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| HA helps Hong Kong achieve territory-wide
"one patient, one medical record" |
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At present, it is not uncommon for one patient to seek medical
care in both private and public sectors, thus have several medical
records, each of which is kept by a different healthcare provider in a
different location and in a different format.
Obviously, a patient is more likely to receive better care if all the
information contained in these records is accessible to all medical
professionals who are treating him or her at different times.
This is the logic behind the concepts of "one patient, one medical
record" and "records follow patients". Now, with the HA's assistance,
the government is working to turn them into reality by developing a
territory-wide patient-oriented electronic health record (eHR) sharing
system that will link medical records being kept in the public and
private sectors. It will also play a key role in the government's
important healthcare reform agenda. |
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| In this article, Dr NT Cheung,
Chief Medical Informatics
Officer-cum-Consultant
(eHealth) of the Food and
Health Bureau (FHB), and
Dr KM Choy, Chief Manager
(Service Transformation),
who is also on secondment
to the FHB as Consultant
(Public-Private-Partnership), tell HASLink about how
they and their colleagues are supporting this goal. |
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| Building on the success of CMS |
Funding to develop the first stage of the eHR sharing system was
approved by the Legco Finance Committee in July this year, and the
eHR Record Office (eHR Office) has since been set up under the
FHB to co-ordinate this complex and multi-faceted programme.
Although the eHR system is a ground-breaking concept, it is
not being built from scratch. In fact, the HA's own home-grown
computerised patient records system, the Clinical Management
System (CMS), has been making it possible for public hospitals to
share electronic patient records since as long ago as 2000. It is Hong
Kong's largest integrated electronic medical/patient record system,
and it now contains nine million patient records.
Community-wide platform for health data sharing
The government is therefore leveraging on the HA's invaluable
expertise to extend the CMS to the private sector. That is why our
IT Services have been given the very important mission of providing
technical support to the eHR Office.
According to Dr Cheung, the HA's major role in this 10-year
programme is to use its knowledge and experience of developing
clinical IT systems to help the private sector in the areas of
standardisation and interfacing. And Dr Cheung and his team will
also be helping to make the CMS an integral part of a community-wide
electronic health data sharing platform by developing a new
version of it — CMS Phase III.
Needless to say, this is an extremely talent-intensive programme,
and Dr Cheung is busily recruiting technical staff at the moment. Up
to 300 health informatics and IT professionals will be working on it
during its various development stages.
Key tool for public-private partnerships
Apart from further developing the CMS, the HA is also building the
Public-Private Interface – Electronic Patient Record Sharing Pilot
Project (PPI-ePR). Launched more than three years ago by the HA,
this project now links 12 private hospitals, over 70,000 patients and
over 1,400 private and NGO healthcare professionals with access
to the HA's CMS. This is further solid proof of the feasibility and
acceptability of eHR sharing. The PPI-ePR also allows private
healthcare practitioners who participate in the HA's public-private
partnership (PPP) projects to access its patient records, subject
to the patient's consent. They will also use it to input key clinical
information about the patient into the HA's patient record database,
so that the HA can track clinical outcomes and monitor the patient's
status. It will also help to ensure that the patient receives ongoing
care if he or she seeks a consultation at a public general outpatient
clinic in the future.
So far, the HA has launched
two PPPs, the Cataract
Surgeries Programme and
the Tin Shui Wai Primary Care
Partnership Project, in February
and June 2008 respectively. Dr
Choy says both programmes
are running smoothly and
effectively. Overall, an average
of two to three thousand new
patients are joining PPI-ePR
every month.
Starting next year, the HA will offer more choices to patients by
developing other PPPs. For example, one of them will purchase
haemodialysis services from private or NGO-managed centres for
40 end-stage renal disease patients who are currently receiving
treatment at HA centres.
Improved diagnosis and treatment
"PPI-ePR will continue to evolve, and it will form an essential
building block for future eHR sharing infrastructure. However,
eHR is much more than just an IT innovation. Information is not
shared automatically. It only takes place if the patient agrees. But
the patient will benefit at the end of the day, because it will result
in more timely, accurate and reliable diagnosis and treatment," Dr
Choy adds.
As you would expect, a project as large as eHR requires the support
and commitment of many different parties. They include private
healthcare and IT service providers and other stakeholders in the
community, as well as the general public. Nonetheless, Dr Cheung
and Dr Choy are both confident that eHR – as well as the "one
patient, one medical record" and "records follow patients" concepts
– will be well received.  |
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Dr NT Cheung (left)
and Dr KM Choy. |
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