The Centre for Behavioural and Implementation Science Interventions (BISI) at the Yong Loo Lin School of Medicine, National University of Singapore (NUS Medicine), used implementation science methods to help NUHS@Home, a National University Health System (NUHS) programme that delivers acute-level care to patients in their own homes, evaluate how best to expand safely and effectively from a small pilot into a full-scale service.
Using a structured implementation science framework, Professor Nick Sevdalis, Director of BISI, worked with Dr Stephanie Ko, lead of NUHS@Home to systematically understand the considerations and approach needed for scaling NUHS@Home from 2022 to 2025. These insights were presented at the Behavioural and Implementation Sciences in Health, Asia Conference 2026 (BISHAC 2026), Singapore's first behavioural and implementation sciences in health conference, as a real-world example of how these sciences can accelerate healthcare transformation.
NUHS@Home is NUHS’ hospital-at-home or Mobile Inpatient Care service, delivering acute-level care to patients who would otherwise require ward-based hospitalisation but are clinically stable enough to be managed at home. Launched in September 2020 as a three-bed proof-of-concept pilot, the service was subsequently pivoted to support COVID-19 care as part of the national pandemic response.
Since May 2022, NUHS@Home has grown from an average of 48 patients a month to over 300 a month by 2025 – a roughly 7-fold increase - while virtual beds scaled 15-fold, from 6 to 90. At full-scale, NUHS@Home beds make up 3.3% of total bed capacity across NUHS – up from 0.6% at the start of the scale-up, or a roughly 5.5-fold increase – reflecting a growing share of hospital-level care now being safely delivered at home instead of in a ward. Over this period, the programme saved an estimated 21,800 hospital bed days – freeing up capacity for patients who need ward-based care.
As the service expanded, 30-day readmission rates and home visit frequency showed no statistically significant difference, meaning the rapid growth did not come at the cost of patient safety or care intensity.
Three factors were associated with successful scale-up: growing the healthcare workforce trained to deliver hospital care at home, expanding the number of clinical conditions that can be managed at home such as patients with cancer and those recovering after surgery, and strengthening quality and safety processes.
“Behind every number in this study is a patient who got to recover in their own bed, surrounded by family, instead of in a hospital ward. Working with BISI helped us understand how to scale that option safely, so more patients now have the choice of receiving hospital-level care where they're most comfortable,” said Dr Stephanie Ko, Lead, NUHS@Home.
To accelerate the translation of research into frontline care across NUHS, a dedicated BISI team will support the scale-up of effective projects under the auspices of the newly established NUHS Health Services and Population Health (HSPH) Unit, using behavioural and implementation sciences, alongside data science and health economics. Established on 1 August 2026, the HSPH Unit is positioned to drive health services innovation and population health improvement across the cluster.
“Good ideas don't scale by themselves. With the right method, a proven innovation can be grown quickly, safely and at lower cost. By applying implementation science methods, we helped NUHS@Home identify how to best grow and get the right care to more patients faster. With the new NUHS Health Services and Population Health Unit, our goal is not only to help scale more effective programmes in NUHS, but to help build the cluster’s capability to translate evidence into better care, routinely,” said Professor Nick Sevdalis, Director of BISI and the HSPH Unit.
Held from 3 to 5 September 2026, BISHAC is the inaugural conference convened by BISI, one of the few centres in the world to combine both behavioural science and implementation science expertise. Behavioural science explains how people make decisions, while implementation science explains how evidence-based practices can be embedded into systems and workflows. BISHAC 2026 marks the first time these two fields are brought together in Singapore, with a focus on Asian health systems.
BISHAC also marks the launch of the Hub for Implementation, Voices and Engagement (HIVE) initiative. Jointly led by BISI and the School of Public Health of Zhejiang University, HIVE is a pan-Asian research collaboration that brought together implementation science researchers across the region to set shared priorities for implementation research across Asia over the next five to seven years. A total of 67 senior scientists across 15 Asian countries contributed their expert views and identified 27 priority areas to accelerate the translation of evidence into practice across Asian health systems.
Top priorities identified include advocacy for implementation work with research funders, close working with communities, development of partnerships between researchers and policy makers, development of regional mentorship and training programmes, and establishment of sustainable financing for scaling successful health interventions. These priorities offer HIVE its first shared roadmap for advancing implementation science in healthcare, with the aim of closing the gap between health evidence and everyday care for Asian communities. These areas will be strongly represented, discussed and debated in depth at the BISHAC 2026.