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Boarding the “Train” of eHR Sharing

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

Under the Electronic Health Record Sharing System (eHRSS) Ordinance, a total of 13 healthcare professional groups can access the Electronic Health Record Sharing System (eHRSS). Dentist is among the first group to have access to the system. Dr Johnny Wong of the Hong Kong Dental Association (HKDA) talked to eHealth News about electronic health record (eHR) sharing from the perspective of a dental surgeon.

Dr Johnny Wong
Chairman of Information Technology Committee,
Hong Kong Dental Association

Dr Wong, Chairman of the HKDA’s Information Technology Committee, believes that eHR sharing is a future trend for the dental profession. “Patients have responded positively to the eHRSS and a lot of them have in fact asked us to join,” he said.

In an effort to facilitate and promote private dentists’ participation in eHR sharing, the HKDA has developed the Dental Clinic Management System (DCMS) with the support of the Government. The new version of the system, DCMS 2.0, complies with the eHR standards to support data exchange with the territory wide eHRSS.

The eHRSS development programme continues into the second stage
Dr Johnny Wong says comprehensive information can help improve care quality and patient safety
“It’s good that the dental profession can contribute to the eHRSS. I will definitely join the system and consider myself a pioneer, gaining first hand experience on its performance and suggesting what further improvements should be made,” he said.
eHRSS: a Train to Board
As eHR sharing through the eHRSS is new to the entire dental healthcare sector in Hong Kong, Dr Wong said he understands there are concerns about the system from fellow dentists.
“The common concerns are information security, system reliability, the extent to which they contribute to data sharing, the costs involved in investing in the relevant hardware, as well as our fellow colleagues’ reaction towards changing the existing operation mode,” he said.
“Dentists have a self-learning culture. As long as you have established a good system, they will find out its unique features,” he stressed.
“The eHRSS is like a train moving in a valued direction. The question for individual dentists is to decide when to board the train,” he commented.
Comprehensive Records with eHR Sharing
Under the eHRSS, participating dentists and other healthcare providers can share patients' clinical data with their consent. As one may wonder how patients’ dental records and medical records are related, Dr Wong elaborates on how the availability of comprehensive health information can help improve care quality and patient safety.
“We can check out medications and allergy interactions, as well as the potential interactions between medications and the dental treatments,” he said.
“For example, anticoagulants for cardiovascular diseases can largely prolong bleeding time, while some medications will lead to osteoporosis and affect bone health. It would not be desirable for patients to undergo tooth extractions while they are on these medicines. We may need to wait until the patients have stopped using the medicines and their bones have become stronger,” he said.
Dr Wong continued that great care has to be exercised when using ultrasonic cleaning devices on patients with pacemaker devices, which can be interfered by the use of machines nearby.
“With a platform where comprehensive information is readily available, we do not have to totally count on patients to give us their medical information. Rather, we can have reliable, accurate and updated information served up to us by the system,” he noted.
First Step towards eHR Sharing

For local dentists who want to participate in the eHRSS, they need to first adopt HKDA’s DCMS 2.0, the only dental clinical system to date that has built-in connectivity to the eHRSS.

The DCMS 2.0 is a streamlined and standardised open-source system specially designed for dental practitioners. It was developed in a “not-for-profit” manner and is made available free-of-charge to all dental clinics in Hong Kong.

The eHRSS development programme continues into the second stage
HKDA's DCMS can support data exchange with the eHRSS
Main features of the DCMS 2.0 :
  Open-source, scalable and extensible
  Advanced client-server architecture, supporting multi-doctor and poly-clinic environments
  Versatile, user-friendly and comprehensive functions to improve clinical operation, manage documents, and configure treatment and billing plans
  Dental imaging integration and image-enabled patient record standardisation
  Standard-driven: data format, diagnostic codes, drug references and address formats
  Built-in connectivity to the eHRSS
With funding support from the Food and Health Bureau, the HKDA provides free-of-charge services, including installation, training and one-year technical support to dental clinics in Hong Kong to facilitate their adoption of DCMS 2.0 and participation in the eHRSS.
DCMS: A Different Patient Experience

Dr Wong has been using the DCMS since 2010. He commented that apart from being able to help improve clinical efficiency, the system has brought new experience to patients, “We have better communication with patients by using the DCMS during consultation,” he said.

The eHRSS development programme continues into the second stage
Better communication with patients with the DCMS
In explaining the functionalities of the DCMS, Dr Wong said the system can capture and store digitised dental and x-ray images and display multiple images on one monitor screen, making it easier for dentists to explain the oral health problems and propose treatments to patients.
“We can even convert the images to jpeg format and send them to patients by email or to their mobile phones,” he said.
Not only that, dentists can also input medical background of individual patients, and make medical remarks and dental remarks to help them customise their services, Dr Wong said. “Patients’ feedback has been positive. They appreciate that we are doing this to improve services for them.”
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