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Background
Founded in 1963, Hong Kong Baptist Hospital (HKBH) was the first private hospital in the Kowloon area of Hong Kong. Started as a private clinic, the hospital has grown into a large modern private medical institution with more than 800 beds and a staff strength of over 2,200. HKBH is one of the social service institutions of the Baptist Convention of Hong Kong.

HongKongBaptistHospital_imageIn 2009, the Hong Kong Legislative Council embarked on the first stage of a territory-wide patient-oriented electronic health record (eHR) sharing system. In order to align with the government initiative, HKBH committed to convert their paper medical record system to an electronic system. After careful consideration, in 2009 the hospital chose the InterSystems TrakCare unified healthcare information system to achieve their goals.

The project, also referred to as the “Clinical Enterprise System (CES)”, aims to achieve all six of the widely identified care improvement goals: Safety, Effectiveness, Patient-Centric Care, Timely Delivery, Efficiency and Equality in healthcare access. The ultimate goal of the project is to achieve a patient-centric and paperless healthcare environment to improve patient safety and satisfaction with a single source of patient information.

The Challenge
Historically, HKBH has a nurse-driven administrative-centric care model due in part to the fact that 97% of the doctors at HKBH are affiliates. As a result, when TrakCare was initially configured, it was built according to the specifications and requirements set out by nursing and administrative members who focused mainly on the administrative and billing process, with little involvement of resident or affiliated physicians. Configuration requests were also often made in silos with consideration for individual departments only, rather than as a unified approach.

The net result was a clinical configuration that was not optimised for clinicians, and lacked unity across departments. This limited the benefits of the CES; and according to HKBH policy, required extensive duplicate paperwork and electronic entries by nursing staff. In addition, the absence of remote access due to lack of physician involvement in configuration impeded both resident and affiliate physicians from using the system practically and efficiently. On top of this challenge, many clinicians were reluctant to learn the new system.

The Solution
While it is important to choose an EMR system with rich functionality that will grow and evolve with your requirements, it is critical to manage EMR projects as change initiatives, not just IT projects. Implementing an EMR provides healthcare organisations with an opportunity to improve workflows and processes to achieve better business results and patient outcomes. During the project’s Pre-Go-Live days, HKBH management, in conjunction with InterSystems, worked together to develop a clinical adoption program to drive change. The hospital appointed a dedicated Clinical Lead, Dr. Alex Yu, to help achieve their adoption goals.

Clinical adoption of health information tech-nology is an integral part of the success of the overall CES project. Implementing Healthcare IT, specifically an EMR and the technologies that it supports cannot be viewed as an IT matter only.

Dr. Alex Yu
Director of Medical Services
Hong Kong Baptist Hospital

The effort included a detailed review of current configurations, assessment of clinical areas to ascertain how the system was currently used by both nursing and physician staff, and execution of configuration modifications designed to simplify and improve clinical work-workflow, decrease duplicate entries, and make better use of TrakCare’s capabilities and functionality.

With InterSystems’ help, HKBH broadened the clinical functions to healthcare providers. InterSystems worked closely with HKBH and formed a “Clinical Adoption Working Group” with medical directors, doctors, nurses, IT staff, and InterSystems staff. The objective of the working group was to transform the way the HKBH staff think and work, to achieve a unified, patient-centric care environment. The working group established a purposely designed process to evaluate and modify system configuration specifications, to ensure all requirements aligned with the hospital’s set goals. The working group also helped to unify physi-cians, nurses, and IT departments at HKBH, and helped them to gain further familiarity with the new system and its benefits. InterSystems conducted system configuration “walk throughs” and workflow reviews in each clinical, administrative and operational area as well as further system trainings.

InterSystems helped us to transform our care paradigm from administration-centric and nurse-driven, to patient-centric and doctor-driven. It helped us to achieve paperless (on-line) operation in the long run. With a single source of patient information, the “Clinical Enterprise System” is going to enhance our data accuracy and productivity and will speed up patient diagnosis and treatment while offering improved patient safety and satisfaction.

Dr. Alex Yu
Director of Medical Services
Hong Kong Baptist Hospital

The Outcome
Under the transformation, the CES Project went live in two months starting with the Renal Department, followed by Obstetrics/Gynecology and Paediatrics departments a few months later. Feedback on the hospital’s electronic medical record system from the Resident Medical Doctor has been very positive. The nurses also feel confident in using the system, which makes their daily work much easier. The hospital has made it their mission to encourage more affiliate doctors to use the system. In May 2014, InterSystems’ Hong Kong team received a Certificate of Appreciation from HKBH, recognising the team’s passion and hard work in helping HKBH to succeed. It is the first time HKBH has ever awarded a vendor.

Hong Kong Baptist Hospital now has a team of clinicians and IT staff working collaboratively to increase adoption of the EMR, improve work practices, and derive ever more value from the investment. While technology is important, it’s the people involved in EMR implementations that really make the difference.