Medcare home care service
Image Credit: Supplied

Medcare’s Homecare Services provides world class medical care from the comfort and convenience of the patient’s home.

Marwa Saffi, Head of teleMEDCARE and Homecare Services

Can you tell us about the role that Medcare has played in offering home-based healthcare, before, during and after the Covid-19 crisis?

“We’ll treat you well” is Medcare’s promise, which is truly embedded in the organisation’s core values. With this in mind, Medcare’s vision to introduce home care services to enhance our patients’ journey and provide them with premium healthcare services at the convenience and comfort of their own home began in 2019.

The Covid-19 pandemic served as a catalyst to grow our home care service into an independent department offering an extensive range of home care services including laboratory sample collection, vaccination, nursing services, PCR swab collection, physiotherapy and GP consultations, all at a click away.

Beyond the impact of the pandemic, what are the other reasons that Medcare would want to offer home-based care?

Our home care department has achieved great success at making healthcare convenient over the last two years. As a result, Medcare has decided to expand the department and introduce new service lines to meet the growing need. Understanding the needs of our patients and their caregivers is essential. Our new services go beyond the needs of the patient, also addressing the needs of their caregivers as we recognise the burden and frustration associated with caring for a loved one without the correct knowledge and skill set.

We are proud to announce the launch of our post-operative, post-delivery and elderly home care services. We have equipped our nurses with adequate training to cater to the needs of new mothers and their babies, patients recovering from surgery and our elderly patients (whether they require assistance in their daily activities or are bed-ridden).

What challenges do home health providers face in today’s market?

Health is a delicate matter with a heavy reliance on confidence and trust in the provider. The provision of healthcare services in a patient’s home increases its sensitivity. As Dubai is a culturally colourful city, it is essential for the home care provider to understand and respect the diversity and cultural boundaries, as well as have interpersonal skills and consideration.

Other challenges include the limitation of medical device usage, family involvement, and the lack of patient and caregiver education.

Various health settings are increasingly looking to incorporate technology to enhance value and improve the patient experience at home. What role do you see technology playing for Medcare?

Digitalisation is the way forward. In this day and age, people understand the value of time, and technology has enabled us to cut a large amount of the unnecessary time wasted such as travel and waiting times. With the introduction of teleMEDCARE — our teleconsultation platform, patients are now able to connect to their doctor and carry out a consultation from the comfort of their own home.

Laboratory orders may be collected by the home care team, and medications prescribed delivered to the patients’ door step — providing a whole continuum of care from the patient’s home.

2020 was a hard year to say the least. What makes you hopeful about the home health and home-based care industry in 2022 and beyond?

Since 2020, we have carried out 22,000 home care services throughout Dubai. The last couple of years have been a learning curve for the world, and especially for the residents of Dubai who lead very busy lives.

As Covid-19 restrictions are easing and people are more comfortable to go out, our patient-base is no longer those anxious to go into a hospital setting, but rather those who have adapted to the time efficiency, convenience, and easy access to healthcare we provide them.

We aspire to understand our patients’ requirements and are taking the first step to fulfil them with the implementation of our new service lines.

Marwa Saffi Medcare
Marwa Saffi, Head of teleMEDCARE and Homecare Services Image Credit: Supplied

Dr Karima Kardi, General Practitioner, Medcare Hospitals

When we think of hospital-level care, we think it is care that requires specialised equipment, specialised technology, specialised training and staff. How do you actually make that happen in someone’s home?

Hospital-level care encompasses more than specialised equipment and technology, it depends heavily on specialised training and staff, and this is where we come in. Our team of home care experts are highly trained and can navigate this challenge with ease to help our patients.

A professionally trained doctor can deliver medical care to patients in their home in case of acute conditions; provide medical care for the elderly, or chronically ill patients. The doctor will give you more attention at home and medical assistance will be more accurate and precise because he/she knows about all your surroundings. The possibilities of getting infections will be less and will decrease the workload for the caretakers of the patient.

They also feel more freedom and are more exposed to medical assistance, as the doctor meets the patients directly at home, examines the health status and formulates a medication plan to maintain the best of health. Home visits also allow primary intervention to prevent disease or injury from occurring.

An important part of in-clinic or in-hospital care is asking the patient how they are feeling or observing their level of discomfort, and that happens when you see the patient personally. Can patient-reported outcomes and home monitoring devices adequately capture the patient’s health?

Patient-reported outcome measures and home monitoring devices are important in clinical practice. The growth of electronic health technologies provides unprecedented opportunities to systematically collect information via patient reported outcomes, improve data quality, result in similar or faster completion time, decrease costs, and facilitate clinical decision making and symptom management.

