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Healthcare

Hong Kong hospital keeps standards high on a low budget

By Jianggan Li | 27 May 2009

As many other healthcare providers, Hong Kong Sanatorium and Hospital (HKSH) started the development of a billing system in the 1980s and gradually moved to work on a sophisticated clinical system in 2002.

Since its inception in 1922, HKSH’s management has insisted on providing patients with ‘a high standard of health and medical care and with the best equipment available, supported by highly trained staff’.

Over the years the hospital has evolved from a 28 bed ‘Happy Retreat” to a modern hospital with more than 400 beds and state-of-the-art medical facilities.

Lily Cho, HKSH’s CIO, explains that the emphasis on high standard also applies to IT.

Its clinical management system was first launched in its outpatient department in 2004 and received good feedback from both clinicians and patients.

The hospital has also installed bedside thin-client terminals in all the news wards. “This will not provide tangible return immediately,” Cho explains. “But it is closely aligned with our management concept which is to make patients happy and therefore promote the image of our hospital.”

Experiences in many countries have shown that charging patients for bedside terminal will reduce the usage and render the system ‘white elephant’. HKSH patients will be offered with the information and entertainment services for free.

The system can be launched once the process of re-issuing staff access cards is complete – clinicians & clinical staff in wards will be able to their new staff cards to access these bedside monitors.

“Doctors will not use any authentication which is more complicated than any single-factor,” Cho says. “For security we record all the log-in attempts and trace them.”

Fingerprint authentication was embedded in all the applications developed by Cho’s team from its very beginning. Doctors in outpatient clinics use their fingerprints to log on to their console; clerk also have to use their fingerprint to access the document imaging system in order to scan and send documents.

The log out time will depend on the specific needs of each department – which are all specified in the access control software that Cho’s team developed.

Cho believes the software team is capable of creating all the applications required by the hospital. Only the development of the HR application has been outsourced. “We have too many things to do and we want to concentrate on clinical systems,” Cho explains that the reason to outsource HR application development is that the system can be fairly standalone, though still connected to other IT systems in the hospital.

However, only part of the inpatient system has been computerised at present, with doctors’ notes & nurses’ notes are still handwritten. Cho explains that full digital system is not possible at the present moment because most of the doctors are visiting doctors, it will be quite difficult to ask all of them to use computers. Also, nursing notes at HKSH are mostly Chinese based, it’s more time consuming to enter chinese characters than english.

Out of the more than 1000 doctors registered with HKSH, more than 500 visit the hospital regularly.
The IT team also developed an online forum for doctors to exchange ideas and discuss issues. All the doctors registered in Hong Kong are able to access the system using their registration number as credentials.

“There are many things to do and we have limited IT capabilities,” Cho says. “We’ve evaluated a few commercial package but they are too customised to the insurance-based environment in the US.”

Take the billing application for example – there are many criteria and specifications unique to the hospital. “Hong Kong is a fast-paced society,” Cho says. “Whenever there are changes to the billing applications we can implement them in the IT system within a day or two.”

“And it will take commercial software support weeks,” she adds.

The current billing system was developed many years ago, and the IT department is in the process of re-writing the whole system, which also includes the migration to a more updated software platform.

“Inside the system, maybe we are too customised to this hospital,” Cho says. To satisfy 1500 staff in 70 departments who have new requests every day, the 21-strong IT workforce does not have an easy job.

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