In this study, responses were sought from public sector IT Executives in
The People’s Republic of China, Hong Kong, Malaysia, The Philippines,
Singapore, Thailand, South Korea and Taiwan. Respondents were initially
contacted by FutureGov Research via email and telephone in September.
They were invited to complete an online questionnaire that was hosted
on the FutureGov web site between September and October 2009.
In all, 172 responses were received before the study was closed in
early October 2009. However, not all questions were answered by all
respondents and some were not included. A total of 169 respondents
were included in this study. In addition, five hospital executives in the
region were contacted after the initial analysis had been completed and
asked for their anecdotal comments on some of the survey questions.
What is the importance given to ERM?
How advanced are public sector health organisations in the region in scanning and imaging for converting paper forms into digital formats?
What role does outsourcing play in Asia Pacific’s healthcare sector?
What have healthcare organisations adopted within their strategic plans as offices move toward greater automation?
In order to improve patient care and workflow, who are the decision makers and which departments are involved in IT initiatives?
What are the priorities for deciding how to implement major projects?
Value Proposition canvas- Customer needs and pains
Is Asia’s Healthcare Sector Ready for the Future?
1. October 2009
Planning Ahead
Is Asia’s Healthcare Sector Ready for the Future?
Sponsored by Fuji Xerox
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3. PREFACE
Planning Ahead - Is Asia’s Healthcare Sector Ready for the Future?
is a FutureGov Research whitepaper, sponsored by Fuji Xerox. The
views may not necessarily reflect those of the sponsor. This report
was researched, written and prepared by the FutureGov team. The
principal contributors were James Smith, Jianggan Li, Chris White
and Ran Elfassy. The cover was designed by Patrick Schulze. Our
sincere thanks go out to all those that contributed their time to
the survey and the interviews.
4. 1 I 34
www.futuregov.net
TABLE OF CONTENTS
u ABSTRACT 3
u EXECUTIVE SUMMARY 4
u RESEARCH DEMOGRAPHICS 7
» Geographical segmentation 8
» Segmentation by Organisational Type 9
» Organisational size 10
» Organisational by Service Type and Location 11
u The role of it in asia’s healthcare 12
» Introduction 12
» The Importance of Electronic Record Management (ERM) 14
» Insights 16
» Looking Ahead – Where Strategic Plans Are Taking Healthcare 17
» Insights 19
» The Role of Outsourcing 20
» Who Decides on IT Investments? 21
» Insights 22
» Deciding What’s Important – Prioritising IT in Healthcare 23
u CURRENT CHALLENGES – BREAKING THROUGH THE IT BARRIER 25
» Finding the Paper Trail in an Age of Innovation 26
» Insights 30
» Making the Jump and Getting Connected 31
» Getting Networked – Connectivity in Healthcare 32
» Insights 33
u CONCLUSION 34
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5. 2 I 34
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TABLE OF FIGURES
Figure 1 - Respondent profiles by staff role (%). 7
Figure 2 - Respondents by location (%). 8
Figure 3 - Respondents by geographic location from private/
public sector healthcare organisations. 9
Figure 4 - Respondents by size of organisation (%). 10
Figure 5 - Healthcare services by geographical location. 11
Figure 6 - Medical insurance coverage in China from 2003 to 2008. 12
Figure 7 - Relative importance of ERM for the future (% of respondents by location). 14
Figure 8 - Investment areas over the next 1 to 2 years period by
geographical location (% of respondents by location). 15
Figure 9 - Areas of focus for a three-year strategic plan (% of respondents by location). 17
Figure 10 - Organisation’s outsourcing behaviour (% of respondents by location). 20
Figure 11 - Parties responsible for IT investment (% of respondents by location). 21
Figure 12 - Ranked importance of implementing major IT projects. 23
Figure 13 - Improvement area of interest (% of respondents by location). 25
Figure 14 - Dependence on paper-based processes to manage
internal workflow and patient care (% of respondents by location). 26
Figure 15 - Whether or not manual paperwork contributes errors
and increases risks to patients (% of respondents by location). 27
Figure 16 - Agreement that organisational dependence on paper-based processes
has contributed to errors (% of respondents by location). 28
Figure 17 - Whether or not the organisation implemented, or is it in the process
of implementing, Electronic Record Management (% of respondents by location). 29
Figure 18 - Time period legally required to keep patient records, even after
being stored digitally (% of respondents by location). 31
Figure 19 - Why multifunction devices have not yet been connected
to the network (% of respondents by location). 32
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6. 3 I 34
Abstract
In this study, responses were sought from public sector IT Executives in
The People’s Republic of China, Hong Kong, Malaysia, The Philippines,
Singapore,Thailand, South Korea andTaiwan. Respondents were initially
contacted by FutureGov Research via email and telephone in September.
