Cloud-hosted electronic medical records lead to improved patient care

Since 2011, Singapore has been working towards a “One Patient, One Health Record” system.

The public healthcare system consists of the National Electronic Health Records (NEHR), a repository that manages patient’s summary health record centrally, and the Next Generation Electronic Medical Record (NGEMR) at hospital level.

Powered by Epic, NGEMR is one of the major healthcare programmes by national health tech agency, Synapxe.

Epic is a critical part of a hospital’s workflow: administering day-to-day operations, patient admissions, vital sign recordings, recording clinical notes, drug prescriptions, and many more.

The ability of healthcare systems to provide a holistic picture of patients’ healthcare history across different settings can deliver better outcomes and patient-centric integrated care, according to Synapxe’s website.

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EMR on the cloud

Traditionally, Epic applications are hosted on-premise in data centers in most countries.

As part of their healthcare transformation, Canadian counterpart, Scarborough Health Network (SHN) have chosen to deploy Epic on their Amazon Web Services (AWS) cloud since 2021.

As a result, it has consolidated 14 different clinical information systems across its seven regional hospitals.

Beyond receiving access to cloud storage, hosting Epic on the AWS cloud allows healthcare providers to tap on AWS’ analytics and scaling capabilities to add value to their data.

The Canadian healthcare provider was among the first in the country to tap on cloud capabilities for real-time data storage as well as for back-up and disaster recovery.

SHN’s Chief Data Officer, Andrew Kelly, shared more about the benefits the agency has seen since adopting Epic on the AWS cloud. He also shared the key ways Epic has enabled population health efforts in the region.

Scale, speed and savings

The ability to scale, speed of deployment, and savings were among key reasons cited by Kelly in hosting SHN Epic system on AWS.

In terms of scale, he observed an uptake of data analytics tools since moving Epic to the AWS cloud. The ability to utilise real-time data and run algorithms on these datasets has improved the quality of care delivered to patients, he said.

The network has seen a dramatic decrease in the lag time of using data to inform decision making, he explained.

Prior to hosting Epic on AWS, SHN had to wait for two to four months for data to be coded and reported. Currently, immediate access to datasets and insights enables them to act on a daily or weekly basis.

Epic is also integrated with medical devices used in healthcare institutions, so clinicians can access the data directly and run the analyses immediately.

Better patient outcomes measured include a stronger referral network, decreased duplicated tests, increased visibility into individual patient care, and increased communication between clinicians on patient care, he said.

Time is a crucial factor in healthcare, and using EPIC on AWS cloud made it possible for SHN to migrate the data and build a secondary data center for backup and disaster recovery purposes.

Kelly also observed “substantive” cost savings when his organisation migrated from a traditional data centre to the cloud.

“At the beginning, we had to over-provision (data centre compute). We were able to scale that down with Epic, and that helped us manage costs appropriately and provide the right performance for the environment,” he added.

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Scaling innovations to the population health level

SHN serves a patient population of up to 1.6 million. Using Epic on AWS has given the organisation an opportunity to not only implement best practices in one team, but standardise them across other teams, said Kelly.

He shared the example of the Congestive Heart Failure (CHF) team that implemented a specific programme and replicated it across other departments.

Epic on AWS has enabled SHN to build on evidence-based best practices, including clinical processes, data management and outcomes tracking, said Kelly.

SHN is amidst discussions with Epic and AWS to explore new opportunities to use artificial intelligence (AI) models to enhance both its operational and clinical efficiency.

“Break the mold with the use of cloud,” said Kelly. He advised other healthcare providers to not think about cloud as simply replacing traditional data centres, but to take advantage of unique cloud-based capabilities, such as analytics and AI.

“The way we use the cloud has allowed us to move quickly – much quicker than many would have expected – and we have reaped the benefits of it by being at the frontend of innovation and the partners we have selected, specifically with AWS,” he said.

He explained that AWS was also able to tailor the application for them, which they were not able to do with the traditional data center environment.

The benefits become substantial over time, he added, as the ability to customise enables healthcare providers to refresh the architecture and tap into the latest technologies.

Aside from having a “strong partner” during and after the implementation, his other advice is to start small. For SHN, they did not start with mission-critical applications but basic EHR storage to grow the team’s confidence in the software.

Given the benefits of enhanced security, reduced downtime and improved resiliency, running EMR on AWS emerges as a compelling solution for healthcare organisations seeking to accelerate their digital transformation.

Find out more about how AWS has been transforming health systems globally by watching this video presentation from last year's AWS Public Sector Day Singapore >>>

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