It helps us to monitor patient experience, and track the changes of symptoms. When patients were initially seen, we had multiple domains that were concerning, including pain, physical function, pain interference with their day-to-day life, and global health. Now we can receive multiple feedback that can allow us to asses and quantify our care decision.

How does the hospital address the problem of patients who are being monitored at home who require blood draws or other in-person services?

Depending on the individual requirements of the patient, a wide range of services can be arranged by the homecare team to be provided in the patients’ home including laboratory sample collection, nursing care, physiotherapy or vaccination.

What are the barriers you see to implementing home health services?

Barriers include unpleasant or occasionally dangerous situations, and restricted diagnostics options. Deficiency of supporting infrastructure, including life-sustaining and assistive durable medical equipment also makes it challenging to manage patients’ acute care needs at home.

Besides, lack of education of family members surrounding the patient for daily monitoring, or sanitisation because it reflects in the high levels of self-reported health and low levels of morbidity, mortality, and disability. Medicine is a clinical job that depends on a healthcare professional’s expertise with technology that increases the percentage of certainty of diagnosis and medical management.

Dr Karima Kardi, Medcare
Dr Karima Kardi, General Practitioner, Medcare Hospitals Image Credit: Supplied

Akanksha Dicholkar, Chief Nursing Officer, Medcare Hospitals

What does a typical day look like in the life of a home care nurse?

A nurse is an integral part of home care services and her day is dynamic and it is different from the hospital setting where you have almost set routines. Nurses working in the hospitals have scheduled, set assignments and they need to complete their tasks under the supervision of their head nurses or doctors.

Home care nurses start the day with certain unpredictability as the continuity of services is dependent on patients’ preferences vs care in traditional brick-and-mortar settings.

In the hospital they have support service available in the premises but in a home care setting there is no supply room, any technical support, required documents, office supplies, or health care items. So these nurses have to keep additional items in hand and many times their vehicle becomes their office.

As they are expected to deliver the nursing care, they are expected to connect with their assigned patients, provide the services they need, and maintain any relevant records.

Why do you think the role of a nurse is very crucial when it comes to offering home care services?

As they have to operate independently they need to be competent and skillful not only in providing nursing care to the patient but they need to have certain other qualities such as critical thinking, observational and problem-solving skills, communication skills and adoption to changes to provide top-quality care to their patients.

How nurses prioritise tasks while maintaining excellent patient care?

We orient our nurses to prioritise tasks for excellent patient care with the following:

Use of ABCs: They apply the concept of ABCs for each patient’s assessment to help them determine the immediate threats to life.

The ABC pneumonic stands for airway the priority, moving to breathing, and circulation.

Get basics right: During nursing care, nurses are focused on the basic needs when prioritising care. Physiological and safety needs are basic requirements for positive patient outcomes.

Use of nursing process: Nurses study the steps of nursing process during foundational nursing course and utilise it throughout their career for direct patient care to determine priorities based on clinical judgment.

What is the most difficult thing about being a nurse doing house calls? How can you overcome this difficulty?

Hazardous cConditions: Home health nurses have little control over the conditions of the homes they enter. This may include environmental hazards such as infection control, sanitation, and physical layout; challenges with caregiver communications and handoffs; lack of education and training for patients and family caregivers; and lack of continuous health monitoring. This can all put patient and home health nurse’s safety in jeopardy.

Upon receiving the call, we rigorously assess the required support and resources for the care. We have inclusion and exclusion criteria to assess the suitability of care as per our defined scope. Patient safety and staff safety is our priority so we ensure the safety of medical equipment and supplies used at home.

What technologies and services could change how home-based treatments and monitoring are delivered? What needs to happen to make the system more effective?

In delivering effective and efficient homecare, technology holds a central role. It enables remote patient monitoring and interventions in a patient’s home rather than increasing the expenses by keeping the patient in the hospital.

Home healthcare services that want to serve their patients better and stay competitive must adapt to the following technology trends:

Mobile health devices: Smart devices monitor the patient’s vital signs remotely in real-time and provide regular updates to the health care team. It can give the alert of early warning signs, which enables the team to ensure timely response to improve patient safety.

Electronic medical record: This gives a holistic view of the patient’s health to all the authorised healthcare professionals allowing them to concentrate on deeper analysis of patient data, especially when handling high-risk cases.

Telehealth: By using mobile apps or video conferencing, doctors and nurses are just a finger touch away. This avoids the traveling hassles, especially for elderly and bed ridden patients. It allows doctors to examine patients anywhere, anytime, and share the outcomes in real time.

Virtual reality: Virtual reality is now used for training healthcare professionals in a more realistic and low-risk environment. It also helps in building the age gap between young doctors and elderly patients. This way, medical professionals get a chance to increase their capabilities.