Electronic Health Record Sharing Benefits and Challenges

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Scott Tate
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1 Electronic Health Record Sharing Benefits and Challenges ehealth Record Office Food and Health Bureau Slide 1

2 Objectives Develop a territory-wide patient oriented electronic health record (ehr) sharing system Enhance the continuity of care and better integration of different healthcare services Slide 2

3 Present Situation Hospital Authority (HA) 9 million patient records 800 million lab results 340 million prescribed drug records 34 million X-ray images 3 million transactions per day Department of Health (DH) Essential health data, e.g. vaccination Preparing for ehr sharing Private Hospitals Mainly electronic billing and financial systems Electronic record lacks sharing capability Private Clinics Mostly paper-based records Electronic record lacks sharing capability Private Labs/ Allied Health Providers Not connected to other providers Slide 3

4 Without ehr Dentists Private Hospital HA Doctors DH Nurses X-ray Slide 4

5 With ehr Slide 5

6 ehr Sharing: Win-win-win situation Patients Healthcare Providers ehr Sharing System Society Slide 6

7 Benefits of ehr Sharing For Patients Whole record available online Timely and accurate information for care Increase the speed of treatment Reduce medication errors Save cost and avoid repeated medical procedures by reducing duplicate tests Slide 7

8 Benefits of ehr Sharing For Healthcare Providers Improve availability of shared information Timely access of information Efficient clinical practice Avoid errors associated with paper records Slide 8

9 Benefits of ehr Sharing Hospital Authority Department of Health For Society More efficient and better quality healthcare More efficient use of society s limited healthcare resources Disease surveillance Public health and policy making Private Hospitals Slide 9

10 Guiding Principles Government-led model for development Compelling but not compulsory record sharing Data privacy and system security of paramount importance Open technical standards for private participation Building-block approach for ehr components Slide 10

11 10-Year ehr Programme First stage ( to ) Funding approved: HK$702 million Targets: To have the ehr sharing platform ready by for connection with all public and private hospitals To make available electronic medical/patient record (emr/epr) systems with ehr sharing capability Legal framework Second stage ( to ) Estimated budget: HK$422 million Slide 11

12 Challenges Privacy and security concerns, ehr legal framework Change management - Project management and institutional framework - Standardisation - Building block approach modular development with pilots Public private partnership - ehr Engagement Initiatives - Partnership project - ehr core infrastructure and CMS extension Slide 12

13 ehr Legal Framework The privacy and security challenges of ehr An ehr specific legislation Balance protection of patients data privacy and healthcare providers clinical needs Slide 13

14 Privacy Safeguards Data management life cycle Collection Storage Use Data Lifecycle Sharing / Transmission Retention Access and Correction Data Context - Express and informed consent - Primary use - Secondary use: research and disease surveillance - Length of retention - Withdrawn / deceased patients - Role-based access control - Track and trace changes in corrections Slide 14

15 Project Management and Institutional Framework Hospital Authority (HA) Government Private sector HA IT Services ehr Office ehr PMO Steering Committee on ehr Sharing Working Group on Institutional Arrangement Working Group on Legal, Privacy and Security Issues Working Group on ehr and Information Standard Working Group on ehr Partnership ehr Projects Public- Private Interface Projects Private Projects Slide 15

16 Standardisation of Health Record Define a scope of ehr sharable data Standardise Patient Master Index, immunisation record, drug record, laboratory record Support promotion of HL7, ICPC, SNOMED CT, etc. Slide 16

17 Pilot Projects Public Private Interface-Electronic Patient Record (PPIePR) Sharing Pilot allows private healthcare providers to view patients medical records kept at HA with consent Implemented patient enrolment to PPI-ePR using SmartID card on 31 August 2010 Expanded enrolment to PPI-ePR to NGOs, elderly home and old-aged home Set up radiological image sharing pilot with private hospitals and private radiology centre Slide 17

18 Private sector involvement ehr Engagement Initiatives (EEI) 1st stage for Private Healthcare Sector Launched in October 2009, over 50 proposals received Implementing on-going engagement plans 2nd stage for IT Sector Launched in November 2010, over 50 proposals received To explore new ideas and IT opportunities Partnership projects Validation Platform for ehr Data Standards Conformity Wuhan Project of the Hong Kong Medical Association Dental Clinic Management System of the Hong Kong Dental Association Laboratory Integration Platform of the Hong Kong Association of Medical Laboratories Slide 18

19 ehr Sharing System Development Prepared blueprint documents for Core Infrastructure and CMS Extension Development of CMS adaptation modules for private healthcare provider and CMS On-ramp prototype Slide 19

20 Thank you Slide 20

Hospital Authority. Electronic Health Record Initiatives

Hospital Authority. Electronic Health Record Initiatives Quality Patient-Centred Care Through Teamwork For comment on 23.4.2009 AOM-P610 Hospital Authority Electronic Health Record Initiatives Purpose The purpose of this paper is to brief members on the role