

Ladies and gentlemen                 

1.               Good morning. It is my pleasure to join you at the 23rd edition of the Singapore Health and Biomedical Congress organised by NHG Health. This year's Congress theme, "Is More Tech Actually More in Health?", really gets to the heart of the challenges that we're all facing today. Locally and globally, we are all striving to build a healthcare system that maximises quality of care, allows space for innovation while keeping healthcare costs affordable and sustainable.

2.               Now as a surgeon myself, I know that we always want the best or want to do more for our patients. But we also need to understand that more is not always better. There must be 'value’ in the care, which means adopting practices that are grounded in evidence, implemented in a well-coordinated way, and able to produce good patient outcomes. Because ultimately this is what the patients desire – a good outcome, and this is why Singapore is prioritising the implementation of Appropriate and Value-based Care or AVBC.

Appropriate and Value-Based Care: From Concept to Impact

3.               Now at its heart, AVBC is about delivering the right care, at the right time, in the right setting, and maybe, some say the right cost; guided by evidence and focused on what truly matters to patients. When done right, it benefits our patients, partners, and our people. It begins with a simple but powerful question: What matters to our patients? The answer goes beyond just procedures and prescriptions, to outcomes that genuinely improve lives whilst ensuring that every dollar we spend delivers optimal value.

4.               AVBC should not be seen as an abstract concept or distant aspiration. It is practical and a shared responsibility where every clinician, administrator and frontline staff – all of us in fact, have a role to play. AVBC is about rethinking how we deliver care daily, and how we organise our healthcare teams, and design the future of healthcare in Singapore.

5.               For patients, AVBC translates into tangible improvements in their care experience and outcomes. Let me cite a few examples. You’re heard just now from Prof Chin that NHG Health has transformed its Total Knee Replacement care programme by standardising care pathways and leveraging clinical data. Average hospital stays reduced by 63%. Day surgery rates increased from a mere 2% to 32%. These are remarkable results achieved while maintaining stable costs and safety standards. But most importantly, patients benefited from shorter hospital stays and quicker recovery at home.

6.               Now in delivering these kinds of excellent outcomes, we must realise that it will not happen overnight just because we adopt a new care protocol, just because we bring in new technologies. I recall some 20 odd years ago when we first started doing the very first few cases of laparoscopic cholecystectomy. I can tell you, it was an exercise in frustration. Camera systems were not that good. The technical approaches were not as well thought out or refined. Surgeons were beginning to do laparoscopic surgery, trying to move from an open approach, so the views look different in a camera than what you see in an open surgery. The first few cases I think we did take more than six or nine hours to do, and all of us were so conservative, we put in a drain to prevent or detect any bile leaks that may happen because our techniques were not refined. Patients stay for almost a week, get fasted for two three days before they start eating, and if you look at the metrices used today to measure outcomes of those days, laparoscopic cholecystectomy will not have crossed any value-based outcome thresholds.

7.               But it took us time to refine our techniques or technologies to improve further, and today uncomplicated laparoscopic cholecystectomy has become a day surgery procedure. Patients eat almost immediately after surgery, and we are now refining approaches to do it through a single port, not through multiple laparoscopic ports. So sometimes when we talk about value-based healthcare, we must also put a time horizon to it. And without the initial learning curve that we struggle through, without technology improvements that come along the way, through increased demand from the doctors, we will never reach this stage where AVBC for laparoscopic cholecystectomy reaches maturity, and patients and hospitals, payers, truly benefit from it.

8.               Another example is how Singapore’s healthcare clusters have progressively leveraged Patient-Reported Outcome Measures (PROMs) to capture the outcomes that matter most to patients. PROMs give patients a voice in clinical decision making, help them better understand their own progress, and importantly, become more engaged in managing their own care. We are no longer in the era where consent-taking is about just putting a thumbprint, and the patient doesn’t know anything about the procedure, thinking they have gone for a haircut. Now we spend a lot more time explaining to patients, they are more engaged, and post-operatively, they are a lot more engaged in wanting to do better for themselves. So the process has changed. This kind of patient outcomes transform AVBC into a lived experience by ensuring that care is done with patients as partners rather than them just being mere recipients of our care. So that relationship has changed. The social contact between the doctor and the patient has evolved over time.

9.               Applying AVBC principles in health technology means having better tools to support clinical decision-making and enable healthcare professionals to provide more efficient, accurate and safer care for our patients. And in this aspect, NHG Health is progressively expanding AI-enabled X-ray analysis capabilities across the cluster – from using AI for chest X-rays to prioritise urgent cases and reduce turnaround times at Geylang Polyclinic, to applying AI for faster fracture detection at Woodlands Health's emergency department.

10.           Investing in capability building will be crucial for our success in delivering AVBC. For example, MOH has integrated AVBC principles into medical education through the National Outcomes Framework for Medical Graduates, establishing AVBC as a core competency for healthcare professionals. We are also exploring how we can do the same for other healthcare professionals. The launch of the CHI Value Academy thus complements our efforts by equipping current and future health professionals with the knowledge and skills to practise AVBC in NHG Health. The structured training, project coaching, and practical toolkits provided will spur our healthcare professionals to lead and implement more value-based care innovations.

Forging Academic – Clinical Partnerships for Integrative Care

11.           Building on this foundation of value-based care, we must also embrace the innovative partnerships that expand our understanding of effective treatment modalities. Singapore has taken proactive steps to develop integrative medicine, particularly in the area of Traditional Chinese Medicine (TCM), bringing the east and west together, trying to get the best of both worlds. MOH has launched the TCM Research Grant in 2014 and the TCM Development Grant in 2018 to support collaborative research and practical TCM implementation. This year, we advanced it further with the TCM Integrative Sandbox initiative. This initiative includes testing and evaluating evidence-based and cost-effective TCM treatments for specific conditions in our public healthcare institutions.

12.           NHG Health is also piloting the Integrative Medicine models at Tan Tock Seng Hospital, where techniques like acupuncture are used to complement rehabilitation. Such efforts are important to show how integrative medicine can enhance chronic disease management, rehabilitation and preventive health. And with more than 20% or so of our population already having touchpoints with TCM, this is a good segue for us to bring TCM into more mainstream use and meet the needs of our population, especially in preventative health.

13.           Today, I am pleased to announce that NHG Health is deepening this commitment to integrative medicine through a Memorandum of Understanding between TTSH and the Nanyang Technological University of Singapore. This partnership will launch the Prevention and Recovery through Integrative Medicine, or PRIME, Taskforce, which will align clinical and academic efforts to enhance patient care, provide cross-training for TCM and Western medical students, and advance research and evidence-based practices in integrative medicine. This collaboration will equip more clinicians with skills to meet the growing demand for integrative care practices.

Conclusion

14.           These initiatives exemplify the collaborative approach, which is key to improving population health across Singapore. Achieving this vision demands strong partnerships across healthcare institutions, academia, industry and community organisations. It is such collaborations that will shape the future of healthcare in Singapore.  And it takes all of us working together, building networks, understanding, being able to speak in each other’s languages in order to materialise this vision.

15.           In closing, I wish this year’s Congress continued success in sparking bold ideas, meaningful collaborations, and collective progress toward a healthier Singapore. Because when Singapore is healthy, you and I will be healthy. I wish all of you the best in this Congress, and a fruitful and meaningful learning experience over the two days.

16.           Thank you very much.