The Healthcare Information and Management Systems Society (HIMSS), in conjunction with CHIK Services, organised AsiaPac08 at the Hong Kong Convention and Exhibition Centre, attended by more than 1,500 health information technology professionals. It offered healthcare IT leaders throughout the region valuable insights from their peers who have successfully advanced the delivery of healthcare through IT.
Highlights of the conference included illuminating keynotes by industry leaders on trends, practical application and management of healthcare IT in the region. Keynote speakers included Dr. York Chow, SBS, JP, Secretary of Food and Health, Government of the Hong Kong Special Administrative Region; Shane Solomon, Chief Executive, Hong Kong Hospital Authority (HA); Tan Sri Dato’ Dr. Abu Bakar Suleiman, President, International Medical University, Kuala Lumpur, Malaysia; and Dr. Andy Wiesenthal, Associate Executive Director for Clinical Information Support for The Permanente Federation, USA.
The conference included more than 50 education sessions and 50 exhibitors on the exhibit floor. In the 3-day conference, attendees had the opportunity to attend three keynote sessions, Thought Leader Sessions, education sessions and e-sessions covering four different tracks, clinical leadership and governance; ehealth; EHR, EMR, EPR, PHR; IT strategy and innovation.
During the conference, HIMSS joined the other individuals and corporations in helping the victims of the recent earthquake in China. “The tragic earthquake that hit Sichuan last week has deeply saddened everyone in the region,” said Steven Yeo, HIMSS Vice President and Executive Director, Asia Pacific, in a news release issued during the conference. “A disaster of this magnitude needs help from all corners of the world to provide assistance to the earthquake victims. HIMSS has donated US$ 10,000 to the Hong Kong Red Cross relief to help alleviate the suffering of the people in Sichuan.”
Dr. York Chow, SBS, JP, Secretary, Food and Health, Government of the Hong Kong Special Administrative Region and Shane Solomon, Chief Executive, Hong Kong Hospital Authority (HA) opened the conference with a welcome address. They expressed recognition of the transformation of healthcare delivery throughout the world with the adoption of health IT.
A physician who worked in the public hospital system for 30 years before becoming the Secretary for Food and Health in Hong Kong in 2004, Dr. Chow said that “four key factors in action” helped the Clinical Management System in Hong Kong succeed:
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Strong leadership
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It being a healthcare project, not an IT project
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It being a bottom-up process rather than top-down development process
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The Clinical Management System, which is designed, developed and implemented, through a close and seamless partnership, by a team of IT-minded clinicians and IT-experts with health informatics exposure.
“An electronic health system, with a population-wise and territory-wide electronic health record system at its core, is the vision that is being sought after most in health informatics,” said Dr. Chow in his opening keynote address. “It (the system) serves as a fundamental infrastructure underpinning healthcare transformation, removing the boundaries between different healthcare professionals who are providing different levels of care in different sectors, enabling them to work as a team to bring quality health care to patients. Building toward that vision is what you will see in this conference and exhibition.”
Mr. Shane Solomon of the Hong Kong Hospital Authority discussed the business value of the HA’s information technology system, which was rolled out in 1995 with direct clinician documentation and order entry. The HA operates 90% of the hospital beds in Hong Kong through 41 hospitals, and delivers 7.9 million specialist outpatient attendances each year and 4.8 million primary care clinic attendances with 122 clinic sites. This system is the only source of subsidised medications in Hong Kong.
In his presentation, Mr. Solomon noted that health IT has helped provide “universal access to hospital care at a very low cost to the patient and to society.” The HA is 95% dependent on government funding, but still delivers universal access to healthcare and a GDP spending on public healthcare of 2.8%.” In addition, the HA IT system is home-grown with an annual cost to the HA system of 1.96% of its total annual expenditure.
While these figures present the quantitative overview of the Hong Kong Hospital Authority, Mr. Solomon noted that “there is more that IT will do to transform healthcare.” He suggested a co-production approach to healthcare, where “you should not only be able to read your own health record, but you will contribute to creating it. I can envision patients monitoring their vital signs at home, such as their blood pressure, weight, and blood glucose levels, entering this information into their own health record, where it will be graphed, with information about what action needs to be taken by the patient if it is outside the normal range.”
Borrowing a business strategy from the Toyota Production System (TPS), two presenters offered case studies from Alexandra Hospital in Singapore that used the Toyota approach, which says that:
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the customer is the heart of the organisation’s
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the organisation continuously reflects and learns.
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the organisation sees processes end-to-end and removes silos.
Dr. Tan Yung Ming, Product Development Manager, Health Group, Singapore, and Chew Kwee Tiang, Chief Operating Officer, Alexandra
Hospital presented “Lean Healthcare IT systems: The Toyota Way” and demonstrated how this approach can be transferred to healthcare organisations. They shared how the hospital used this philosophy in reviewing and revamping the hospital websites, its health screening service and the development of the IT system.
For example, healthcare processes are often complex and not streamlined. Thus, they explained, an EHR system implementation and development can be challenging because applying technology over inefficient processes can amplify underlying problems and lead to project failures.
“TPS principles can be used to analyse and streamline these processes before any system is designed or implemented. By studying all processes end-to-end, the goal is to create a continuous flow so that any hidden issues can surface.”
Interoperability in healthcare became a universal focus of the conference, with presenters discussing how sharing of patient health information through technology can improve healthcare delivery and reduce medical errors. One speaker who provided an update on global health IT standards was Dr. Yun Sik Kwak, Medical Informatics, Kyungpook, National University, Republic of Korea.
As Chair, HL7 Korea, Dr. Kwak discussed, in one session, various HL7 standards, such as V2.X and V3 that have been introduced to help establish integrated and connected health information systems. Dr. Kwak is also the Chair, ISO/TC215, Health Informatics, (Republic of Korea). He, with Audrey Dickerson, Secretary, ISO/TC215 Health Informatics (USA), and Manager, Standards Initiatives, HIMSS, presented current developments for health IT standards by ISO/TC215, Health Informatics. Both HL7 and ISO are separate but collaborative standards development organisations (SDOs) that recognise that developing countries depend on standardisation for some of their IT infrastructure in hospitals and in their clinics, for health IT systems and devices. In addition, telemedicine has been used as a consultant network in some countries, especially China, where the network is advanced to assist local doctors with diagnosis.
“International standards are used locally for the betterment of patient care,” said Dr. Kwak. “It is important for developing countries to see what works in other countries so that they may try to implement the same types of technology in their own healthcare setting. These countries have completed their initial work in health IT that is good for patient care.”
Don Newsham, Co-Chair WG9 and CEO, ISO-TC215 and COACH, Canada, and Elizabeth Hanley, Senior Project Manager, Human Services, Standards Australia, Australia, discussed “Navigating the Sea of E – Health Standards
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