CEBU CITY – The traditional IT environment inside hospitals and healthcare facilities in this city is effectively changing to meet rising patient quality expectations, keep up with the exponential growth of data, and enable labor-saving management of day-to-day operations.
This was the picture that emerged in a forum on healthcare organized by Exist Software Labs and Computerworld Philippines at the Radisson Blu Hotel, Cebu City last June 15. Representatives from four Cebu private hospitals – Chong Hua Hospital, Perpetual Succour Hospital, St. Vincent’s Hospital, and Vicente Gullas Memorial Hospital – attended the half-day event to share experiences and validate real-world healthcare information technology (HIT) adoption and utilization strategies.
“The ultimate goal is to have all the relevant clinical information at the point of care,” Dr. Michael Hussin B. Muin, chief information officer of The Medical City (TMC), said. Dr. Muin, who was invited to the forum as a resource speaker, made a presentation on TMC’s Patient Records and Integrated Medical Exchange (TMC PRIME), a clinical application that he and his IT team are developing in partnership with Exist. TMC’s Wellness department has been using this application since February this year.
“With TMC PRIME, we hope to address the challenges of our paper-based system,” Dr. Muin explained. “Instead of having results and reports scattered all over the hospital, patient information is now accessed via a single web-based application.”
He noted, however, that many of TMC’s systems are still standalone installations at the moment. “All of our different systems should eventually be integrated into one clinical data repository,” he said. “In the next 3-5 years, TMC will have passed Stage 3 of the HIMSS EMR model.”
Based in Chicago, the HIMSS or the Healthcare Information and Management Systems Society is a non-profit organization dedicated to improving the quality, safety, cost-effectiveness, and access to healthcare through the best use of IT and management systems. It has created an electronic medical record (EMR) adoption model that identifies the levels of EMR capabilities, ranging from limited ancillary department systems to a paperless EMR environment.
Echoing Dr. Muin, Jerry Rapes, Exist CEO, pointed out that it is critical in healthcare to have a system through which all involved in a patient’s care can share information when and where needed. “Integration is a natural progression in the hospital’s future-proofing to enable better, faster decision-making and, as a result, deliver better patient outcomes,” he said.
But while integration may be a natural progression, it is by no means an easy process. At the forum, the attendees mentioned some of the challenges that confront them.
Sonny Zacarias, CIO of Chong Hua Hospital, said that while their strategy of assigning “process champions” who ensure that HIT implementations complement existing care processes is proving effective, a number of issues remain. For instance he said most off-the-shelf healthcare products, even modern ones that were built to scale, have traditionally not met process and people expectations of different healthcare practices. This renders the products unusable, he noted. “The buy / build scenario is that if you buy, (the tendency is to) adapt to the product. On the other hand, to support existing processes, the way to go is to build,” he said.
St. Vincent General Hospital, which operates an off-the-shelf product at its facility, cited its issues with the “buy scenario.” “We have a system but we need to scale and we need to have control of our data and, right now, we have to do this through our vendor,” said Moma Ortega, IT director of the hospital. “We inevitably need to integrate, especially with and to our Finance department.”
Rapes agreed that this could be a problem with many off-the-shelf products. “If hospitals allow themselves to be locked in to a system, at the end of the day, they won’t be able to do anything, and have no choice but to go to (or run after) the vendor,” he said.
Thus, he said, hospitals planning to go through the “buy” route should ask two key questions: Will the vendor be able to support the hospital’s growing needs? If not, can the user integrate to it (the product sold by the vendor) or does it have the ability to interface, maybe build on top of it?
In this case, St. Vincent, which is currently developing its IT team, is fortunate to have manpower resource assistance from the academe in pursuing its IT initiatives. Affiliated with the University of Cebu, the hospital is making use of its academic tie-up to bolster its efforts in research and development, said Ortega, who also teaches at the university.
“We also have full support from top management when it comes to ‘innovation’ and exploring opportunities,” added Joy Sanchez, St. Vincent finance comptroller.
Vicente Gullas Memorial Hospital and Perpetual Succour Hospital are also on their way towards integrating their standalone systems into a more interoperable network. Both hospitals recognize the enormous value of immediate access to a consolidated view of patient information.
“In healthcare where saving lives is part and parcel of service delivery,” Rapes said, “the future workspace will evolve in such a way that (consolidated) data drives actionable intelligence.” Armed with years of experience in developing solutions for the healthcare sector and in delivering enterprise software for the global market, Exist, he noted, can help Cebu healthcare providers identify growth areas and opportunities to improve healthcare services delivery.
Outside the hospital setting, EMR adoption remains relatively low with less than 10% of clinics having some form of automation, said Willex Perez, product development director at Exist’s healthcare division.
Noting that this market remains under served in terms of technology, he said Exist has developed a clinical practice management and EMR system that gives doctors the ability to digitize their clinic practice without the costly IT investment. The new offering, dubbed Medcurial, is designed and deployed via the software as a service (SaaS) model to realize economies of scale and incorporates the user experience of popular social networks to simplify adoption.
“We’re using technology as an enabler to improve how patient care is delivered in clinics,” said Perez.
Medcurial is set for beta release this June. To test drive the application, visit www.medcurial.com.