Holistic Healthcare with eHRSS

“Private hospitals in Hong Kong welcome the Electronic Health Record Sharing System (eHRSS) and can contribute towards building comprehensive records for patients through eHRSS participation.”

Dr Anthony Lee,
Chief Hospital Manager and Medical Director of the Union Hospital,
and Chairman of the Hong Kong Private Hospitals Association

With over two decades’ experience in heading a local private hospital, Dr Lee noted Hong Kong has a healthcare system in which the public and private sectors complement each other. While the majority of in-patient services are provided by public hospitals, the private sector is serving as a major provider for out-patient services.

“A lot of patients, especially those with chronic diseases requiring specialist care, are using both public and private healthcare services,” Dr Lee said.

He explained that as long-term specialist follow-up and medications in the public sector are more affordable, some patients of private hospitals, out of financial considerations, would request referrals to public hospitals. “This is patients’ choice and we respect it,” he said.

The public and private sectors collaborate to meet the demand for healthcare services

There are also patients who would come back to private hospitals for consultations with the specialists they are familiar with, he added. “This way, they have more confidence in the care they receive,” he remarked.

public and private healthcare services corss over

Patients with chronic disease requiring specialist care are more likely to use both public and private healthcare services

For example, about half of the specialist care patients at the Union Hospital are moving between the public and private sectors. “With patients’ consent, eHRSS has made possible the viewing and sharing of patients’ medical records among different doctors, be it public or private,” said Dr Lee.

“Doctors taking care of the patients are actually communicating through eHRSS, though in an indirect way. This is already a kind of public-private collaboration.”

eHRSS at Private Hospitals

At present, all of the 12 local private hospitals have already joined eHRSS. Dr Lee said patients are generally positive about the programme.

“Patients learn about eHRSS and can find relevant information from channels like promotion leaflets or TV broadcast. They understand that joining the system is for their own benefits. The registration process is also simple and fast,” he said.

As for private hospitals being healthcare providers (HCPs), Dr Lee observed that they are willing to share data but would progress at different paces.

“Some hospitals are more ready to fully take on the eHRSS modules for data sharing. Others that have long developed their own clinical management systems may need more time to resolve technical issues before data can be shared to the system.”

“For the latter, they can modify their systems to comply with the eHRSS configuration and this can be complemented with adaptation modules developed by the Government,” said Dr Lee.

Dr Lee observed that specialist doctors can also be a driving force for eHRSS usage at private hospitals.

“A lot of private specialists in Hong Kong used to work for the Hospital Authority and are familiar with electronic health record (eHR) sharing and the interface. They find the system helpful and this would constitute a demand. They may naturally refer patients to hospitals where the system is used more,” he said.

Dr Lee agreed that eHRSS can help raise the quality and standard of healthcare in the long run

Union Hospital’s eHR Experience

On developing eHR, Dr Lee said the Union Hospital has substantial experience and has put a great deal of resources into it.

“Our patient management system is able to capture a wide range of clinical information, including nurses’ observations, laboratory test results, imaging records, prescription and diagnoses.” he said.

“We have also built up case summaries of our patients. They are useful reference that can be shared through eHRSS when technically ready.”

To facilitate data entry by doctors, Dr Lee said the hospital has developed a mobile system whereby doctors can conveniently upload information or make changes by using mobile gadgets such as smart phones or tablets.

“For example, they can do it when reviewing patients’ conditions during an in-patient ward round,” he said, adding that plans have been made to scan all old paper records into digital records with automatic indexing.

Another eHR initiative is e-prescription. “We have been using e-prescription in our out-patient service. For in-patient, the service has just been rolled out at the children’s ward in July,” said Dr Lee.

Further Development and Challenges

Agreeing that eHRSS can help raise the quality and standard of healthcare in the long run, Dr Lee commented that the next step for eHRSS development should be the capability to upload radiological images.

“Specialist doctors prefer to view these images themselves. They have the specialised medical knowledge and do not want to solely rely on radiology reports in text format,” he explained.

Dr Lee admitted that promoting eHRSS participation among private doctors can be challenging, as they may have worries about sharing data.

“We need to educate doctors that for the well-being of patients, the more information the better. It helps doctors provide continuous and holistic care to their patients. At the end of the day, the ideal is to have an all-inclusive system of patient records,” he said.

“On the technical side, having more common modules can definitely help encourage doctors use the system,” he commented.