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Financing model needed to push EMR adoption

A financing framework is needed to drive the adoption of electronic medical records among clinics and other step-down healthcare facilities such as nursing homes and rehabilitation centers.
Written by Eileen Yu, Senior Contributing Editor

SINGAPORE--A financing model must be established to encourage clinics and other step-down healthcare facilities, such as nursing homes and rehabilitation centers, to adopt electronic medical records (EMR).

Singapore, for instance, began its EMR efforts in 2008 and also rolled out an integrated clinic management system to help general practitioners (GPs) e-enable their work and better manage patient records.

However, while larger medical entities including hospitals have hopped on the bandwagon, pockets of healthcare service providers have yet to embrace the digital route and still rely on paper-based patient records.

"Cost is holding them back," said Chong Yoke Sin, CEO of Integrated Health Information Systems (IHIS), who noted the need for a financing model to help these healthcare providers adopt EMR.

She explained that step-down facilities such as nursing homes, rehabilitation centers and hospices often rely on charity funds to support their operations and would rather invest in initiatives that directly benefit healthcare, than on ICT deployments.

The government does play an important role here but there also needs to be a national healthcare infrastructure that caters to all segments of healthcare providers, including these step-down facilities and smaller clinics, Chong said.

She called for the establishment of a financing model, pointing to efforts by organizations such as HIMSS (Healthcare Information and Management Systems Society) to help demonstrate, for instance, how healthcare service providers can achieve economies of scale by adopting ICT.

Chong was speaking to ZDNet Asia on the sidelines of a media briefing held here Tuesday at the HIMSS Asia-Pacific conference and exhibition. A not-for-profit organization founded in 1961, HIMSS aims to encourage the adoption of ICT to improve healthcare. It has over 47,000 individual members worldwide including Asia, the United States and Europe.

HIMSS establishes APAC governing council
HIMSS today also unveiled its new Asia-Pacific Governing Council, chaired by Chong, and includes nine other members including Wong Chun Por, president eHealth Consortium and of Hong Kong Hospital Authority, and Hsu Chien Yeh, professor and director at Taipei Medical University in Taiwan.

Following the ethos of its governing councils in the U.S. and Europe, the Asia-Pacific team will drive the HIMSS policies and procedures as well as the adoption of ICT to improve healthcare in this region.

Chong said: "Although Asia-Pacific as a whole is very diverse, our healthcare systems share and face many similar challenges in our own countries. Asia-Pacific has a growing population and we are also ageing rapidly, particularly with increasing life expectancy. Many healthcare facilities are seeking quality care with better utilization of manpower.

"As we plan to deal with these healthcare challenges, IT will play a profound and important role in shaping the future of healthcare services," she noted. "There are many winning best practices on healthcare IT and we all need a platform to learn from each other to improve patient care."

The HIMSS Asia-Pacific Governing Council aims to address issues such as patient engagement, improving physician workflow efficiency, patient safety and overall quality of care, she added.

Efforts it will embark on include a dialogue series which will be held in Shanghai and Seoul in November, as well as New Delhi in February 2013, as well as the HIMSS AsiaPac13 to be held September 2013 in Hong Kong which will focus on China's healthcare issues.

Elaborating on the need for a regional governing council, HIMSS President and CEO Stephen Lieber said the creation of a "dedicated and committed" group of industry experts will help drive the use of healthcare information technologies and management systems.

"In addition to providing strategic guidance, these councils [including the U.S. and Europe] also help develop strategies for growth, provide content expertise, assist in efforts to grow membership, and help identify key subjects, partners and speakers for education programmes," added Leiber who was also at the briefing and a member of the Asia-Pacific council.

Role of ICT in healthcare
During his opening address at the HIMSS conference, Singapore's Minister of Health Gan Kim Yong highlighted the need to reexamine how healthcare services are organized and delivered.

With a rapidly ageing population, where 1 in 5 residents here will be 65 years and above by 2030, effective management of chronic diseases is increasingly important and will require new models of care, Gan said.

He stressed the need for healthcare providers including acute hospitals, community hospitals, specialist centers, polyclinics, GPs and nursing home to be connected, so the right information and decisions can be made by any clinician, and at any point, in the patient's care continuum.

"Healthcare information must be current and complete to be useful," he said. "It is our aim that both the private healthcare and public healthcare sectors have their records linked together to facilitate referral and transfer of medication information."

Singapore's national EMR system aims to "connect the dots" among public and private healthcare services to enable a complete medical record of the patient, he added.

"Having a clinical repository of information for every patient is but only a first step to achieving better care for patients. What is more important is how we can use that information to preempt adverse medical conditions and deterioration in the condition of the patient.

"The rapidly growing field of healthcare informatics requires close collaboration between the healthcare practitioners and IT professionals," Gan noted, pointing to the Centre for Health Informatics (CHI) as an example of a government-funded effort to help train IT professionals for a career in healthcare informatics.

An institute under the School of Computing at the National University of Singapore, the CHI is funded by ICT regulator, Infocomm Development Authority of Singapore, and also trains healthcare professionals in ICT.

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