They were invited to complete an online questionnaire that was hosted
on the FutureGov web site between September and October 2009.
In all, 172 responses were received before the study was closed in
early October 2009. However, not all questions were answered by all
respondents and some were not included. A total of 169 respondents
were included in this study. In addition, five hospital executives in the
region were contacted after the initial analysis had been completed and
asked for their anecdotal comments on some of the survey questions.
The responses were spread relatively evenly across the countries, with
the greatest number of respondents coming from Singapore (49) and
the least coming fromTaiwan (6).
The survey sought to receive from the respondents their thoughts
on the current state and use of IT within their organisations, and
the strategic value given to electronic record management (ERM)
as they moved into the future. Investigated topics included:
• What is the importance given to ERM?
• How advanced are public sector health organisations in the region
in scanning and imaging for converting paper forms into digital
formats?
• What role does outsourcing play in Asia Pacific’s healthcare sector?
• What have healthcare organisations adopted within their strategic
plans as offices move toward greater automation?
• In order to improve patient care and workflow, who are the decision
makers and which departments are involved in IT initiatives?
• What are the priorities for deciding how to implement major projects?
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7. 4 I 34
Executive Summary
In Planning Ahead – Is Asia’s Healthcare Sector Ready for the Future?,
researchers sought responses from public sector IT Executives in The
People’s Republic of China, Hong Kong, Malaysia, The Philippines,
Singapore, Thailand, South Korea and Taiwan. The survey attracted
169 complete responses in total, with representation for respective
roles being:
• 32% from senior management;
• 53% from middle management; and
• 15% from patient care staff, department coordinators and
administrative staff.
Just over one third of respondents were employed by government
healthcare organisations located in Singapore, with the remainder
being roughly split among the remaining countries.
The division of respondents coming from public or private hospital
facilities was roughly even, with the remaining 4% coming from other
medical facilities and clinics.
In terms of organisational size, the majority came from organisations
with less than 500 staff, and then organisations that were between
501 and 1000 staff members.
The majority of respondents (96%) reported that ERM of patient
information over the coming years will be ‘Very Important’ or
‘Somewhat Important’. Hence, both frontline staff and the executive
office are taking ERM very seriously.
Most respondents agreed on the importance of Quality Management
in ERM, especially over data collection and institutional transparency.
Where outsourcing of IT processes hasn’t been fully adopted, this
may be due to a lack of outsourcing agents; that if there are agents,
they have had difficulties with integrating into the country system;
or, as in the case for China‘s particular context, the survey wasn‘t able
to capture the details of the organisations‘ outsourcing behaviour. In
areas like Hong Kong, Malaysia, Singapore and Thailand, outsourcing
activity has been used for in-house printing facilities, printer
management, and document scanning.
Deciding how to identify and then fill the gaps is a challenge that is
especially pressing in the healthcare sector, and IT Departments have
generally been given autonomy and responsibility to decide how IT
budgets will be spent.The only responses where IT Departments were
not the most responsible for IT investments were from Singapore,
where roughly equal decision power is shared by the IT Department,
Department Heads and the CEO.
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8. 5 I 34
Executive Summary - continued
On the whole, respondents considered ‘Increased quality of patient
service’ as the most important measure of whether an IT project
should or should not be implemented.
Respondents were also highly focused on improving Quality of
Service. Singaporean and Thai respondents reported that Return on
Investment (ROI) was a concern, and this was correlated to responses
regarding improved cost savings.
Hospitals and other such organisations are still heavily dependent on
paper-based processes to manage workflow and patient care. Results
showed that risk to patients seemed to increase when patient data
were paper based.
The study also measured the length of time that departments were
required to keep patient records, even after they were stored digitally.
The majority of respondents reported that they were legally bound to
keep the records from 4 to 10 years.
Inthefinalpartofthestudy,participantswereaskedwhytheythought
multifunction devices were not yet connected to the organisation’s
IT network. The greatest factors hampering connectivity in the
healthcare organisation relates back to procurement and technical
issues. Much as staff may want new technology and see it as a means
to reduce inefficiency and mitigate patient risk, there remains the
barrier of getting the hardware and software and ensuring that it
actually works ‘on the ground’.
