Mr. Charles Mok . 2 Feb 2010

CMS III & eHR Update

Multidisciplinary CareIntegrated CarePreventive / Primary CarePublic-Private / Public-Public CollaborationPatient Empowerment / EngagementProtocol DrivenClinical Decision SupportEvidence-based Practice

Need for future healthcare

Challenges• High patient volume

• Aged population

• Transition between different healthcare settings

• Paper records

• Record sharing

• Integration care processes

• Comprehensive care plan program

• Outcome measures

We see chances

• Public awareness of the importance of integrated care

• Management and clinician support

• More integration, intelligence and capabilities in CMSIII

• Clinical workflow and efficiency support

CMSIII

Clinical Management System

12,000 Workstations29,000 Clinical Users162 HA Locations

Single Sign on24 x 7 x 365 service

Major Functions

Patient Administration Clinical DocumentationDiagnosis / Procedure codingOT RecordingConsultation Note Discharge SummaryPrescriptionClinical Investigation OrderingClinical Investigation Result Reporting (Lab / Rad)SchedulingAnalysis & Reporting (CDARS)Electronic Patient Record (ePR)

CPR / ePR is essential in healthcare

• Each Day...

• 12,000 users

• 90,000 patients

• 4.5 M CMS transaction

• 600,000 ePR transaction

• To Date...

• 9 M patient records

• 3.9 Tb ePR data volume

• 12 Tb ePR Images

• 23 M Image

• 41 M radiological report

• 942 M ePR Lab records

• 420 M Dispensed drug

Electronic Patient Record in HA

• Web-based lifelong longitudinal record of all healthcare transactions for all Hong Kong citizens

• Many data formats (textual, numerical and digital image)

• Network connectivity (giga LAN)

• Security (audit log and user authentication)

• Efficiency (tightly integrated workflow)

Integrated Record

HKU Cyber Institute Hong Kong Society of Medical Informatics Hong Kong Hospital Authority

Copyrighted 2007

Multimedia

Vision of CMS III

CMS Phase III will be a system that supports the delivery of care in the HA with tools to improve quality and reduce errors, improve efficiency, and improve overall service management, and that will be an integral part of a community wide platform for sharing of electronic health data

4 Strategic ObjectivesImprove the outcome

Facilitate the process

Develop the content

Extend to the community

4 PerspectivesPatient perspective

Clinician perspective

Operational perspective

Management perspective

Future CMSIII Functions• Chronic disease management

• Clinical decision support

• Workflow and efficiency

• Streamlined communication

• Outcome measurement and monitoring

Mr Donald Tsang, CE, HKSARPolicy Address 2007

We take pride in our current health

care system.We will develop a territory-

wide, patient-oriented Electronic Health Record, through public-private-

partnership.

Development of a Electronic Health Record Sharing System

VisionA Patient’s Electronic Health Record is

available to all caregivers that need it; at all times, in all places in a secure way

that respects patient privacy

EHR objectives and benefits

With eHR

HA

DH

Private Hospitals

X-ray

LaboratoryPrivate Clinics

Patients

Doctors & NursesOther healthcare

professionals

Patient-oriented

healthcare records

Public-private interface and partnership

DH

Family doctor concept; integrated

primary and hospital care

eHREssential Infrastructure for Healthcare Reform

Why eHR?

HA Private Hospitals

23

Institutional Setup Government-led model

Steering Committee

Gov’t office responsible for - 1. Legal framework 2. eHR standardization3. Design, develop, operate and maintain

eHR sharing infrastructure 4. Administer partnership models with

private sector

Provide guidance and inputs to the work of the eHR Office

eHR Office

Leverage HA’s expertise in HI/ IT

Guiding principles of eHR development

1. Government-led model

2. Compelling But Not Compulsory Record Sharing

3. Privacy and Security of Paramount Importance

4. Open Technical Standards

5. Building Block Approach

Using Internet to access patient record

Patient benefitsWhole record always available onlineTimely and accurate information for care

Clinician benefitsEfficient clinical practiceAvoid errors associated with paper records

Society benefitsDisease surveillanceMonitor outcomes, performance and resource utilization HA Private Hospitals

eHR Time Line09/1009/10 10/1110/11 11/1211/12 12/1312/13 13/1413/14 14/1514/15 15/1615/16 16/1716/17 17/1817/18 18/1918/19Sharing

CoverageSharing

Coverage 0.1M0.1M 0.2M0.2M 0.3M0.3M 0.5M0.5M 1M1M 2.5M2.5M 4.5M4.5M 5.5M5.5M 6M6M

HA CMS adaptation (Basic)HA CMS adaptation (Basic)HA CMS adaptation (Basic)HA CMS adaptation (Basic)HA CMS adaptation (Basic)HA CMS adaptation (Basic)HA CMS adaptation (Basic) CMS adaptation (Advanced)CMS adaptation (Advanced)CMS adaptation (Advanced)CMS adaptation (Advanced)CMS adaptation (Advanced)CMS adaptation (Advanced)CMS adaptation (Advanced)CMS adaptation (Advanced)

DH ePR and computerizationsDH ePR and computerizationsDH ePR and computerizationsDH ePR and computerizationsDH ePR and computerizationsDH ePR and computerizationsDH ePR and computerizations

PH systems upgradePH systems upgradePH systems upgradePH systems upgradePH systems upgradePH systems upgrade

Interface pilotsInterface pilotsInterface pilotsInterface pilots

eHR infrastructureeHR infrastructureeHR infrastructureeHR infrastructureeHR infrastructure Phase 1 eHR (Dr portal)Phase 1 eHR (Dr portal)Phase 1 eHR (Dr portal)Phase 1 eHR (Dr portal)Phase 1 eHR (Dr portal)Phase 1 eHR (Dr portal) Phase 2 eHR (Patient portal)Phase 2 eHR (Patient portal)Phase 2 eHR (Patient portal)Phase 2 eHR (Patient portal)Phase 2 eHR (Patient portal)Phase 2 eHR (Patient portal)

CMS on rampCMS on rampCMS on rampCMS on rampCMS on rampCMS on ramp

eHR Certification SchemeeHR Certification SchemeeHR Certification SchemeeHR Certification SchemeeHR Certification Scheme

PPI-ePR and pilotsPPI-ePR and pilotsPPI-ePR and pilotsPPI-ePR and pilotsPPI-ePR and pilotsPPI-ePR and pilotsPPI-ePR and pilotsPPI-ePR and pilotsPPI-ePR and pilotsStandardization - ongoing

Team Approach

Support with IT systems and information

Multi-Team Collaboration

NGOsDH

Citizens HACHP

Private Sectors