Partnering patients and community partners for Better Health: Virtual Care Centre’s person-centred approach to enable timely access to acute care.

Abstract

Background: Demand for acute hospital resources is at an all-time high as Singapore’s healthcare system faces mounting pressure from an aging population and increasing care complexity, resulting in overcrowding in emergency departments (EDs), potential delays in access to acute and definitive inpatient care. At the same time, frail older adults and caregivers struggle to navigate the complex healthcare ecosystem contributing to fragmented care, unnecessary ED visits and admissions. Here we describe the National University Health System’s (NUHS) Virtual Care Centre (VCC), the first medical helpline within a regional health system designed to bring together hospital and community services to help patients and caregivers traverse this network of care with the simplicity of a single touchpoint, and support care in the community.   Approach: Launched in July 2020 as a post-discharge helpline, the VCC encourages patients with urgent but non-emergency medical concerns to call before visiting the ED. Care Managers trained to triage these calls either re-direct patients to emergency services or escalate to the care team comprising nurses, pharmacists or physician for teleconsultations based on care protocols.   Where needed, nurses will perform urgent home visits with SmartGlass technology for real-time physician input. If inpatient acute care is needed, VCC activates NUHS’ Hospital at home unit, or facilitate a direct admission to a regional brick-and-mortar hospital. This ensures that patients receive the right care at the right time by the right professional, at the right site, utilizing the right resources whilst empowering care at home where safe and possible.   Results: Between 2020 and 2024, the VCC received 4,857 calls, with 59.3% being medical in nature. Of these, 19.4% were diverted to an ED; 26.9% were urgent; and 78.4% were moderate to low acuity. Over half (53.4%) of medical cases were resolved by the CMs together with nurses and physicians, further 16.6% involved specialist physician input, while 6.8% required pharmacist collaboration. For those requiring inpatient care, direct admission to either a brick-and-mortar hospital or hospital-at-home service was activated in 3.3% of medical calls. Through the VCC, patients received timely access to acute care centred around patients in the community, avoiding unnecessary ED attendances and coordination burdens. Direct admissions alleviated caregiver distress, while personalized education empowered caregivers to manage conditions confidently in the community.   Implications: The NUHS VCC exemplifies how virtual care, powered by an integrated workforce, can deliver responsive, safe, and accessible care while preserving hospital capacity for critical and time sensitive conditions. Further, by partnering with patients and caregivers, the VCC reduces fragmentation, fosters empowerment and engagement, and strengthens confidence in home-based care. It prioritizes care coordination around people’s needs over institutional workflows, and a clear demonstration how technology and teamwork can reframe the way we look at delivering care. With global health systems confronting similar challenges, the VCC aspires to be more than a medical helpline; it is a vital lifeline and blueprint for delivering better health, care, and value. Further evaluation of costs and outcomes will support broader adoption and inform future workforce strategies in virtual care delivery.