Respondents from Singapore and Malaysia also identified ‘Lack of
centralised vision during purchase cycles’ as a possible source of
organisational inertia.
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9. 6 I 34
CONCLUSIONS
• Improved ERM is a critically important area of concern, where new
technologies and customised solutions to patient information
must be adopted.
• Outsourcing is one way of quickly adopting and launching
solutions, but the need to have these solutions customised to the
local context is crucial.
• There remains much room for improvement when it comes to
adopting scanning and imaging technology to convert paper
forms into digital formats.
• Quality Management around data collection, institutional
transparency and improved ERM processes was the most
important strategic concern for the future.
• IT Departments play the greatest role in deciding how IT budgets
will be spent for local decisions within an organisation, yet for
greater implementation it is up to the Department Heads and the
Executive Office to set the vision.
• Increased risks to patients are believed to come from errors
associated with workflows and processes that remain dependent
on manual inputting across paper-based methods.
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10. 7 I 34
Research Demographics
The survey Planning Ahead – Is Asia’s Healthcare Sector Ready for
the Future? attracted a total of 169 complete responses, with their
respective roles indicated by Figure 1 below. Those from senior
management positions in the public sector amounted to one third
of the respondents, and half came from middle management. The
remainder came from patient care staff, department coordinators and
administrative staff. The breakdown of respondents by geographical
location and by organisational size (in terms of staff numbers) is
outlined in the following sections.
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u Figure 1 - Respondent profiles by staff role (%).
CEO, Managing Director, President
CFO/Controller, COO or Chief Administrative Officer (CAO)
CIO - IT General Manager
Vice President of Operation, General Manager (GM)
Senior Management - Vice-President
IT Manager
Middle or Line Manager, Director, Manager, Head of Dept. etc.
Patient care staff, dept coordinator, Administration
11. 8 I 34
Geographical Segmentation
ThelocationofthosewhorespondedtothesurveyisshowninFigure3
below. As indicated, just over one third of respondents were employed
by government healthcare organisations located in Singapore, with
the remainder being roughly split among Mainland China, Hong
Kong, Malaysia, The Philippines, Thailand, South Korea and Taiwan.
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China
Hong Kong
Malaysia
The Philippines
Singapore
South Korea
Thailand
Taiwan
u Figure 2: Survey respondents by location.
12. 9 I 34
Segmentation by Organisational Type
The division of respondents coming from public or private hospital
facilities was 83 and 80, respectively, with the remaining 6 coming
from other medical facilities and clinics. Figure 3 details how
China, Hong Kong and Singapore were mostly represented from
staff working in public sector healthcare organisations, whereas
respondents from the remaining countries were mostly represented
by professionals coming from private sector.
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u Figure 3 - Respondents by geographic location from private/public sector healthcare organisations.
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
China Hong Kong Malaysia The
Philippines
Singapore South Korea TotalTaiwanThailand
Private
Public
Other
13. 10 I 34
Organisational Size
Respondentswereaskedtonominatethesizeoftheirorganisation,
including satellite hospital locations like clinics and offices. They
then chose from 7 different options, running the range from less
than 100 staff to over 10,000 staff, to the disclosure of uncertainty
around staff count. The results from this survey follow in
Figure 4 below.
u Figure 4 – Respondents by organisational size (%).
<500
501 to 1000
1001 to 5000
> 5000
Don’t know
14. 11 I 34
Organisational by Service Type and Location
With regard to the scope of healthcare services offered by the
respective organisations, Figure 5 below provides a breakdown of
each,bygeographicallocation.Itisofspecialinterestthatrespondents
from Mainland China, which were similarly represented from staff in
Medical Care and Specialty Care departments, will likely see a rapidly
and dramatically changing landscape over the coming years. This is
especially important, as how Premier Wen Jiabao’s major healthcare
reform will impact on the Asia Pacific healthcare sector – predicted
to revolutionise public health in China – is bound to change the
healthcare landscape.
Special attention is also brought to the rise in so-called ‘medical
tourism’, wherein patients from around the world are choosing to
undergo elective surgery in countries like Malaysia, Singapore, and,
most famously, Thailand. Regions like Hong Kong and Mainland
China have been taking strong steps to develop such medical
tourism within their borders, and it is assumed that patient/client
expectations will likely pressure both private and then public sector
healthcare organisations to keep up to speed in both medical care
and patient information.
u Figure 5 - Healthcare services by geographical location.
