September 25, 2023

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Singapore’s Digital Solutions for Advance Care Planning

According to Masagos Zulkifli, Second Minister for Health at the recently concluded 8th Advance Care Planning International Conference, person-centred care includes prioritising the patient’s choices and involving the patient and their family in care decisions. As a result, advance care planning (ACP) allows individuals to communicate their enhanced healthcare preferences.

ACP has been adopted in Singapore under the Advance Medical Directive Act and the Mental Capacity Act. Over 35,000 Singaporeans have completed their plans under the “Living Matters” programme, which promotes ACP.

In the future, the Ministry of Health hopes to raise awareness and acceptance of ACP, which has earned global prominence for aligning care with individual beliefs.

Minister Masagos noted that three issues must be overcome to promote the wider adoption of ACP. To begin, Singapore’s traditional society requires a mindset shift to normalise dialogues about death and dying, particularly among the elderly.

Second, additional facilitators, particularly trustworthy doctors, should be included to effectively engage the community. Finally, the present ACP facilitation approach requires an improved structure that can accommodate a larger group without losing quality.

In addition, technology should be used to reach out to digitally literate populations and increase scalability. Overcoming these obstacles will allow ACP to gain wider support and implementation in Singapore.

The Ministry of Health hopes to improve accessibility and ease in the ACP process as Singapore embraces technology. Individuals can now complete their ACP autonomously, without the necessity for in-depth talks with facilitators, thanks to the use of digital technologies, especially for those who are generally healthy.

This transition to digital solutions tackles the scalability and resource intensity issues that have plagued traditional ACP facilitation. It also serves a growing generation of digitally literate consumers who want more control over their healthcare decisions.

The ACP community must work with the healthcare system’s continuing improvements, particularly the Healthier SG project, which emphasises preventive care. Key shifts are required to enhance ACP knowledge and implementation.

Also, a societal mindset shift is required, which includes outreach, providing ACP outside of clinical settings, and establishing a statewide Pre-Planning Campaign. Roadshows, workshops, and a digital campaign on the My Legacy site will be part of this effort.

Individuals can use this gateway to get extensive information about ACP, start conversations, and make informed decisions about their life preferences. These programmes not only empower individuals but also promote early planning, ensuring that their values and priorities fit with their care goals.

Individuals and their families will benefit from these efforts, which aim to stimulate talks and early planning for end-of-life care. It is critical to begin these discussions and make the appropriate arrangements, including as purchasing insurance and establishing a durable power of attorney and wills.

Two critical shifts must occur for ACP to be widely adopted. First, healthcare personnel should be encouraged to incorporate ACP dialogues into routine treatment, giving them the knowledge and ability to discuss end-of-life planning with their patients.

This involves starting early dialogues with people who have significant illnesses about how to connect their care plans with their values. Second, to improve the ease, the ACP procedure should be digitalised.

While third-party facilitators are still required in some circumstances, digitally savvy persons who are relatively healthy can self-facilitate the broad ACP without in-depth conversations. Citizens can empower themselves to finish the ACP process independently by leveraging technology and digital platforms.


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