Objectives: Healthcare delivery in Singapore is currently fragmented with over-emphasis on expensive episodic hospital care. Most family physicians can be better equipped to deliver chronic disease management (CDM). The distribution of CDM between family physicians in the public and private sectors is disproportionate. We believe that the Patient-Centered Medical Home (PCMH) model of care which emphasizes integrated care will a) lead to improved patient outcomes, reduced cost and greater efficiency; b) increase the engagement of private family physicians for CDM. Methodology: In this paper, we describe the implementation and initial experience of the Frontier Family Medicine Clinic (a public-private partnership to pilot the PCMH model) and its potential to address the care gaps in our healthcare system. The PCMH model involves population management of 1000 patients, including 100 high-risk patients for complex case management. Results: Implementation required intensive engagement of multiple stakeholders, including educating both family physicians and hospital leadership on the value of this approach. With

Objectives: Singapore's healthcare landscape comprises public and private sector providers. Care in public sector institutions is heavily subsidised. The public polyclinics, comprising 14% of our primary care doctors, manage 45% of the country's chronic disease load in primary care. This disproportionate distribution resulted in an under-utilisation of our private physician resource and strained the public sector. An innovative public-private partnership model was conceived to establish new Family Medicine Clinics (FMC). This may lead to better optimisation of healthcare resources, and lower overall healthcare costs. Methodology:The model involves a multi-disciplinary team led by private Family Physicians in a group practice setting. We will discuss the planning considerations to establish the country's first FMC, the value propositions and how it aimed to address some of the gaps in the healthcare delivery system. Challenges and preliminary observations will be shared.Results: Extensive physician and patient engagement was conducted to promote this new model of care, resulting in increased referrals from the hospital's specialist outpatient clinics. Continuity of care was established through shared medical records and close physician interaction between the hospital and FMC.Conclusions: Preliminary observations demonstrated a potential for this model to be replicated to strengthen healthcare delivery in Singapore and reduce fragmentation of care.

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Objective: The patient-centered medical home (PCMH) model of care may bring about higher job satisfaction among staff but may also lead to staff burnout. We report the baseline results of a staff satisfaction survey as we refine the processes in implementing the PCMH for the first time in Asia. Methodology: An abridged version of the Patient Aligned Care Team (PACT) Personnel Survey (30 items) was self-completed by staff of the Frontier Family Medicine Clinic in collaboration with National University Health System when it was newly opened in April 2013. Results: Among 19 respondents, majority were female (74%), aged 40-49 years (42%), of Chinese race (79%), were less than 6 months into their current job (63%), and had a clinical job (53%). Majority (55%) experienced stress occasionally with 16% experiencing at least some degree of burnout. Majority (53%) were somewhat satisfied and 16% were very satisfied with their job. Majority (68%) agreed that they were involved in developing plans for improving quality. Majority (89%) felt that they spent at least 50% of their time on work that matched their training well. Conclusions: The management needs to be aware that while staff felt involved in this new setup, the stress involved may have affected job satisfaction.