70%
60%
50%
40%
30%
20%
10%
0%
China Hong Kong Malaysia The
Philippines
Singapore South Korea TaiwanThailand
Medical Care
Cosmetic Surgery
Medical Tourism
Specialty Care
15. 12 I 34
THE ROLE OF IT IN ASIA’S HEALTHCARE
Introduction
Astheworld’slargesteconomyiscurrentlythrowninsocio-politicalturmoil
around public healthcare, the US Government’s decisions over providing
public and/or affordable health coverage for its citizens are bound to
have impact on the healthcare sectors in Asia Pacific. An overhaul of how
the health insurance and medical sector will cover costs, and the degree
to which hospitals will be able to retain staff is expected to dramatically
change the medical communities. The ‘carrot and stick’approach for care
providers to adopt Electronic Medical Records by a certain deadline, as
stipulated in the US stimulus legislation, will have its implications felt in
the US as well as trickling through to Asia Pacific.
Moreover, the massive overhaul of Mainland China’s healthcare sector,
this from what is emerging as the world’s next-largest economy, will
only increase the complexity and impact on healthcare delivery around
Asia Pacific and beyond. On the one hand, the massive investments
spearheaded by Premier Wen Jiabao will likely spur major opportunities
throughout Asia Pacific, and on the other hand, these investments may
attract medicalprofessionalsawayfromtheirhomecountriesleadingtoa
dirth of qualifieid professionals in other countries. This may apply to both
medical staff as well as health IT specialists required to plan, upgrade and
maintain systems. It is generally understood the lack of qualified health IT
professionals is a severe problem impeding greater leverage of IT within
the care providers across the region.
Over the next decade, the country’s much-anticipated reform to fix
the ailing medical system is slated to begin, and the task of delivering
fair and affordable healthcare to all its 1.3 billion citizens will likely have
consequences that will continue for many years to come. Of special note,
thedividebetweentherelativelyadvancedurbanhealthcareinfrastructure,
as compared to the very basic healthcare services in rural China, which is
often non-existent in certain areas will need to be addressed. Dr Hans
Troedsson, the World Health Organization’s representative in China, said
“WHO is pleased to see that the Government of China has made a firm
commitmenttouniversalcoverageofessentialhealthcare.”Helateradded
that, “however, China has a long way to go in terms of improving equity in
financing and provision of essential health care for all.”
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1200
1000
800
600
400
200
0
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
2003 2004 2005 2006 2007 2008
Population (millions)
Coverage Ratio
u Figure 6 - Medical insurance coverage in China from 2003 to 2008.
*Source: 2003-2007 data from the Chinese Ministry of Human Resources
and Social Security; 2008 data from the National Statistics Bureau of China.
16. 13 I 34
After three years of intense debate, The Central Committee of the
Communist Party of China and the Chinese Cabinet issued the
Guidelines on Deepening the Reform of Health-care System. The goal
was to deliver a basic universal health-care system by 2020. On the
roadmap for reaching this goal, a 3-year implementation plan was
recently launched. An investment of US$124billion has been secured
and healthcare service providers around the world will likely be
affected. This impact represents huge opportunities for China’s rapidly
developing healthcare sectors, with massive investments being made
in both securing better facilities and qualified staff, but these changes
will spark equally massive new challenges, especially around staffing in
all the countries surveyed in this study.
The challenges likely to unfold will affect how hospitals, service
providers and administrative departments use IT to manage the
significant waves of patient records that the overhaul will trigger.
For IT executives and their staff, these pressures will place even greater
expectations by their national programmes to deliver effective and
efficient support. Understanding the context and available resources
is what was explored in this next part of the study.
17. 14 I 34
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TheImportanceofElectronicRecordManagement (ERM)
In a widely cited paper, Richard Hillestad et al argued that
adoption of electronic medical records by healthcare providers
brings significant economic and efficiency savings, as well as
dramatic safety benefits (Health Affairs, September 2009). This
was certainly supported by the respondent data in the current
report, as the vast majority of respondents (96%) in the study
reported that ERM of patient information over the coming years
will be ‘Very Important’ or ‘Somewhat Important’ (Figure 7).
Ofthesurveyedcountries,theresearchrevealedthatrespondentsfrom
The Philippines felt that a solid ERM was most urgently needed.
