ArticleJMIR formative research2026
Regional Virtual Acute Care Helpline in Singapore at a National University Health System Virtual Care Centre: Retrospective Study.
Article in JMIR formative research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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17 authors.
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Abstract
Background: Emergency department (ED) overcrowding and delayed access to care are ongoing challenges in Singapore. The COVID-19 pandemic further underscored the need for scalable virtual care models that go beyond traditional hospital settings, allowing patients to access acute specialist care quickly and efficiently. Objective: This study describes the design, implementation, and early outcomes of the National University Health System (NUHS) Virtual Care Centre (VCC), a clinician-led helpline aimed at reducing unnecessary ED visits and supporting community-based acute care. Methods: In 2020, the NUHS launched the VCC, a helpline at Alexandra Hospital, as a prehospital triage model. The helpline functions as a nurse-led telephone triage with real-time escalation to doctors for urgent medical issues. It ensures the continuity of care for patients recently discharged and diverts nonemergency cases from the ED. A retrospective analysis of call data from 2020 to 2024 was conducted to evaluate utilization patterns, clinical outcomes, and safety. Results: Over 4 years, the VCC managed 4857 calls, of which 59.3% (n=2879) were clinical in nature. Nearly two-thirds (1834/2879, 63.7%) were resolved remotely, preventing in-person ED visits. Only 13.8% (397/2879) required redirection to an ED, and 3.3% (95/2879) were directly admitted to an acute hospital or hospital at home service. Within 72 hours of call resolution, 69.1% (1990/2879) of the callers avoided an ED visit. Undertriage was 4.9% (110/2232) at 72 hours post call resolution, with no high dependency or intensive care unit admissions during this period. Mortality rates were low (1.0% at 14 days; 2.3% at 30 days). Conclusions: The NUHS VCC provides a feasible and safe model for virtual acute care triage within the public health care system. It effectively diverted lower-acuity cases from the ED and ensured continuity of care, offering a scalable approach aligned with national efforts to extend health care beyond hospital walls.
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