MIC@Home: Bringing Hospital Care Into Your Home

Contributed by Zann Soh

Consider this scenario: You’re recovering from an illness, but instead of lying in a hospital bed, you’re in your own home; surrounded by loved ones, recuperating and resting in your own bed, and still receiving hospital-level care. Sounds like a glimpse into the future? In Singapore, it’s already happening.

The Mobile Inpatient Care @ Home – or MIC@Home – programme allows teams of doctors, nurses and allied health professionals to care for suitable patients in the comfort of their own homes through a combination of remote clinical monitoring, teleconsultations and home visits. It provides an alternative for patients who would otherwise be admitted to an acute hospital.

Suitable patients are those who have established treatment plans that consist of medication, antibiotics or fluids delivered intravenously.

This innovative care model was piloted by MOH Office for Healthcare Transformation (MOHT) in 2022 and is now available in all government restructured hospitals (except IMH) since being mainstreamed by the Ministry of Health (MOH) in 2024.

What happens in a “Home Hospital”?

The idea of a “home hospital” was seeded in 2019, with the demand for such a care model exacerbated during the COVID-19 pandemic.

Patients requiring hospitalisation or continued hospitalisation will be assessed by a doctor for suitability for the MIC@Home programme. Conditions for eligibility include:

• Patients who are clinically stable and unlikely to require intensive hospital care

• Patients who are able to care for themselves independently, or having sufficient caregiving support, and

• Patients who have internet connection so they can communicate with the doctors or nurses in charge.

The scheme – which started in 2023 with patients with general medicine conditions such as skin infections, gastroenteritis, cellulitis, urinary tract infections and congestive heart failure with fluid overload – was extended to other areas, including paediatric medicine, obstetrics and gynaecology, rehabilitation medicine, and elective surgeries.

Hospital-level care at home leverages technology to support clinical decision-making, monitoring, and intervention, in the following ways:

• Hybrid care provision: The care team can visit the patients in their homes or use teleconsultations to check in virtually without patients needing to leave home.

• Remote clinical monitoring solutions track patients’ vital signs in real time, alerting healthcare teams to any concerns.

• Portable medical devices (like ultrasounds and ECG machines) mean nurses and doctors can conduct essential tests at home.

• Medication/supply deliveries ensure patients get the right treatments on time and conveniently, without extra trips to the hospital.

Hospital-at-Home, which is the overseas equivalent for MIC@Home, is practised in many countries, such as Spain, UK and Australia. MIC@Home has also evolved through collaborative, multi-agency study trips, workshops, and conferences, where the team learns from international best practices and adapts them to Singapore's healthcare needs.

Benefits of MIC@Home

For patients, recovering at home in a familiar and comfortable setting can positively impact their emotional and physical well-being. Being treated at home can also reduce the risk of hospital-acquired infections, in turn leading to fewer complications during recovery.

For doctors and the care team – collaborating with patients and their families enhances care team – patient relationship and promotes patient empowerment and sense of ownership.

For the system, the option to enable stable patients to recover from home alleviates stress to congested hospitals, characterised by perennial bed crunch.

In 2023, more than half a million patients were admitted to public hospitals, an increase of about 4 per cent over the previous year. With Singapore’s rapidly ageing population, the demand for hospital services will continue to increase in the coming years.

Today, MIC@Home is offered in the eight major public hospitals and has served more than 2,400 patients with approximately 12,000 hospital bed days saved in the first six months.

Healthcare of Tomorrow

MIC@Home reshapes the way we think about healthcare.

Today, hospital congestion persists due to rising demand, bottlenecks at Emergency Departments, and fragmented care transitions. While conditions like uncomplicated pneumonia or cellulitis do not always require in-hospital ward care, limited community alternatives have led to default in-hospital stays.

To balance the number of beds that hospitals can manage with the growing need for healthcare, patients should be given the option to be cared for at home in virtual wards, rather than in a hospital.

MIC@Home is a part of MOHT’s Patient Flow Optimisation strategic pillar, which looks critically at how and where care is delivered.

Currently, many flow initiatives remain fragmented, limiting broader system impact. MOHT envisages a coordinated, data-driven patient flow ecosystem where patients are cared for at the most appropriate setting for system value and acute service utilisation is contained through triage, alternative care flows, and proactive management.

Scaling MIC@Home as a national initiative will reduce reliance on acute hospital beds. It paves the way for the shift from hospital-centric care to a home-first model, where technology and community-anchored care play a bigger role in managing health conditions.

For more information on MIC@Home, check out:

https://www.moht.com.sg/mic-home

https://www.moht.com.sg/blog/building-hospitals-without-walls