In the next section, investment areas that needed more immediate
attention were explored. Figure 8 on the next page shows which
areas would be addressed over the coming two years, which for an
IT project can be considered a very short timeframe. This means
that if the hospital or facility hasn’t already committed to these new
systems, they have likely at least identified and planned to commit
to them in the very near future.
China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Very important
Somewhat important
Neither important nor unimportant
Relatively unimportant
Very unimportant
u Figure 7 - Relative importance of ERM for the future (% of respondents by location).
18. 15 I 34
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China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
70%
60%
50%
40%
30%
20%
10%
0%
ERM
Scanning and imaging to
convert forms into digital
formats
Centralised web-to-print on
demand form management
Electronic distribution of
documents
Workflow automation to reduce
costs and errors
None of the above
u Figure 8 – Investment areas over the next 1 to 2 years period by geographical location (% of respondents by location).
From the respondents, we see that although IT executives and their
staff agreed that ERM is a major point of concern, only more than
half of respondents from China, Hong Kong and Malaysia could
confirm that they were already committed to addressing ERM over
the coming 2 years. Surprisingly, these three countries/territories
also showed relatively fewer commitments to bringing better
scanning and converting to digital formats. The three were also
relatively less committed to launching centralised web-to-print on-
demand ERM. Where these countries did show significant measures
for commitment was in workflow automation to reduce errors.
It is also worth noting that the majority of respondents from
Hong Kong and China were from the public sector (61% and 81%,
respectively), whereas the similar trends coming from Malaysia
were shown from respondents mostly coming from private sector
facilities (78%). This suggests that Hong Kong and China’s public
sector had already committed to ERM enhancements, whereas the
private sector in these countries have either already settled these
issues, or have not yet committed to them.
Notably, respondents from Thailand and Singapore showed strong
interest in scanning and converting documents to digital formats,
as well as enhancing workflow automation in order to reduce costs
and errors. Furthermore, about a third of respondents from Taiwan
saw centralised print-on-demand as needed.
It is also worth noting that respondents from The Philippines and
China had significant responses as ‘None of the Above’, suggesting
that although improved ERM may be needed by these respondents,
theprecisenatureoftheseimprovementsfelloutsidetheboundaries
set by the survey.
19. 16 I 34
At his hospital, they hadn’t yet faced the ERM
challengeindocuments.Designingdocuments,
either into structured or unstructured
formats for full user acceptance, remains a
big challenge. This calls for a paradigm shift
for many people. Although efficiency is very
important, it is equally important that the
documentation interface and utility handles
issues in hand-writing, typing and other
similarly changing dynamics.
At his hospital, they’ve been struggling with
some of the designs they have adopted. The
greatest problems have been in defining what
data points, and hence, data type, to use to
help standardise the information intake. If
forms weren’t well thought out and carefully
designed, one department may find itself
using one form while another department
creates information noise because of small
differences in use. And this only creates big
headaches down the line.
As he put it, if you have a user problem,
you have a design problem; if you have an
interface problem, you have IT and business
process problem.
Hence, he said balancing needs versus
resources is the most critical issue that
needs to be addressed. Prioritising resources
to help everyone across the board was the
most pressing concern, and the next issue for
hospitals was that there are many platforms
available, and the pressure to buy different
system to meet specific needs always crops up.
Again, standardisation has become an issue.
New modules and new applications must
have seamless integration, which is not what
he has seen. And finally, there remained the
issue of hardware. As hospitals increasingly
depend on IT, having so many independent
hardware components at different locations
makes the availability of a shared network all
the more important.
Singapore CIO at a public hospital
From our conversation with a Chief Information
Officer at a Singaporean private hospital, he
asserted that the most important area he saw
was in getting the right information at the
right time. Getting relevant, timely information
throughout the organisation was crucial,
something he felt was the most important
contribution that IT brought to healthcare.
In older, paper-based systems, a person had to
be on site in order to view a patient record. The
innovation of IT across the enterprise, however,
now let staff view information from multiple
areas, and not only where those records were
physically stored.
If access is the greatest benefit, then the greatest
challenge is how to digitise and capture all
records electronically, and make it useful and
relevant. Capturing and scanning is relatively
straightforward,buteffectiveandtargetedretrieval
is very difficult. Questions he has faced are what
documents get scanned and how will they be
archived? And would records be duplicated?
Hence, he would like to see improvements
around scanning technology. Active scanning
is very easy to do, but to scan an old document,
even if it’s only one year old with a different
record format, means that making sense of an
irregular, older format becomes a challenge.
