Is the future of healthcare in the home?

The COVID-19 pandemic forced healthcare providers around the world to rethink their delivery of care, with the majority of patients reluctant to visit hospitals for fear of contracting the virus. […]

The COVID-19 pandemic forced healthcare providers around the world to rethink their delivery of care, with the majority of patients reluctant to visit hospitals for fear of contracting the virus.

This led to a rise in technologies like telemedicine and e-pharmacies, as hospitals digitalised to cope with the challenges of the pandemic.

The significant increase in the use of these remote technologies has not gone unnoticed, and the majority of healthcare providers have also come to realise that telemedicine has enabled them to continue providing quality care to their patients.

For some hospitals, however, the pandemic proved to be the trigger for them to look into bringing healthcare into the homes of their patients.

After all, home-based healthcare brings about several benefits – for both patients and hospitals alike – including cost-savings, better clinical outcomes, as well as helping to reduce the possibility of hospital-acquired infections.

Thailand’s Bumrungrad International Hospital, for example, began offering home care services two years ago.

Named Bumrungrad@Home, the 24-hour service aims to “deliver the same experience and standard of care as provided in the hospital, to help patients recover from illnesses or injuries in the very best location for their individual needs”.

Speaking to Hospital Management Asia (HMA), Dr Chatchai Arthur Yachantha, Chief Patient Experience Officer at Bumrungrad Hospital, said: “You have to understand that, due to COVID-19, there’s a paradigm shift on how care is being provided.

“It’s great that we have a lot of new technologies that allow us to provide care remotely. But everyone at the hospital needs to change their mindset as well and accept that this will likely be the future of healthcare.”

In Singapore, a new programme was recently launched by Changi General Hospital (CGH) that allows newly diagnosed cancer patients to do their pre-operation rehabilitation from the comfort of their homes.

The one-stop screen-and-intervene initiative, which started in 2020 as a pilot study, aims to reduce the number of visits patients have to make to the hospital so that they focus fully on their prehabilitation. As of January this year, the programme has benefitted close to 200 patients.

Clinical Assistant Professor Dr Tay San San, chief of CGH’s department of rehabilitation, said: “Despite the pandemic, our cancer patients have been able to undergo cancer prehabilitation in the safety and comfort of their homes with minimal disruption due to the home-based model of this programme.

“This ‘window of opportunity’ is crucial in empowering our patients to play a part in improving their post-surgery outcomes. With the prehabilitation framework set up by CGH, more cancer patient groups are able to benefit from the one-stop initiative.”

The concept of home-based healthcare is also an area that the renowned Mayo Clinic is focusing on.

Royston Lek, executive director for Asia-Pacific, Mayo Clinic in Rochester, Minnesota, told HMA: “Technologies that connect Mayo Clinic experts in serious and complex conditions with patients in their homes or with healthcare providers in their home communities are another broad area of focus.

“Mayo’s Advanced Care at Home program provides comprehensive care to patients in their homes through services such as skilled nursing, medications, infusions, laboratory and imaging tests and rehabilitation.

“EConsults allow Mayo Clinic specialties to provide consultations to physicians around the globe, providing timely access to their expertise without requiring patients to travel.

“Mayo Clinic also uses telemedicine technology to guide stroke diagnosis and treatment and other emergency care from afar, support rural hospitals’ intensive care units, and help provide critical care to premature or ill newborns.”

Lek emphasised that these home-based care technologies were implemented as part of Mayo Clinic’s goal of improving the quality of care for their patients.

He explained: “In keeping with Mayo Clinic’s core value that the needs of patients come first, patients are at the heart of Mayo’s use of technology. We see technological advances as tools for Mayo’s care teams to use to improve outcomes for patients.”

But while there are several advantages to home-based healthcare, the care model does come with its own set of challenges.

“Not every patient is suitable for home-based healthcare…it really depends on the patient’s situation, as their home may not be conducive for recovery,” a representative from a hospital in Kuala Lumpur, Malaysia said.

“For example, there might be hazards such as poor infection control measures, improper sanitation, and limitations with the physical layout of the home.

“So, we have to assess all the relevant factors – such as supporting infrastructure, patient safety, and of course, patient preference, among others – before deciding if someone is suitable for home-based healthcare. This is done so as to ensure the best clinical outcome for the patient.”

Nonetheless, the representative believes that an increasing number of patients will seek out home-based healthcare in future.

He said: “We are already seeing more patients embracing remote care, so the natural progression would be to receive care in their own homes.

“It is more comfortable and convenient for patients, and as a result, they are able to make a full recovery in a shorter period of time. And from the hospital’s standpoint, this care model can help to ease the heavy burden on medical staff.

“Overall, with technology being as advanced as it is today, the ability for hospitals to provide quality care for their patients is available, so it is something that healthcare providers in the region should really look into moving forward.”