Leveraging eHRSS to Improve the Health of the Community

“In the long run, the Electronic Health Record Sharing System (eHRSS) should be more than a platform for medical records sharing. As its name suggests, the scope of eHRSS could cover ‘health’ records in addition to ‘disease’ records. With increasing participation and data volume, we can leverage the breadth and depth of the data in the system to support the formulation of healthcare policies and initiatives to facilitate disease prevention and health promotion,” said Dr Kwong.

Dr Heston Kwong, JP
Head, Emergency Response and Information Branch
Centre for Health Protection, Department of Health

Dr Kwong, a member of the Steering Committee (SC) on Electronic Health Record (eHR) Sharing and Working Group (WG) on eHR Partnership, saw huge potential in eHRSS. He said the system can bring great benefits to the community when the information contained becomes more comprehensive and representative as more healthcare providers (HCPs) and patients join.

He said the Department of Health (DH), being the Government’s health adviser and agency for executing health policies and statutory functions, looks forward to leveraging the wealth of data in eHRSS, both clinical and social, for analysis.

“Our work is not just about treating patients. We also help safeguard the health of the public through disease prevention and health promotion,” he explained.

“By social information, we mean family history, dietary habit or lifestyle such as exercise pattern, smoking and drinking behaviour, etc,” said Dr Kwong.

Dr Kwong saw huge potential in eHRSS and the benefits to the community

“For example, we can analyse the social information to identify the risk factors of certain diseases or the health needs of different age groups,” he said, adding that the information can potentially be collected from data contributed by patients to the future Patient Portal, a major initiative of Stage Two eHRSS Development.

leveraging the wealth of data in eHRSS for analysis

DH looks forward to leveraging the wealth of data in eHRSS, both clinical and social, for analysis

“We can also educate the public through the Patient Portal by disseminating targeted health information according to their needs based on individual health conditions and profiles.”

Utilisation of eHRSS across DH Services

“At present, eHRSS is used by all 14 clinical services of DH to varying degrees, covering some 170 service units,” Dr Kwong stated.

Six of them, namely, Antenatal Service, Families Clinics, Dental Service, Clinical Genetic Service, Social Hygiene Service and Special Preventive Programme, involving about 70 clinic locations, are already capable of two-way communication with eHRSS via the department’s Clinical Information Management System (CIMS).

As a major provider of childhood immunisation in Hong Kong, DH is also contributing massive immunisation records to eHRSS, mainly from its 30 Maternal and Child Health Centres, 15 centres under Student Health Service and the School Immunisation Teams. For the remaining service units, eHRSS is being utilised by their healthcare professionals (HCProfs) for accessing eHRs of participating patients to support the delivery of day-to-day healthcare services.

“With the target completion of phase two enhancement of our CIMS in about six years’ time, we are confident that all service units can achieve two-way sharing with eHRSS,” Dr Kwong remarked.

Dual-role in eHR Programme

Elaborating on DH’s involvement in eHRSS, Dr Kwong said DH has a dual role here, as a supporter and as a participant.

DH has a dual role in eHR Programme

“We have been actively supporting the planning, development and implementation of eHRSS, being involved in different levels of the governance structure. In addition to SC and WGs, we are also participating in the Coordinating Group on eHR Content & Information Standards and various Domain Groups. Our Drug Office also provides support to the drawing up and on-going maintenance of the Hong Kong Medical Terminology Table which is now used by eHRSS,” he said.

“As the secretariat of healthcare professional boards and councils, DH has assisted in setting up the Common Professional List for professional status verification for eHRSS participating HCProfs. eHR Registration Centres have also been set up at around 20 DH clinics to facilitate patient registration,” Dr Kwong added.

On the other hand, as a major public HCP, DH has joined eHRSS right from the beginning. It is now sharing medical records of some 100 000 healthcare recipients (HCRs). So far more than 1.4 million records, ranging from laboratory results, allergy, adverse drug reactions to diagnosis, etc. have been uploaded to the system. eHR access by DH’s HCProfs has accumulated to about 37 000 times.

IT Enhancement in Synergy with eHRSS

According to Dr Kwong, eHRSS has also catalysed the information technology (IT) development of DH. “We have built our CIMS to tie in with the development of eHRSS and devoted a lot of efforts to enhance our CIMS in order to share data.”

DH has recently obtained funding support from the Legislative Council for taking forward its departmental IT enhancement project. A key objective of the project is to transform DH into a data-driven organisation through infrastructure upgrade, business process enhancement and building up capability in data analytics. To this end, CIMS will be enhanced into an integrated system for storing eHRs of patients in DH and fully interfaced with eHRSS.

CIMS will be fully compatible with eHRSS. This 2 like gears

CIMS will be fully compatible with eHRSS and can accommodate initiatives of future eHRSS development such as capturing and sharing radiological images

Dr Kwong highlighted, “by then our CIMS will be fully compatible with eHRSS and can accommodate initiatives of future eHRSS development such as capturing and sharing radiological images.”

Dr Kwong believed that participation by both HCRs and HCPs is the key success factor of future eHRSS development

Challenges in Future eHRSS Development

Turning to eHRSS’ coming development, Dr Kwong believed that participation by both HCRs and HCPs is the key success factor.

“With increasing participation, more comprehensive and representative information will be available in the system,” he said, stressing the need to drive further participation by private HCPs in particular.

Another challenge is about data security, he remarked, “the Patient Portal can be a motivating factor for HCRs to join eHRSS, but they need to be assured of data privacy.”

As Dr Kwong concluded, “Since the launch of eHRSS two years ago, we see more and more service recipients of DH joining the system. And the more our HCProfs get acquainted with the use of eHRSS, the more they appreciate the values of eHR sharing. Coupled with the enhancement of CIMS and eHRSS’ upcoming development, I believe that greater synergy can be achieved and the benefits of eHR sharing can be fully realised in the long run.”