With scanning, he has found that it is much
easier to go from the present forward, than to
go back in time and use older formats.
For this reason, his ERM could be improved
by addressing user-interface. As there are
multiple departments that must be catered
to, a well designed user-interface is crucial.
Poorly designed interfaces will make doctors
unhappy, as their day is stressful enough
without having to get bogged down by an
interface that complicates the process.
Insights
20. 17 I 34
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Looking Ahead –
Where Strategic Plans Are Taking Healthcare
Whereas the previous section asked what organisations had
committed to over the next two years, this part of the study explored
what healthcare organisations were aiming to achieve over the
coming three years. In the former, investment areas were a measure
of the tools or systems that were currently needed, and in this latter
part the aim was to get a sense of what a target for the future may
look like. From Figure 9 below, the areas respondents had to gauge
included enhanced quality management, improving workflow
efficiency, building strategic partnerships, improving access to
information, improved elder-care services, compliance, preparing for
pandemics, staff retention, and more.
China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Quality Management (data
collection, transparency, ERM
processes, etc.)
Efficiency of document/Forms/
paper processes and workflow
Strategic partnerships
Acquisition of high-quality
care patients
Achieving cost reduction
New Elder care services
Improve Access to Clinical
information
Outcome Quality & Safety,
Compliance Review and Audits
Building operation efficiency
and readiness for Pandemic
Increase quality of patient
related services
Retain and attract the best
nursing staff and physicians
Other
u Figure 9 – Areas of focus for a three-year strategic plan (% of respondents by location).
A review of the responses shows multiple trends, but the most
significant one revealed a general consensus around Quality
Management. This one area was felt as the most important strategic
concern for the future. For all countries, except for South Korea and
Taiwan, which ranked Acquisition of High-Quality Care Patients
and Achieving Cost Reduction, respectively, higher, Improved
Quality Management was ranked highest, with the Singaporean
respondents showing the least pronounced concern. For the other
countries, quality management around data collection, institutional
transparency, improved ERM processes and the like were at least twice
more important than any of the other areas. This is likely when one
considers how the future promises to be even more data-dependant.
21. 18 I 34
The countries that listed Quality Management as most important
were China, Hong Kong, Malaysia and Thailand. As we saw earlier,
the majority of responses from China and Hong Kong came from the
public sector hospitals, whereas Malaysia and Thailand (80%) were
from the private sector. This may be the case because the former
countries have more public hospitals than private ones, but it can also
be because across both private and public sector hospitals in these
countries have yet to fully address shortcomings in these areas.
Clearly, effective management of information is expected to occupy a
significant portion of the respondents’ future. Of these, respondents
from China showed the greatest concern, with nearly 40% of
respondents noting that quality management must be addressed.
Looking at the other end of the scale, folding new elder care
into the strategic plan registered among the lowest among the
respondents. This is quite surprising, given the predicted rise in the
elder population in most of Asia Pacific’s countries. One explanation
of this finding could be that as an IT-related issue, improved elder
care may simply not have yet registered on respondents’awareness.
Much as elder care may be a growing concern in the geriatrics ward,
among sociologists, economists and the like, this may not have
registered yet as a growing concern among the IT professionals and
administrative staff.
Another area of high interest is around increased quality of patient-
related services. This may be due to the increased presence of
competing organisations in the ‘patient market’, and the rising
awareness that patients are increasingly deciding where they seek
their healthcare services. Improving the patient experience is an
important part of practiced medicine, and improving the admission,
stay and overall patient experience seems to be something that
healthcare practitioners are paying more attention to.
This seems to suggest that although respondents felt that improving
how patient information is recorded and managed needs attention,
respondents didn’t feel that improving how this information is
accessed is as important. This may also suggest that at this stage of
the hospitals’ development, they just haven’t yet begun to address
the complex issue of timely information access and its direct impact
to patient safety and care quality improvement.
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22. 19 I 34
the hospital would make its investment; the
hospital did not specifically budget for new
systems adoption. For this reason, the financial
downturn did not affect the hospital’s IT
strategic plans, even when many other factors
did. His hospital conducted a four year plan for
their IT upgrades, including the ERM, and that
was not affected by the financial downturn,
acute though it may have been.
At the heart of the change into new ERM
systems at his hospital was the fact that
the country legalities prevented electronic
documents in a court of law. That was clearly a
hurdle that needed to be addressed. Moreover,
howtomakesenseofthedatawithinascanned
document is problematic, a point common to
almost all respondents in the survey.
