Wednesday 19 September 2012

43 public health-care institutions; 1 patients' database

Hospitals, polyclinics, specialists share access to a person's medical history
By Poon Chian Hui, The Straits Times, 18 Sep 2012

PEOPLE who seek medical treatment at any public health-care institution here, from hospitals to specialist centres and polyclinics, no longer have to recount their medical history to the doctors.

This information is now captured in a centralised database, the National Electronic Health Records (NEHR) System.

With all public health-care institutions using the system, medical details of patients who shuttle between these centres will be pooled into one document for health-care workers to access.

For example, a polyclinic doctor treating a patient with chest pain can call up his medical history to check if he has been treated for heart problems elsewhere, such as at a general hospital.

The polyclinic doctor can then input details of his treatment.

Another doctor signed on elsewhere can access it if the same patient shows up with similar problems.

With this set-up, patients can look forward to fewer duplicate tests and repeat treatments, saving them time and money.

Medication errors can also be minimised as details like allergies are recorded.

Timely clinical information at the health-care provider's fingertips can help cut down on delays in treatment, said Mr Alson Goh, chief operating officer of the National Heart Centre Singapore.

A total of 30 institutions started using the system in two separate batches in April and July.

They join 13 other institutions which were among the first to adopt the system in February.

Community hospitals as well as several nursing homes and hospices are among those accessing the system.

There are now about 4,500 registered users. The system can handle up to 15,000.

The first phase, which cost $176 million, also sees a selected group of general practitioners testing the platform in their clinics.

More GPs will come onboard early next year, said a Ministry of Health spokesman.

"The discussion also continues with government-funded and privately-run nursing homes and hospices which are not using the system yet," she added.

This second phase is expected to go live in early 2014, she said.

Once the system is in full swing in three to five years, every person will have just one medical record, regardless of where he sought treatment - public or private hospitals, nursing homes, GP and dental clinics as well as the army.

The ambitious project was mentioned as early as 2003 by former health minister Khaw Boon Wan.

Slated to kick off in 2010, it went operational in June last year.

Mr Benedict Tan, SingHealth's chief information officer, said the Web-based application has an intuitive graphic user interface.

"Most doctors would know how to use it with little or no training," said Mr Tan, who is also the director of information technology at Singapore General Hospital.

MOH Holdings provides training to all doctors and user guides are also given out.

Dr Eu Pui Wai, chief medical information officer of the Institute of Mental Health, said it has set up a helpline for staff.

Dr Evan Sim, deputy chief medical information officer of National Healthcare Group Polyclinics, said the information mined by the system will help its doctors diagnose and manage patients better.

Agreeing, Mr Goh said an overview of the person's medical history can boost care.

Many heart patients, for example, also suffer from ailments like diabetes, hypertension, high blood cholesterol and kidney problems.

Said Dr Sim: "We hope this will translate to better care as a detailed and current list of medical conditions, visits, medications, drug allergies and laboratory investigations can now be quickly accessed at the click of a button."



HOW IT WORKS
- A polyclinic doctor treating a patient with chest pain can call up his medical history to check if he has been treated for heart problems elsewhere, such as at a general hospital. 
- The polyclinic doctor can then input details of his treatment. 
- Another doctor signed on elsewhere can access it if the same patient shows up with similar problems.

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