This document discusses plans to develop an electronic health record (eHR) system in Hong Kong called CMS III & eHR. The goals are to improve integrated care, support evidence-based practice, and facilitate information sharing across public and private healthcare settings. Challenges include high patient volumes, an aging population, and currently using paper records. Opportunities include increasing public awareness and more capabilities in the existing CMS system. CMS III will improve quality, efficiency and management. The vision is for a system that supports care delivery, improves outcomes, and facilitates community-wide data sharing. Development will be government-led through a multi-phase process with public-private partnerships.

1. CMS III & eHR
Update
Mr. Charles Mok . 2 Feb 2010

2. Need for future healthcare
Multidisciplinary Care
Integrated Care
Preventive / Primary Care
Public-Private / Public-Public Collaboration
Patient Empowerment / Engagement
Protocol Driven
Clinical Decision Support
Evidence-based Practice

3. Challenges
• High patient volume
• Aged population
• Transition between different
healthcare settings
• Paper records
• Record sharing
• Integration care processes
• Comprehensive care plan
program
• Outcome measures

4. 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

5. CMSIII

6. Clinical
Management
System
12,000 Workstations
29,000 Clinical Users
162 HA Locations
Single Sign on
24 x 7 x 365 service

7. Major Functions
Patient Administration
Clinical Documentation
Diagnosis / Procedure coding
OT Recording
Consultation Note
Discharge Summary
Prescription
Clinical Investigation Ordering
Clinical Investigation Result
Reporting (Lab / Rad)
Scheduling
Analysis & Reporting (CDARS)
Electronic Patient Record (ePR)

8. CPR / ePR is essential in healthcare
• Each Day... • To Date...
• 12,000 users • 9 M patient records
• 90,000 patients • 3.9 Tb ePR data volume
• 4.5 M CMS transaction • 12 Tb ePR Images
• 600,000 ePR transaction • 23 M Image
• 41 M radiological report
• 942 M ePR Lab records
• 420 M Dispensed drug

9. 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)

10. Integrated Record
Copyrighted 2007
HKU Cyber Institute Hong Kong Society of Medical Informatics Hong Kong Hospital Authority

11. Multimedia

12. 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

13. 4 Strategic Objectives
Improve the outcome
Facilitate the process
Develop the content
Extend to the community

14. 4 Perspectives
Patient perspective
Clinician perspective
Operational perspective
Management perspective

16. Future CMSIII Functions
• Chronic disease management
• Clinical decision support
• Workflow and efficiency
• Streamlined communication
• Outcome measurement and monitoring

17. We take pride in
our current health
care system.
We will develop a territory-
wide, patient-oriented
Electronic Health Record,
through public-private-
partnership.
Mr Donald Tsang, CE, HKSAR
Policy Address 2007

18. Development of a
Electronic Health Record Sharing System

19. Vision
A 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

20. EHR objectives and benefits

21. With eHR
Other healthcare
Doctors & Nurses professionals
HA
Patients Private Hospitals
DH
X-ray
Private Clinics Laboratory

22. Why eHR?
Patient- Family doctor Public-private
oriented concept; integrated interface and
healthcare primary and partnership
hospital care
records
DH
HA Private Hospitals
eHR
Essential Infrastructure for Healthcare Reform

23. Institutional Setup
Government-led model
Steering Provide guidance and
inputs to the work of the
Committee eHR Office
Gov’t office responsible for -
1. Legal framework
2. eHR standardization
eHR Office 3. Design, develop, operate and maintain
eHR sharing infrastructure
4. Administer partnership models with
private sector
Leverage HA’s expertise in HI/ IT
23

24. 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

27. Patient benefits
Whole record always
available online
Timely and accurate
information for care
Clinician benefits
Efficient clinical practice
Avoid errors associated
with paper records
Society benefits
Disease surveillance
Monitor outcomes,
performance and
resource utilization HA Private Hospitals

28. eHR Time Line
09/10 10/11 11/12 12/13 13/14 14/15 15/16 16/17 17/18 18/19
Sharing
Coverage 0.1M 0.2M 0.3M 0.5M 1M 2.5M 4.5M 5.5M 6M
HA CMS adaptation (Basic) CMS adaptation (Advanced)
DH ePR and computerizations
PH systems upgrade
Interface pilots
eHR infrastructure Phase 1 eHR (Dr portal) Phase 2 eHR (Patient portal)
CMS on ramp
eHR Certification Scheme
PPI-ePR and pilots
Standardization - ongoing

29. Team Approach
Support with IT systems and
information

30. Multi-Team Collaboration
Private Sectors DH
NGOs CHP
Citizens HA