Tan Yi-Roe, Lai Yi Feng & Lim Cher Wee
Partnerships share the workload and multiply the success
In this new era where face-to-face interactions are more limited, there is a need to be more deliberate in collaborating with partners. At MOHT, partnerships play an important role in building a supportive environment for healthcare transformation. In our work during this period, for example, we have seen the spirit of support, trust, and networks open new doors and catalyse innovation breakthroughs.
The home hospitalisation programme (Mobile Inpatient Care at Home, MIC@Home) is one example where MOHT partners stakeholders to advance our joint aspirations to pilot and evaluate the potentials of this emergent care model in Singapore.
Since 2019, MOHT has been looking into MIC@Home as an alternative inpatient care delivery model in the community that bridges traditional multidisciplinary care and telehealth solutions, targeting patients who would otherwise be warded in brick-and-mortar hospitals. In this case, it is different from traditional transitional care programmes such as Hospital-to-Home (H2H) where patients are usually at high risks for readmissions and they are cared for by the programme post-discharge from acute episodes, such that they don’t circle back to the hospitals too easily or quickly.
For initial pilot implementations spearheaded by several public hospital partners, MOHT introduced relevant private service and solution providers to the teams to explore service collaborations and technology adoptions. Examples of such private service/solution providers included (but were not limited to):
Speedoc, a private mobile medicine provider that specialises in providing mobile medicine services at the comfort of patients’ homes.
Doctor Anywhere, a private telemedicine provider that specialises in remote care delivery.
Technology solution providers such as Biofourmis, ISANSYS and ConnectedLife.
Integrating service providers is not easy. Each partner took time to share a common understanding of the problem. Each partner took effort to align on the potential of better integration in optimising manpower resources and attaining economies of scale. Each partner also contributed expertise and resources to amplify success.
Under pilots at NUHS (NUHS@Home) and SGH (SGH@Home), for example, the hospital care teams provided overall medical governance and ensured safety and quality of care of patients, while the Speedoc team supplemented home medical services to provide around-the-clock service when needed. Coupled with remote monitoring solutions from technology counterparts, and MOHT's evaluation capabilities and familiarity with the healthcare landscape, a harmonised effort was made possible by playing to each party’s strengths.
Early results were encouraging. The pilots’ patient demographics were not dissimilar from that of regular inpatients. Outcomes were at least comparable to usual care, while incurring lower costs and manpower resources. These were achieved through the use of telehealth solutions, as well as public-private partnerships. These virtual wards could therefore run with a single-shift manpower compared to the three-shift usual inpatient model. In terms of resulting absolute costs, initial findings showed that the costs could be 40% lower compared to usual care. Amidst the recent hike in COVID-19 community transmissions, our pilots further accelerated through support from the Ministry of Health.
At MOHT, we recognise the importance of maximising system integration and the roles and relationships of different service providers. We will continue efforts to initiate conversations and explore opportunities with relevant public and private stakeholders to validate care delivery models. This can help us to leverage combined capabilities to address healthcare issues in Singapore.