- Yvonne Ng
Singapore is undergoing profound demographic shift, with a quarter of the population predicted to be aged 65 and older by 2030 as compared to 14 per cent in 2019. A rapidly ageing population means more elderly will require hospital care with constant monitoring, but inpatient care brings its own challenges.
Prolonged inpatient care can lead to hospital-acquired infections and physical deconditioning. A greater demand for hospital beds also puts pressure on the healthcare system, which results in higher costs and shortage in clinical manpower.
Mobile Inpatient Care at Home (MIC@Home) provides an opportunity to address these issues by innovating an alternative inpatient care model to deliver hospital-level acute care in the comfort of patients’ homes. MIC@Home allows eligible patients to recover at home, without being isolated in hospitals. This allows a more gradual transition from acute care to recovery outside the hospitals, and encourages an earlier return to independence for patients.
Over the last 3 years, MOH Office for Healthcare Transformation (MOHT) has been working with like-minded clinicians across all three clusters to develop and test this care model.
A National Regulatory and Financing Sandbox went live in April 2022 to scale up the pilots and to simulate mainstream financing for enrolled patients. As we approach steady state of the implementation, it was timely to bring stakeholders together for a visioning and solutioning workshop for MIC@Home to share implementation learnings and experiences, as well as to align visions and action plans moving forward.
107 stakeholders attended the workshop to look at current and anticipated challenges and discuss possible solutions to attain the envisioned future state of MIC@Home.
On 24 November 2022, 107 participants from diverse domains gathered at the workshop to look at the current and anticipated future challenges, and discuss possible solutions and actions required to reach the collective desired future state. Apart from clinicians and leaders from the public healthcare clusters and Integrated Health Information Systems (IHiS), there were also representatives from various Ministry of Health (MOH) divisions including Health Services Group (HSG), Health Regulation Group (HRG), Data Analytics Division (DAD), and Future Systems Office (FSO).
The workshop started with a sharing session by A/Prof Michael Montalto, a veteran in the Hospital-at-Home (HaH) field. He shared his experience and main takeaways from his Hospital in the Home (HITH) implementation journey in Australia, which included how the major cost benefit of HITH is in terms of capital efficiency. Instead of building new acute hospital capacity in the constrained healthcare systems, HaH is a safe and effective alternative to inpatient care. However, he cautioned that mission or definition slippage could be a major risk to this care model.
Following the session, participants gathered in breakout groups to discuss the challenges, shared vision, and possible solutions to advance MIC@Home. They collectively brainstormed on how they could address some of the pain points and plan the roadmap towards the envisioned MIC@Home. At the end of the workshop, each of the participants wrote a postcard to describe the desired future state for MIC@Home and how they could make it happen in their respective individual capacities.
