SCMP Monday, July 31, 2000

Online plan for hospitals on schedule


A 10-year, $1 billion "e-medical" system designed to computerise patient services at all public hospitals is on schedule to meet its 2002 deadline, the Hospital Authority said.

All 44 public hospitals now access patient information from a database of millions of records. The 14 emergency-care hospitals are plugged into two electronic management systems, one for day-to-day clinical care and one for accident and emergency cases.

"This just shows how the computer can improve the efficiency and effectiveness of the communication process," said Dr Jimmy Chan Tak-shing, who helped develop the computer systems.

Under the authority's Strategic Plan for Information Technology, its information technology branch aims to computerise the majority of patient services at all public hospitals.

But one of the complaints from doctors using the new systems is that they get tired of typing in data. "There's been a great lessening in the amount of paperwork, but on the other hand there's been an increase in the amount of typing doctors need to do for data entry. That, to me, is the biggest drawback for more computerisation," said Dr Lai Kang-yiu, president of the Public Doctors Association.

According to the latest reports from the authority's IT team, computerised payroll systems have saved about $5.8 million per year since they came online between 1996 and 1999. Electronic patient billing systems have saved about $1.9 million. Before the development of these schemes, the Government Treasury System had to issue demand notes, at a cost of $15 each.

The clinical management system, which uses a Windows-based program, barcodes and other electronic systems, has cut drug prescription errors from nine per cent to less than three per cent since it was introduced in 1996.

About 70,000 repeat laboratory tests per year have been eliminated through computerised patient records. Test results are available to doctors about two hours earlier than before.

The authority's computerised pharmaceutical supplies system saved $10 million in the 1996-97 financial year through bulk purchasing.

About 12,000 work days per year formerly spent transcribing patient records have been cut through the integrated patient administrative system since it came online in 1993.

The day-to-day clinical system comprises inter-hospital and intra-hospital communications networks with 4,000 work stations in about 400 wards and offices. About 2,000 doctors, 14,000 nurses and 3,000 staff use the system. The authority's hospitals serve more than two million patients a year.

The news that the IT team had met all of the first-quarter 2000 deadlines specified in the plan was a welcome change from the black cloud that loomed over the project last year. In May last year, the authority's board members questioned the competence of some IT team members, and a lack of transparency regarding the $860 million spent on the computerisation project.

An investigation by the Independent Commission Against Corruption was launched and the contract of the authority's deputy director (information systems), John Tse Si-yin, was terminated, while his wife, assistant director of information technology services Teresa Tse Yip Siao-bing, left her post.

The ICAC investigation resulted in no charges being filed, and a special independent taskforce which investigated IT spending reported in September last year that no evidence of misappropriations was found.

The investigations may result in a better end product, as a slow pace in medical computerisation is better than rushing ahead blindly, said Professor Anthony Hedley of the University of Hong Kong's faculty of medicine.

"The world is littered with failed computer-based medical systems," said Professor Hedley. "If Hong Kong makes steady but cautious progress toward computerisation, then the outcome will be much more cost-effective."