Singapore let telemedicine providers operate under direct supervision while it worked out the rules. The test ran, the rules were written, and in 2023 telemedicine became formally licensed. A rare example of a sandbox reaching a clear endpoint.

The dilemma

By 2018, companies offering telemedicine in Singapore, where doctors consult patients by video or phone, were operating under an old law written for clinics with physical premises. The Ministry of Health wanted to let telemedicine grow, but it did not yet understand the service well enough to write good rules for it. Writing rules too early risked getting them wrong. Leaving the service unregulated risked patient safety.

The regulatory gap

What was needed was a staged path. Providers could operate under the Ministry's direct supervision while the rules were being worked out. And there had to be a credible promise that the test would eventually lead to proper licensing, rather than leaving providers stuck in a temporary arrangement forever.

The approach

In April 2018, the Ministry of Health launched the Licensing Experimentation and Adaptation Programme, known as LEAP, starting with telemedicine. The first group included the providers WhiteCoat and RingMD, and eventually 11 telemedicine and mobile medicine providers took part. The idea was that the sandbox would do two jobs at once. It would build a safe track record that justified formal regulation, and it would generate the actual content of those rules, drawn from watching how the service worked in practice rather than guessing in advance.

Results achieved

Video consultations grew sharply, from roughly 1,947 patients between 2017 and early 2020 to 36,000 by January 2021, with the COVID-19 pandemic accelerating demand. The sandbox closed in February 2021, having done its job. The Ministry moved providers to a voluntary listing with required online training, and from June 2023 telemedicine providers have been formally licensed under the Healthcare Services Act. More than 600 providers had voluntarily listed by the time of the change.

The Ministry has since reused the LEAP model for new sandboxes, including a 2024 sandbox letting community pharmacists give flu vaccinations. Singapore's regulatory cooperation also expanded internationally with the December 2025 UK-Singapore Regulatory Innovation Corridor between the two countries' health regulators.

One limit is worth noting. The move from sandbox to law worked partly because Singapore's regulators are unusually well-resourced and centralised. The same approach is harder to copy in countries where regulators do not have the capacity to turn a sandbox into working legislation.

The transferable lesson

The most useful sandboxes are the ones with a clear endpoint. From the start, LEAP committed to formally licensing telemedicine once the test was complete. That gave providers a reason to invest in meeting the rules, gave regulators a deadline to write them, and gave the public a clear sense of where the process was heading. Sandboxes without a defined endpoint tend to drift into endless experimentation.