Ultimately, the heart of the issue of a system’s
success and usability, or so he believed,
transcended the healthcare-specific context.
User acceptance remained the critical and
deciding factor. He felt that despite the so-
called healthcare boom in Asia, most hospitals
remained pen and paper institutions; what he
called “paper-ful” and not “paper-less”.
Breakingthroughthebarrier,hecontinued,may
require the talents of a visionary leader, which
really boils down to luck. Change management
is the other, more systematic approach.
He believed that how to get users into
the habit of capturing the information or
document whenever it is generated is the
point, and the challenge. Hence, user interface
played a big role in letting this change happen.
Currently, there has been much talk around
implementing electronic health records by
taking the approach of a central repository.
However, whether all the information can be
meaningfully captured and stored or not, and
making sense of the information captured in
those files, is an issue that remains unsolved.
On the next level it remained the same
challenges that have been seen across Asia
Pacific and beyond: ensuring a secure platform
where the right professionals and staff get
access at the right time. Doing so just from
within the hospital has been problematic,
and it remains to be seen if a system that
works across organisations can be developed
and implemented.
China CIO at a private hospital
In our conversation with a CIO from Mainland
China, it became immediately apparent that
the greatest hurdle facing his organisation was
simply transferring knowledge and data in a
timely manner. As admissions, diagnostics and
treatment feel the pressure of an increasingly
stressedhealthcaresystem,theneedforeffective
and networked internal communications is
increasingly seen as a means to alleviate those
pressures. That said, there remained a gap in
terms of what information was even available in
the first place.
Astowhatwouldbethemostusefulandeffective
solution to this executive’s current needs, he too
felt that current scanning technologies weren’t
adequate for solving the issues in document
management, even if hospitals found it the
most practical way to get things onto a digital
platform. An automatic means to capture
scanned forms and documents and transpose
them into electronic formats into the database
would be perfect, he explained, although he
doubted that there was a system out there
that could decipher the physician’s writing. His
organisation was very much oriented around
capturing information through manual input
than through automated systems.
When discussing how he would like to improve
the automated systems that dealt with patient
records,hesaidhispreferencewasforcommercial,
off-the-shelfsoftware,whichhewouldliketouse
as much as possible. However, these had to come
at a reasonable cost and be easy to implement.
Having very limited manpower to deal with
new system setup and rollout, he didn’t want
his staff bogged down with maintaining new
systems. As he saw it, ongoing maintenance was
the vendor’s responsibility.
Moreover,anynewsystemwaschosendepending
on whether it could be integrated within the
hospital’s current ERM or not. Doctors simply
would not use the new system if they could
access some information on the ERM but had to
pull documents from another application.
At his organisation, how they decided upon
budgetary limits and systems to finance was
by inviting various vendors to come present
their ERM solutions. Based on these options,
Insights
23. 20 I 34
The Role of Outsourcing
For many hospitals and other healthcare organisations struggling
to keep up with the waves of information, outsourcing to an
outside vendor is often seen as the right solution, at least while the
hospital finds its bearing. The financial advantages and incentives
can be significant and critical, especially when the outsource
agent can deliver or respond with timely, customised solutions.
Figure 10 below details replies to the question of outsourcing in
today’s healthcare facilities.
The results reveal an interesting correlation between the need for
solutions and the degree to which an organisation will outsource
to solve the challenges being faced by the organisation. For
example, in locations like China, which communicated the need
for improved ERM within the organisation, there hasn’t been much
in the way of getting help from an outsourced party. This may be
due to the fact that there is a lack of outsourcing agents; that if
there are agents, they have had difficulties with integrating into
the country system; or that the survey simply didn’t capture the
route that China has taken in its outsourcing.
In areas like Hong Kong, Malaysia, Singapore and Thailand, there
are a few areas that have seen relatively strong outsourcing
activity, such as in-house printing facilities, printer management,
and document scanning, respectively.
Respondents have clearly indicated the need for enhanced ERM,
even the need for outsourcing in order to solve the problems
they are facing in their daily workload, and yet the move towards
outsourcing hasn’t caught up. The demand may be strong but
there is a lag in securing delivery.
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China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Document Scanning
Mail and parcel distribution
In plant printing facility
Fleet of copiers and printer
management
Records/ files management
(printed)
Records/ files management
(electronic)
Printed marketing and
promotional
Other
u Figure 10 - Organisation’s outsourcing behaviour (% of respondents by location).
