More patients in Singapore can receive hospital-type care at home under pilot expansion

SINGAPORE: More patients will be able to receive hospital-type care at home with the expansion of a "virtual" ward pilot programme to more public healthcare institutions, said the Ministry of Health (MOH) and MOH Office for Healthcare Transformation (MOHT) on Monday (Aug 7). 

The Mobile Inpatient Care-at-Home (MIC@Home) pilot, first launched in April 2022, offers patients the option to be cared for in their own homes instead of a hospital ward. 

Selected patients with conditions classified under general medicine, like skin infections, can be admitted to a "virtual" ward, where they will have round-the-clock access to care delivered by a team of healthcare professionals via teleconsultations and home visits until deemed fit for discharge. 

Following its implementation at hospitals under the National University Health System, Singapore General Hospital and Khoo Teck Puat Hospital, MIC@Home has been expanded to four more hospitals: Changi General Hospital (CGH), KK Women's and Children's Hospital (KKH), Sengkang General Hospital (SKH) and Tan Tock Seng Hospital (TTSH).

"The pilot will bolster future hospital planning and add bed capacity buffer for the healthcare system," said MOHT, adding that MIC@Home serves to provide appropriate care for patients in a more comfortable environment without sacrificing care outcomes. 

"The care they receive, as well as resulting outcomes, are expected to be non-inferior to that in hospitals." 

As of June 2023, around 1,000 patients have benefitted from the programme, resulting in an estimated savings of 7,000 bed days.

MORE CONDITIONS COVERED UNDER MIC@HOME

"Apart from general medicine, suitable patients from selected speciality, including paediatric medicine, obstetrics and gynaecology, rehabilitation medicine, and elective surgeries can now be admitted to MIC@Home," MOHT said on Monday. 

As part of the expansion, children and women can also be enrolled into the KKH@Home specialist programme. 

Children with common conditions, including dengue fever, skin infections, eczema and urinary tract infection, as well as women with gynaecological conditions, and skin and wound infections, can be cared for at home instead of being admitted to a hospital.

Associate Professor Mark Koh, clinician lead for KKH@Home, and Head and Senior Consultant of the Department of Dermatology, said the programme can be "particularly beneficial" for children, who may feel anxious in a hospital environment. 

He pointed out the cost and time savings, with less disruption to the schedules of working adults, and "doctors and nurses are able to still identify and respond to changes in patients’ condition in a timely manner”. 

MIC@Home has also been expanded to include rehabilitation cases from TTSH, such as patients undergoing intensive therapy sessions with physiotherapists and occupational therapists. 

SKH@Home also commenced operations recently with the initial focus to recruit suitable patients from the Emergency Department (ED) to reduce the wait time for a bed. 

ADOPTING TECH, DELIVERING EFFECTIVE CARE

The expansion of the pilot paves the way for the adoption of promising technological solutions for more seamless care, said MOHT. 

New capabilities such as remote monitoring for paediatric cases including wearable devices for children as young as six are being explored, allowing care teams to closely monitor patients' conditions and work alongside their families to track their needs. 

Studies of similar models overseas has demonstrated that MIC@Home can help reduce hospitalisation cost and improve patient outcomes.

With the first three pilot sites having shown "early proof of concept results", MOHT said there is potential for the model to provide a "sustainable alternative to traditional hospital care". 

It added that the model is designed to ease the burden on hospitals and healthcare facilities in the long run, particularly in terms of physical resources like bed capacity and to manage patient loads more effectively.

Assistant Director and Project Lead at MOHT Mr Lai Yi Feng said: “We believe that MIC@Home, as a care delivery model, can help address the fast-growing healthcare needs in Singapore.

"Given the pilot findings obtained so far, we are also optimistic that it might even cost less compared to existing hospital-based care."

Mr Lai also said that the programme also hopes to include patients with higher clinical severity of presenting medical conditions and who require a higher acuity of care in the future.