Building A Virtual Hospital

When I first started Speedoc with my co-founder, Serene, we had one goal in mind: to make it easier, faster, and more affordable for anyone in Singapore to get hospital-level care. Over the past 3 years, this goal has slowly become a movement. From our first house call to launching our trademarked Chronic Disease Home Management™ programme, this goal has evolved into a movement with more partners joining us each day.

The concept of decentralised healthcare

Doctors are a limited resource, so we’ve created a system that focuses on maximising the doctor’s time. As patients, we make the trip to a clinic or hospital, wait for our turn to see the doctor, then wait for our medication to be dispensed after the consultation before heading home again. We spend all this time travelling and waiting just to see the doctor for less than 10 minutes, just so that the doctor does not have to spend time travelling to the patient. This is healthcare as we commonly know it today.

Come to think about it, this model of delivering healthcare doesn’t really make sense. Why are we making someone who’s feeling unwell go through all that trouble to see a doctor? Especially for patients with mobility issues, the amount of resources needed just to seek medical treatment cannot be justified. Moreover, with the threat of COVID-19, we shouldn’t be gathering the very people who are most vulnerable in one place.

On the other hand, treating patients at home should be the way we deliver healthcare. As a doctor, you get to spend more time with the patient and, more importantly, you get a better understanding of the patient’s living environment (what they eat, who they live with, etc.) which helps inform your diagnosis and treatment decision. For the patient, this means convenience and not having to leave the home when they’re unwell. This is the core of decentralised healthcare.

Recreating a hospital ward, at home

Providing decentralised healthcare has always been Speedoc’s focus when it comes to developing new products. The advantage we have over our competitors is that we have extensive experience in home care for both physician services and nursing services. This got us thinking - since we already have doctors and nurses treating patients at home, could we possibly recreate a hospital bed in the patient’s home? This would greatly alleviate the strain of hospital beds, and patients would also be much more comfortable getting treated in a familiar environment.

When I put myself in the patient’s shoes, I see more reasons to develop this product, which we call the ‘virtual hospital’ at Speedoc. The home is a superior setting for recovery, where social support and physical help from the people we live with can help make things easier and speed up recovery. I recall my hospital days, where some patients couldn’t wait to be discharged as their caregivers had to go home for the night, or simply because they missed the comfort of a home-cooked meal. The caregivers who could stay for the night always had a tough time getting a good night’s rest on the makeshift bed as well. All these issues wouldn’t exist in the home hospital, especially if you already have the resources to recover at home.

As we were exploring this possibility, Speedoc was invited to participate in a home hospital pilot programme, where patients will still receive the same level of care they would in a hospital, but in the comfort of their homes. The care guidelines used are the same for the home hospital’s ‘virtual ward’ as an actual physical ward, and we remain part of the care team for the same patient until they’re fit to be discharged to ensure continuity of care.

With our prior experience in providing home care, we were able to advise the team on protocols, procedures, and the processes we use on a daily basis. To fully test the feasibility of a virtual hospital ward, and partly due to restrictions brought about by the COVID-19 pandemic, we also brought the daily briefings that a patient’s care team would usually conduct in the hospital before each shift online. We meet via Zoom twice a day on weekdays, once in the morning and once again in the afternoon. In the morning, we discuss what happened over the night and what should be done today. We do the same in our afternoon briefings - going over what happened in the day and what to take note of in the night. On weekends, we meet over text or phone calls in the morning to review the patient’s condition overnight.

One unintended result of our participation in this study is that we’ve been able to see our concept materialise and succeed in a practical setting. No assumptions or hypothetical scenarios - these are real patients with real conditions that have seen real results under the virtual hospital setting. In fact, I can go as far as to say that this could potentially become the ‘new normal’ of hospital care.

This pilot is still ongoing, but I’m glad to say that we’ve received positive feedback so far from the patient, their family, as well as our partners. Patients who have been discharged like that were able to rest in the comfort of their own home, and have home-cooked food instead of hospital food. I’m really excited to receive the results of the pilot, and I’m confident that the conclusion will be that Singapore is ready for a large scale implementation of a Hospital at Home. I consider Singapore as a testbed for Speedoc to put the virtual hospital concept through rigorous tests, and I think it is time to get ready to roll this out beyond our shores.