Hospital Health Check...Hong Kong Hospital Authority

By Medha Basu

Dr Cheung Wai-lun, Director (Cluster Services) of the Hong Kong Hospital Authority, talks about how digital patient records are helping the city’s hospitals.

Millions of patients go in and out of Hong Kong’s 42 public hospitals and 120 clinics every year. The government’s Hospital Authority manages healthcare delivery at all these institutions.

GI interviewed Dr Cheung Wai-lun, Director (Cluster Services), Hospital Authority, on the impact of digital patient records in Hong Kong and its plans to improve data sharing between hospitals.

To what extent have hospitals in Hong Kong adopted digital patient records?

The Hospital Authority (HA) has accorded priority and invested substantial resources in the application of information technology to enhance the efficient operation of public hospital services.

Since the HA was established in 1990, we have started to develop the clinical management system (CMS) as well as digitised patient records.

CMS is an electronic medical records management system tailor made by HA to meet the specific operational needs of Hong Kong public hospitals and clinics. With the system, healthcare professionals are able to quickly access a wide range of patient medical records, such as prescription history, laboratory reports, diagnostic radiology reports and digitised images. Using the CMS, public hospitals and clinics under HA also conveniently share patients’ electronic health records.

What benefits have hospitals seen from the digital records?

Over the years, we have witnessed that the digital medical records have greatly improved the efficiency and quality of care by providing healthcare providers timely access to comprehensive medical records and also minimising duplicated tests.

The digitised medical records also reduce medication errors and improve accuracy of diagnoses by providing a central database of patient’s medical history. Clinicians are benefited from avoiding the cost of storing and transferring medical records in paper form.

Furthermore, digital medical records enable the clinicians to share information, not only improving public-private collaboration but also accomplishing the concept of “records follow patients”, allowing patients to receive treatments in different hospitals or clinics conveniently. It facilitates patients to choose freely between public and private sectors without worrying about the transfer of medical records.
"It facilitates patients to choose freely between public and private sectors without worrying about the transfer of medical records."

How does the Hospital Authority work with private sector facilities?

HA launched the Public-Private Interface – Electronic Patient Record Sharing Pilot Project (PPI-ePR) in 2006. The project facilitates private healthcare professionals to gain access to the electronic health records kept under HA.

With the setup of the e-PR system, the HA is able to launch a series of Public-Private Partnership (PPP) Programmes to test the feasibility and acceptability of patient record sharing with the private sector. Over the past 10 years, the PPP Programmes have been providing more choices to patients, as well as contributing to the effective utilisation of resources by collaborating between the public and private service providers.

These PPP Programmes launched since 2008 include Cataract Surgeries Programme, Tin Shui Wai Primary Care Partnership Project, General Outpatient Clinic Public-Private Partnership, Haemodialysis Public-Private Partnership, Collaboration with Private Sector on Enhancing Radiological Investigation, etc.

Healthcare providers participating in these programmes will be able to enter clinical information and view patients’ medical records via the electronic platform, which has successfully proven the concepts and technologies of electronic patient record sharing.

How will the Authority improve data sharing across hospitals and clinics?

Following the successful trial run of the ePR system by HA, the Hong Kong SAR Government then initiated a project to develop a territory-wide Electronic Health Record Sharing System (eHRSS) to connect various healthcare providers in both public and private sectors since 2009. The vision is to have a centralised platform for sharing patient records between the public and private healthcare sectors in Hong Kong and the need to close the service gap. Acting as the technical agency of eHRSS, the HA is committed to developing the necessary data standards and infrastructure for the Project.

While the eHRSS system allows public and private healthcare providers to view and share patients’ medical records with their consent, it will also improve the quality and efficiency of patient care by providing healthcare professionals with authorised online access to comprehensive medical histories. It will reduce the possibility of duplicated tests or treatment, enable quality assured clinical practice as well as improvement in disease surveillance and monitoring of public health.

What were the biggest challenges for the electronic health records system?

Besides the usual technical issues, the main challenges in establishing this comprehensive platform is to ensure that security measures for this robust system are in place to protect data privacy. Another challenge is building sufficient expansion capacity as the volume of patient data and medical records stored is expected to grow significantly in the future.