eHR is an electronic record containing health data of an individual. With the express and informed consent of the patient, a patient’s eHR, stored in a centralised eHR sharing system, can be shared among different healthcare providers for the continuity of care to the patient. The data stored in an eHR comprises–

1. personal particulars for identification and contact (e.g. name, identification, date of birth, contacts, etc.);
2. health data, e.g. weight, height, blood type, vaccination records, and drug allergies; and
3. medical data, e.g. diagnosis, prescriptions, laboratory test results, radiological images, and discharge summaries.

Presently in Hong Kong, health-related and medical data are usually created and kept by different healthcare providers (or sometimes by individual patients) at different locations in different formats, e.g. at doctors’ clinics and separately at hospitals. With the major exception of the Hospital Authority (HA), such data are usually kept in paper form by most healthcare providers, and while some healthcare providers may deploy electronic patient/medical record systems to store and retrieve such data, such systems are generally not capable of data sharing at any large scale if at all.

The eHR sharing system brings the following benefits –

For clinicians, eHR will improve availability and transparency of information shared between healthcare providers in both the public and private sectors. Healthcare providers will be able to assess the right information at the right time. This will allow healthcare providers to improve the efficiency of their healthcare interventions and reduce the number of consultations that is necessary in order to achieve the desired outcome. Associated efficiency gains will be realised in avoiding the need to store, collage and transfer paper records. Record transportation costs will also be avoided.

For patients, eHR will enhance the quality of care provided to patients by enabling better access by healthcare providers to acquire health information. The healthcare quality benefits will be delivered specifically by – (i) reducing the frequency and scale of medication errors; (ii) providing more efficient and a more effective use of diagnostic tests; (iii) increasing the speed of treatment, for example by eliminating repeated tests or information requests from a patient; and (iv) improving the accuracy of diagnosis and patient management through clinical decision support.

For the healthcare system as a whole, the sharing system minimizes duplicate investigations and errors associated with paper records, achieves more efficient and better quality healthcare and enables disease surveillance and health statistics for public health and policy making.

The Government will take a leading role at the formative stage, and deploy dedicated staffing and funding resources to spearhead and co-ordinate the eHR programme on a continuous basis. At the same time, the Government will leverage the successful experience and the invaluable expertise accumulated in the public sector, in particular the HA in developing its Clinical Management System, and make available HA’s system and know-how to the private sector for developing electronic medical/patient record systems that are interoperable with the eHR sharing system.

The 10-year eHR Programme, straddling from 2009-10 to 2018-19, will cost HK$1,124 million. The first phase of the eHR programme covering the period from 2009-10 to 2013-14 requires a capital cost of some HK$702 million.

Our target is to have the eHR sharing system ready by 2013-14 for connection with all public and private hospitals, and to make available electronic medical/patient record system or other health information systems for private healthcare providers to connect to this platform. Prior to the commissioning of the system, we will formulate a legal framework for the eHR sharing system to protect data privacy and security.

After the commissioning of the eHR sharing system in 2013-14, patients and healthcare providers may voluntarily participate in eHR sharing. Prior to that, the Government and HA have launched the Public-Private Interface – Electronic Patient Record Sharing Pilot Project (PPI-ePR) since April 2006 to enable participating private healthcare providers to view patients’ medical records kept at HA hospitals, subjects to the patients' consent. You can gain some of the benefits of eHR sharing by joining PPI-ePR. More information of the PPI-ePR pilot project can be found at the website (http://www3.ha.org.hk/ppp/text/ppiepr_a.aspx?lang=eng)

Protection of patient data privacy and security is of paramount importance in developing the eHR sharing system. In addition to the protection currently provided under the Personal Data (Privacy) Ordinance (Cap.486), the eHR Office will formulate a long-term legal framework to safeguard the privacy and security of the eHR sharing system and its data. We will consult the relevant professions, stakeholders and the public in 2011 in this regard. In addition, we will commission a Privacy Impact Assessment and a Privacy Compliance Audit, as well as Security Risk Assessments and Security Audits to ensure the eHR sharing system provides a comprehensive protection to data privacy and system security.

The engagement and participation of all stakeholders in the private and non-governmental sectors are essential to building up a territory-wide patient-oriented eHR sharing system. Given the importance, the eHR Office launches the eHR Engagement Initiative (EEI) invitation exercise to invite private healthcare and IT sectors to submit proposals on their engagement in the development of the eHR sharing system.

To facilitate investment in and development of eHR-sharing-ready systems in the private sector, the Government will consider in-kind technical support (both tangible and intangible including intellectual property rights) and financial sponsorship to the private healthcare and IT sectors.

The eHR Office launched the first stage EEI invitation in October 2009 to invite partnership proposals from the private healthcare sector that would facilitate deployment of electronic medical records systems contributing to the development of the eHR sharing system. The first stage EEI received very good response with more than 50 partnership proposals submitted by private healthcare and related sectors.

Taking into account the partnership projects and development needs raised by private healthcare stakeholders during the first stage EEI, the eHR Office launched the second stage EEI in November 2010 to invite IT professional bodies and private IT vendors to further explore proposals contributing to eHR development.

The engagement for private stakeholders will be an on-going exercise after the launch of this EEI exercise. The Government considers engagement of the private sector an integral part of eHR development, which will be an interactive process that will continue among all stakeholders throughout the life of the project, guiding the planning, facilitating the roll-out of individual project and enhancing systems as they mature.