S'pore e-health records roadmap 'pragmatic'

Singapore and other Asian countries have ingredients for successful implementation of e-healthcare services, say executives from GE Healthcare.
Written by Vivian Yeo, Contributor

Singapore and some of its Asian peers stand in good stead for the successful implementation of e-healthcare initiatives such as electronic health records (EHR), according to executives from GE Healthcare.

Clarence Wu, vice president and general manager for GE Healthcare IT in the Asia-Pacific region, told ZDNet Asia healthcare regimes in the region tend to be less fragmented and governments are typically a "heavily involved" stakeholder.

In many instances, Wu said, the government forks out money for healthcare initiatives and, in turn, demands quality. As such, countries in the region may find it easier to achieve "successful implementation" in the drive toward e-healthcare, he said.

GE has partnered the Hong Kong Hospital Authority to image-enable its electronic medical records (EMR) system across public and private hospitals, as well as participated in South Korea's national healthcare information infrastructure project, he said.

Singapore's approach, in particular, has been a pragmatic one, Wu noted, adding that the local authorities' plans for an integrated national EHR system by 2014 encompasses a five- to 10-year blueprint that clearly spells out steps to achieve the vision.

"[The authorities] have said they don't want custom-built [systems but instead] they want mature, readily available solutions. That gives the project an increased chance of success," he said.

Singapore's healthcare sector, which includes public hospital clusters, private medical institutions, community hospitals and general practitioners (GPs), is governed by the Ministry of Health. Last year, the ministry announced through its corporate arm, the MOH Holdings, plans for the EHR, which would capture patient data in a single record and allow appropriate access by medical personnel from different entities.

In an e-mail interview, a spokesperson from MOH Holdings told ZDNet Asia the tender for the EHR system will be awarded at the end of next month. The EHR is scheduled to be ready by November 2010, with participation initially from a pool of medical entities, including public hospitals, community hospital and general practitioners. Private hospital networks will eventually be included "in the long run", the MOH Holdings spokesperson said.

The EHR, she explained, builds on the Electronic Medical Record Exchange initiative that enables public hospitals and community hospitals to view patient electronic medical records (EMR).

"The EHR system takes this [initiative] much further by letting healthcare providers' respective EMR systems be interoperable," she said. "More than the view-access to patient records, the standards-based approach of the EHR system will allow for the extraction of clinically relevant information from each patient's encounters at various healthcare settings, to form an integrated patient-centric EHR. Authorized clinicians and healthcare providers across the healthcare sector will have secure, real-time access to the EHR."

According to the spokesperson, data captured in the EHR system includes diagnoses, allergies, immunizations, current medication, investigations, procedures administered, referrals and care plans.

To establish safeguards against unauthorized access, the MOH is currently "defining a privacy and security framework" and working with Singapore's ICT regulator the Infocomm Development Authority and the Attorney General's Chambers to resolve issues, such as access levels and how data will be used. The authorities are also "looking into EHR legislation and the need for a regulatory or oversight body", she added.

Data challenges abound
According to Blair Butterfield, GE Healthcare's vice president of global market development for eHealth, the establishment of policies around data security and privacy remains one of the trickiest components of EHR planning.

Administrations that embark on such initiatives have to architect systems "in a way that data is secure, both in motion and in rest", Butterfield explained. That includes the ability to audit access to data and ensure the persons accessing the information "are who they say they are".

There are also softer issues to manage, such as assuring there is sufficient budget and gaining the consensus and willingness to collaborate, he said. In addition, it may not necessarily make sense to push the envelope by introducing new concepts or tools. He noted that better progress can sometimes be made by scaling back goals, or aligning them to be consistent with what other countries are doing.

A GE-sponsored whitepaper authored by Alex Kim, research director at IDC's Health Insights, offers the following advice to healthcare providers looking to invest in e-health services:

1. Plan big but start small.
2. Plan in advance and understand integration strategies.
3. Check readiness of organizations.
4. Get buy-in by clinical staff. Have a multidisciplinary team to evaluate products and services before deciding to go with a particular system.
5. Understand the budget. Factor in non-implementation costs such as maintenance.
6. Outline success factors and ROI metrics.

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