eHRSS: The New World of Healthcare

As Hong Kong enters the age of healthcare delivery with the launch of the Electronic Health Record Sharing System (eHRSS), Dr Ko Wing-man, Secretary for Food and Health, said the new system can bring about broad and long-term benefits to society.

Dr Ko Wing-man
Secretary for Food and Health

The eHRSS Vision

The Government put forward the idea to develop a territory-wide patient-oriented eHRSS in the Healthcare Reform Consultation Document “Your Health, Your Life”, published in March 2008. Dr Ko said the concept, among other service reform proposals, received broad support from the community during the consultation.

“The public welcome the eHRSS which will be an essential infrastructure facilitating public private sector collaboration in healthcare provision.”

In July 2009, the Finance Committee of Legislative Council approved a new commitment of HK$702 million for implementing the first stage of the Electronic Health Record (eHR) Programme starting from 2009-10. The Food and Health Bureau (FHB) set up the Electronic Health Record Office (eHR Office) in the same year to take forward the complex and multi-faceted eHR development.

The necessary preparatory work to develop eHRSS requires the early engagement of stakeholders. Back in July 2007, the Government appointed the Steering Committee on eHR Sharing (the Steering Committee). Comprising healthcare professionals from both the public and private sectors, the Steering Committee serves to enhance the progress and development of the eHRSS over all these years, while serving as a communication bridge between the FHB and the healthcare sectors.

“The work carried forward over the years reflects that the eHRSS has been built upon a consensus on key issues reached among healthcare professionals from both the public and private sectors in the Steering Committee,” said Dr Ko.

Better and More Comprehensive Healthcare Service

With the implementation of the eHRSS, Dr Ko said integrated care can be achieved by medical record sharing, adding that it will in particular benefit our senior citizens, children and persons who frequently use both public and private healthcare services.

In explaining, he said apart from the records kept in the Hospital Authority, currently quite a lot of healthcare data in Hong Kong is created and kept by different healthcare providers (HCPs) at different locations using different formats.

“While some HCPs may deploy electronic medical/patient record systems to store and retrieve medical/patient data, such systems are generally not capable of data sharing at any large scale, if at all,” he added.

“Through developing a territory-wide patient-oriented system operated with patients’ consent, the eHRSS will greatly facilitate continuity of care, and allow better integration of different healthcare services to bring about benefits for individual patients,” he elaborated.

Benefits of the eHRSS

Underscoring the benefits of the eHRSS, Dr Ko said they can be reflected in three different dimensions.

“For patients, the system can maintain comprehensive online records for HCPs, allowing timely and accurate information required for healthcare delivery. It also minimises the need for patients to undergo duplicated tests and treatment procedures,” Dr Ko said.

“On the clinical side, HCPs will be able to make use of the eHRSS as an aid in their diagnosis and deliver efficient and quality assured clinical practice to their patients, thereby reducing errors associated with paper records,” he added.

“For the community, what we will see is overall improvement in the quality of services. The new eHRSS will also be conducive to disease surveillance and public health monitoring. By gathering more comprehensive statistics, we can generate reliable statistics supporting the formulation of public health policy,” he remarked.

Bringing the Public and Private Sectors Closer

The benefits of the eHRSS are obvious and participation is entirely voluntary. The eHRSS will support the sharing of participating patients’ health data by authorised HCPs in both the public and private healthcare sectors.

“Through timely sharing, different HCPs can provide collaborative patient-centred care more efficiently and in a seamless manner, and patients will be able to experience the convenience of eHR sharing”, Dr Ko said.

As the essential platform supporting the sharing of patients’ clinical information among healthcare providers in the public and private sectors, eHRSS will become an integral part of various healthcare public private partnership (PPP) programmes. The government has been proactively promoting public private partnership in the provision of healthcare services, such as the General Out-patient Clinic PPP Programme. The Secretary called for early registration of healthcare providers and citizens. “Registration is easy and our colleagues are ready to assist,” he added.

Privacy and Data Security of Utmost Importance

Dr Ko emphasised that the Administration well understood the concern about privacy and data security of patients. “Citizens will not join a scheme sharing their information if they think it is not secured. The best way to encourage participation is to build up their confidence. So what have we done? First, we spent efforts on engagement, promotion and publicity. Second, we deployed appropriate technology to safeguard system security. Third, we prepared specific legislation to provide robust legal protection for the privacy and confidentiality of patient information.”

To safeguard system security, participating healthcare providers have to install secured communication module to connect to eHRSS. The eHRSS Ordinance, governing the sharing, use, and protection of information and data in eHRSS, also comes in operation in December 2015.

“Specifically, for a healthcare professional of a participating HCP to view a patient’s record, he has to be properly authorised and need to follow the requirements as set out in the eHRSS Ordinance, the Code of Practice and be in line with “patient-under-care” and “need-to-know” principles,” he added.

Principles to safeguard data privacy and system security are adopted in the development of the eHRSS

Ready for Launch

With the satisfactory completion of preparation work, Dr Ko is confident that the launch of eHRSS in March 2016 will be a success. “I am much delighted that all private hospitals, which are the key stakeholders contributing important clinical information of patients, have registered to join eHRSS,” Dr Ko said. Representatives of private hospitals were invited to officiate at the launching ceremony held on 7 March 2016.

Dr Ko called on other healthcare providers such as solo practitioners to also join the eHRSS. He also said the support of healthcare professionals (HCProfs) who are main users of the system, will be crucial.

“As the Secretary for Food and Health and as a doctor, I honestly believe that individual doctors and patients will benefit from joining the eHRSS,” he said.

Continued Development of the eHRSS

Upon the launch of the eHRSS, preparation for stage two of the eHRSS development programme will commence. The second stage will explore the expansion of the sharable scope of data to include radiological images and other health-related information. Facilitation for patients to access their eHR more conveniently will also be studied.

With increasing public acceptance on Chinese medicine and integrated care, Dr Ko said the Government will, on the foundation of Chinese medicine data standards framework, promote the use of clinical management system suitable for Chinese medicine clinics, assess the feasibility and conduct studies on the sharing of Chinese Medicine data. “We may also implement pilot projects for testing various concepts,” he added.

Recognising the rising aspiration on access to citizens’ own health records, Dr Ko said the Government will also look into different design options and assess their technical and security implications to facilitate patients to more conveniently access their data, for example setting up a “Patient Portal”.

“We have also planned to conduct a study on additional access control for sensitive data. Reference will be made to overseas practice and experience,” he added.

When asked about whether the political sentiment may affect the implementation schedule of Stage 2, Dr Ko said, “Stage two eHRSS bring further benefits to our citizens. I sincerely hope our Legislators will support our funding proposal.”

Principles to safeguard data privacy and system security are adopted in the development of the eHRSS