Regulatory Reinvention: Paving the Way for Mainstream MIC@Home

A critical aspect of MIC@Home’s success in Singapore has been the proactive and adaptive regulatory environment. Traditional healthcare regulations are often premises-based, meaning they primarily govern care delivered within a physical hospital building. For MIC@Home to become a sustainable, mainstream service, a significant shift was required towards a “services-based and premises-neutral” regulatory framework.

The Ministry of Health, through the Healthcare Services Act (HCSA) 2020 and subsequent amendments, has been instrumental in creating this enabling environment. The initial sandbox provided a controlled space for providers to test and refine MIC@Home models while gathering data for regulatory adjustments. This iterative process allowed regulators to understand the unique risks and requirements of home-based acute care, enabling the co-creation of appropriate risk mitigation measures. From April 1, 2024, MIC@Home was officially mainstreamed, meaning it is now recognized as a regular service within public hospitals. This move was accompanied by clear licensing conditions under the HCSA, specifically for Outpatient Medical Service (OMS) licensees who also provide Acute Hospital Services (AHS). These conditions outline the standards for patient assessment, care delivery, and emergency protocols in the home setting, ensuring patient safety and quality of care even outside the traditional hospital.

Key Regulatory Changes:

Shift to Premises-Neutral Regulation: Moving away from a focus on physical buildings to the service itself.
HCSA Adaptation: Leveraging and amending the Healthcare Services Act to accommodate home-based acute care.
Sandbox-to-Mainstream Pathway: A structured approach to piloting, learning, and then integrating new care models.
Defined Licensing Conditions: Clear guidelines for providers ensuring patient safety and quality.

Related Literature & Sources:

Isomer – MOH Circular No. 18/2024: Notice of Proposed Licence Conditions Under The Healthcare Services Act 2020 (HCSA): New Licence Conditions On Providing Or Intending To Provide Mobile Inpatient Care At Home: Details the regulatory framework for mainstreaming MIC@Home. https://isomer-user-content.by.gov.sg/7/091c4c8c-a962-468b-91e8-339bccd71659/moh-cir-18-2024-proposed-new-lcs-on-mobile-inpatient-care-at-home-oms.pdf
Hospital Management Asia – Care beyond hospital walls: Singapore’s continued drive of home-based care concept: Discusses the regulatory sandbox and its implications. https://www.hospitalmanagementasia.com/tech-innovation/care-beyond-hospital-walls-singapores-continued-drive-of-home-based-care-concept/