The Big Read: When home is where the hospital bed is

Should MIC@HOME COST MORE OR LESS?

In his political talk, Mr Ong said MIC@Home is no set to charge more than a typical doctor be, and might be projected to cost the same or less. &nbsp,

” People can be assured that they will not give any more for this service than they do in a public hospital as all our institutions intend to value MIC@Home related to or lower than a typical ward”, Mr Ong said. &nbsp,

MIC@Home may be supported by incentives and coverage and savings strategies such as the&nbsp, Integrated Shield Plan, and the Central Provident Fund ‘s&nbsp, MediShield Life&nbsp, and&nbsp, MediSave, if appropriate. &nbsp, &nbsp,

With MIC@Home still a work in progress, there has been some controversy as to how much it may cost. Some feel that the program may cost less than a typical doctor be, given the lack of medical settings and use of its facilities. &nbsp, &nbsp,

However, Assistant Professor Ian Ang, from Saw Swee Hock School of Public Health ( SSHSPH) at the National University of Singapore, said:” Even though the patients are not in the physical hospital facilities, the cost is not necessarily cheaper in providing the care- telemonitoring devices are used, and there are still mobile care teams that will travel to the homes of the patients who need certain in- person care treatments” .&nbsp, &nbsp,

Adjunct Assistant Professor Melvin Seng, also from SSHSPH, said he will not be surprised if MIC@Home costs more initially, as starting new programmes usually requires higher costs. &nbsp,

This is due to the set- up of equipment and processes, as well as the training of healthcare providers, patients and caregivers. &nbsp,

” The good news is that, in the long run, there should be cost savings once the programme is well set up, running smoothly and with good uptake”, said Asst Prof Seng, who is also an occupational medicine specialist.

WHAT IT MEANS FOR CAREGIVERS

While the MIC@Home programme allows patients to recover in the comfort of their homes, the knock- on effect of this arrangement is also keenly felt by their caregivers. &nbsp,

Mr Adrian Tiam, a 53- year- old private hire driver, felt reassured having his daughter Charlotte recuperate at home in February after she was diagnosed with dengue fever and required hospitalisation due to a dangerously low platelet count of&nbsp, 50, 000 per ml. &nbsp,

Platelets help to clot a person’s blood and prevent excessive bleeding. When the platelet count is low, one may have trouble stopping bleeding. &nbsp, &nbsp,

Since normal platelet counts are between 150, 000 and 450, 000 per ml.

When Charlotte, 16, and Mr Tiam went to CGH, they had to wait 12 hours before she finally got a bed close to midnight and was warded for one night. &nbsp, &nbsp,

” I felt nervous and uneasy in a new environment as I had to sleep in the hospital overnight”, said Charlotte.

The student was “quite happy” to be told by the CGH@Home team later that while her platelet count was still low, she would be eligible for the pilot programme to recover from home. &nbsp,

Once back home, Charlotte was instructed to take her temperature, blood oxygen level, and blood pressure three times a day: At 9am, 1pm, and 4pm.

These vital sign readings will be automatically uploaded to CGH@Home’s command centre, where a medical team monitors patients around the clock. &nbsp, &nbsp,

A nurse also went to her house to do a blood test for Charlotte. &nbsp,

” I definitely felt well taken care of, as the nurses and doctor would call me if I did n’t take my blood pressure readings at my normal times”, said Charlotte. &nbsp, &nbsp,

Mr Tiam said having Charlotte recover at home meant he and his wife could watch over her” 24 hours a day”, and did not have to make special arrangements at work to accommodate the hospital’s visiting hours. &nbsp,

” You can just be at home, and we can request to work from home to care for her, it ( MIC@Home ) made it really easy and good for us”, said Mr Tiam. &nbsp,

He also noticed that Charlotte’s mood improved when she was at home for three days in the virtual ward. &nbsp,

” She appeared to be much more cheery and happier… She also seemed to be less worried about her illness”, said Mr Tiam. &nbsp,

The same can be said for 64- year- old Sarbjit Singh, who was diagnosed with lower limb cellulitis, a bacterial infection, during his holiday in Malaysia in January.

After returning to Singapore, the director and chief executive officer of a pest control company saw a general practitioner who advised him to go to a hospital immediately. &nbsp,

When he arrived at SGH, the doctor said that his condition was serious. If left untreated, Mr Singh might need to amputate his leg.

Mr Singh needed antibiotics to be administered three times a day, and while hospitalisation was recommended, there were no beds available for him at that time. &nbsp,

After a day of waiting, Mr Singh was offered the MIC@Home service, which he readily accepted. &nbsp, &nbsp,

During his eight days under the programme, he received intravenous antibiotics at home, and the SGH care team went to his house daily three times a day to clean his wound and change bandages until he recovered. &nbsp,

” The good part is that when you are home, you get your own food compared to the hospital, ( where ) sometimes you do n’t like the food”, he said. &nbsp,

More than that, Mr Singh said the undivided attention the doctor and nurse gave him put him much at ease, and alleviated any worries he might have had.

” The doctors who visited me felt less rushed than those in the wards because they only had one patient. They have time to explain and we can ask questions too”, said Mr Singh.