Demonstrating benefits to patients and clinicians will significantly boost interoperability, hhealth information exchange and digitization of medical records in the Asia-Pacific region.
Dr. Mahesh Appannan, Director of Digital Health at the Ministry of Health Malaysia, Seyoung Jung, Assistant Professor and CIO of Bundang National University Hospital in Seoul, South Korea, and Gareth Sherlock, CEO of Turimetta Consulting and former CIO of Cleveland Clinic in London and Abu Dhabi, delved into best practices and challenges in EMR implementation during the panel session “EMR Experiences in the Asia-Pacific Region” at HIMSS24 APAC.
Sharing preliminary findings from a recent region-wide study on healthcare providers’ experiences using EMR systems, HIMSS APAC Editor-in-Chief Thiru Gunasegaran, who also moderated the panel, noted that physicians spend an average of five to six hours using EMR system.
When asked how much time should be spent on the EMR, Sherlock immediately replied “as little as possible.” The time spent on the EMR, he said, depends on factors such as specialty, payer expectations and regulatory compliance.
For Dr. Appannan, it depends on the type of case. “Complex cases take more time.” He said the time a pharmacist spends contacting doctors about their prescriptions should be taken into account.
System automation, which is becoming more common in healthcare settings, can also lend a hand save time when performing an EMR examination, Dr. Appannan added. “Our doctors in electronic clinics in Malaysia can see a patient within 10 minutes because we have innovative ways of creating templates… and this saves a lot of time. So do we [use] vote for text that [automatically populates clinical notes] while talking to the patient.”
In the context of the ongoing doctors’ strike in South Korea, Dr. Jung said that medical professors “don’t have enough time right now” to put complete medical information into a patient’s EMR.
Demonstrating the benefits
The panel also discussed challenges and best practices in integrating and sharing hospital and health data.
“I could go to a hospital in central London… and [go] down the street to a private hospital. One has an EMR, the other on paper. They have different cultures, employee numbers, workflows and results… If this happens within a few miles of each other, it shows the substantial differences and the huge challenges we face,” Sherlock said, demonstrating his point that many organizations still not largely in paper form.
“We need to ensure alignment and standardization and look at data quality [to start enabling data exchange]”
Agreeing, Dr. Appanan emphasized that organizations must not forget to consider the most essential actors in health data exchange and interoperability – patients. “Patients [are] mediators of health information exchange.”
“We need to involve our patients [so they can] Take control and have information at your fingertips.”
To encourage patients to consent to – and ultimately promote – according to Dr. Jung, sharing health data and showing best-case scenarios may be key. For example, SNUBH uses a continuous blood glucose monitoring system based on artificial intelligence, the so-called Pasta has recently been integrated into the EMR system in accordance with HL7 FHIR standards. ” [mobile] The solution helps patients control their blood sugar levels on their own. It also guides changes in their lifestyle.”
Managing lead changes
Another key finding from the study was that clinical decision support systems are the most arduous efficiency tool to implement in hospitals.
Commenting on this, Sherlock said it would take a “huge cultural shift” for doctors to confidently exploit CDSS. “They need to go through the entire journey from start to finish and understand how everything will change as they transition to a fresh way of working. After all, it’s their system.”
“The people who are the hardest to change are the doctors themselves… There is always something to disprove,” Dr. Appannan added.
Citing a potential exploit case for CDSS in the face of the growing global Mpox epidemic, he said: “This will be helpful for rural nurses and doctors who are not up to date with the latest clinical developments. CDSS [must be] obligatory. In Malaysia, having some type of clinical decision-making support is required.”
Dr. Jung highlighted another issue: the lack of analysis after CDSS implementation. “Co-workers have complaints about CDSS but have no way to report them.”
This then leads to a lack of confidence in the exploit of CDSS, he said. SNUBH is now seeking confirmation for the fresh one The AMAM24 model, which also assesses the organization’s analytics lifecycle from development and implementation to evaluation.
A joint effort
Dr. Appannan calls the process of implementing and deploying EMRs a “science.” “Before implementing an EMR, planning – including having the basic infrastructure and connectivity in place – is critical… You need to have a fantastic pre-deployment strategy.”
He said the Malaysian government is now focusing on uniting all stakeholders in the healthcare system cooperate in developing digital transformation standards.
By issuing national mandates for the adoption of EMRs and allowing the sharing of health records, Sherlock suggested providing incentives.
Overall, Sherlock suggested considering the intended outcomes an organization expects from implementing an EMR.
“What are the most important things you would like to accomplish? What clinical and business processes need to change to make this happen? Then explore the technologies that will enable these business processes to achieve these results.”