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Applying eHR Sharing to Healthcare Improvement and Clinical Practices

Training on eHR and Onsite Registration Campaign at HA/DH Clinics

The University Health Service (UHS) of the Hong Kong Polytechnic University (PolyU) is the first healthcare provider (HCP) under a local tertiary education institution to join the Electronic Health Record Sharing System (eHRSS). Dr Steven Ho Yiu-keung, who has just retired as Director of the UHS, believes that electronic health record (eHR) sharing can greatly improve the healthcare service and facilitate future health planning.

Dr Steven Ho Yiu-keung
Former Director of the University Health Service,
Hong Kong Polytechnic University

“Over the years, various healthcare providers (HCPs) have captured and kept a lot of quality clinical information, but such information is all silo data isolated from each other and not sharable,” said Dr Ho. “The data can only be best utilised when there is a flow of information.”

“We are in the era of big data. The sharing of medical data from different sources is very useful in several ways,” he said.

The eHRSS development programme continues into the second stage
A lot of quality data are held by different doctors but they cannot be shared
Commenting on the benefits of eHR sharing, Dr Ho said diagnostics improvement and timely treatment for patients can be achieved through efficient exchange of clinical data. “It’s quick, accurate and safe.”
data sharing = Quick + Accurate + Safe
On societal level, he said the data collected can be analysed to identify future healthcare needs, for instance, the need of individual geographic districts, and to facilitate planning for healthcare provision.
Dr Ho also envisaged a bigger picture in which the building of a territory-wide database can significantly impact future healthcare delivery and management.
“We can use the structured data to develop a smart and intelligent healthcare system. When DNA sequencing technique or molecular pathology technology is applied, patients’ medical records can be analysed to help predict disease trends and thus enhance prevention,” he added.
Data Sharing Experience of UHS

“Patients of the UHS have been positive towards the launch of the eHRSS,” Dr Ho said. “Elderly patients welcome the system for practical reasons as they need to consult different doctors, while students are more receptive to new information technology tools.”

In fact, data sharing is not a new concept to the UHS, which has long established an interface with the public healthcare sector. “We have participated in various public private partnership programmes of the Hospital Authority, including the Public-Private Interface - Electronic Patient Record Sharing Pilot Project,” said Dr Ho.

The eHRSS development programme continues into the second stage
Elderly patients and students are positive to the eHRSS
“Our patients include students, staff members and retirees. Apart from using our service, they would also need to use the public healthcare system. After joining the eHRSS, the medical records captured in our Clinic Information System will definitely help when our patients acquire public healthcare services.” he added.
The UHS is now working to upload more data in the eHRSS. “Right now we are sharing the patient's master index, and consultation date and time. We will soon upload allergy records and medication. Diagnosis and vaccination will follow,” said Dr Ho.
As to fostering an understanding on eHR sharing amongst healthcare students, personally Dr Ho is of the view that students can be given an introduction on the eHRSS to help them grasp the concept of the model.
Digitisation at UHS

Dr Ho has for 31 years served the UHS which has a long history of computerisation. It started with the Clinic Information System developed by the centre about two decades ago.

A keen advocate of eHealth himself, Dr Ho said computerisation can help the UHS fulfil its mission to deliver quality and timely services. “From reception, consultation, laboratory examination to billing, our Clinic Information System captures every step of the workflow.”

“We handle close to 100,000 patient accounts each year. With digitisation, we can exercise better quality control,” he stressed.

“It’s also environmentally friendly as there is no more bulky paper record to store, manage and retrieve,” he said, adding that only electronic and standardised data can facilitate eHR sharing. “Paper records can hardly bring us this kind of convenience.”

The eHRSS development programme continues into the second stage
“With digitisation, we can exercise better quality control,” Dr Ho stressed
Over the years, the UHS has accumulated tens of thousands of electronic patient records. There are times in which such data was used to help open up avenues of research. For example, the PolyU has made use of de-identified data in a research on osteoporosis to help analyse causes of the disease and identify preventive measures.
A Real Case: Better Coordinating of Care across Different HCPs
Dr Wong Ho-cheong, who has succeeded Dr Ho as the UHS’ Director, cited an example of how the eHRSS has worked for patients.

“A female patient in her 50s came to us because of a month-long fever with unknown origin. Since our x-ray showed a black spot on her lung, she was referred by us to the Queen Elizabeth Hospital (QEH), where several examinations were performed on her. As the patient had registered to the eHRSS, we quickly retrieved the hospital’s examination results through the system with her consent. On the advice of both the doctors of our team and QEH, the patient promptly took a positron emission tomography (PET) scan and underwent a surgery at a private practitioner. Laboratory tests on the substance took out from her body showed that she has contracted tuberculosis. She was able to be treated in a timely manner.

The eHRSS development programme continues into the second stage
A UHS patient was able to receive timely treatment with the help of the eHRSS
This is a case in which the eHRSS has played an important role in:
  enabling timely treatment for the patient;
  saving the patient's time and money by avoiding repeated tests and examinations by different HCPs; and
  reducing her anxiety as she could seek assistance from her primary care doctor at the UHS she is familiar with.
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