24. 21 I 34
Who Decides on IT Investments?
Deciding how to identify and then fill the gaps is a challenge that
is especially pressing in the healthcare sector. If outsourcing is an
untapped resource – since it can provide the quickest path to efficient
implementation and reduced waste – there may be organisational
inertia from the decision makers themselves, delaying the push to
outsourcing due to anticipated investment potential. Hence, the
report paid special notice to the decision makers in both private
and public sector healthcare organisations, in order to identify
who on staff has the power and capacity to bring about the much-
needed change. In Figure 11 below, the management office and staff
responsible for identifying and investing in the needed change are
listed by geographical location.
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Procurement
IT department
CFO or Hospital controller
Logistics Department
Board of directors
Government Officer or
Representative
Head of department
CEO
Clinicians
Other
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
u Figure 11 – Parties responsible for IT investment (% of respondents by location).
25. 22 I 34
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Generally speaking, IT Departments are given enough autonomy and
responsibility to decide how IT budgets will be spent. This makes
sense, as these professionals are generally well suited for knowing
what is out on the market, what will fit the needs of the organisation,
and they will have the contacts for purchasing and installing the new
systems. The only responses that indicated that IT Departments were
not the most responsible for IT investment were from Singapore and
Taiwan. In these two countries, roughly equal decision-making power
is shared by the IT Department, Department Heads and the CEO.
A telling result is seen in respondents from China, where the second-
most powerful deciding power came from a Government Officer or
Representative. In all these other countries, such a Government Officer
ranked among the lowest in the hierarchy of IT spending decision making.
It is also interesting to note that clinicians play a relatively minor or
completely removed role in terms of the IT decision-making process.
Although clinicians are likely involved in some of the operations that
involve scanning, capture and other ERM processes, and they may
have good input in terms of fulfilling their needs on the operational
level, the results suggest that what hardware and software is at their
disposal is decided by more technical professionals.
– be it an updated or improved ERM system –
but to ensure that once defined or designed
by the HA, the updated systems rolled out on
schedule and on budget.
He then commented that although Hong Kong’s
healthcare system effectively took him out of
directly serving users’ needs, he believed the
remaining concern from users remains whether
or not ERM systems were user-friendly. He said
that once patient information was been stored,
a key concern he regularly faced was how this
data gets aggregated for use. There remained
the need to define and store the data so it is
useful and accessible.
He concluded by pointing out that the HA was
currently pushing public and private hospitals
towards shared patient records across platforms
and institutions. Having data so easily available
will be a great benefit to clinicians, staff and
patients, but there were privacy issues that
needed attention. He anticipated a roll out to
occur over the next 2 to 3 years.
Hong Kong IT Manager at a public
hospital
Fromoneofourone-to-oneinterviews,it became
clear how the Hong Kong Hospital Authority (HA)
created a unique reality in the city’s healthcare
landscape. The HA’s top-down decision-making
process with regard to new IT systems meant
that IT managers at his hospital were exclusively
focused on installing or updating new systems
that weredefinedbytheHA,leavingthestrategic
issues for IT essentially outside of the hospital’s
mandate. He said this is common in Hong Kong’s
healthcare organisations.
Hence, the greatest challenge for Hong Kong’s IT
executive is with working within this framework
of implementing new IT systems from a
coordinator’s perspective, and not from the
user’s. Frontline and administrative staff that
use the systems are the users, and as far as his
duties were concerned, their needs were beyond
his areas of control. He then added that he did
not decide which new technology to implement
Insights
26. 23 I 34
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DecidingWhat’s Important – Prioritising IT in Healthcare
Respondents clearly communicated that IT departments are among
the leading voices for choosing how and on what to invest on when it
comes to IT-related spending, followed by the executive office and the
CEO. Yet how do they decide what to invest in, and more importantly,
what benchmarks or other measures are used to decide whether or
not the investment was sound? In the following part of the study,
as detailed in Figure 12 below, respondents were asked to rank and
prioritise the importance of 7 measures against the backdrop of an
implemented IT project.
China Hong Kong Malaysia
The
Philippines
Singapore
South
Korea
Thailand Taiwan
Return on
Investment
within 2 years
Ranked
as Least
Important
(86%)
Ranked
as Least
important
(61%)
No
significant
trend
No
significant
trend
Ranked as
Relatively
Unimportant
(52%)
No
significant
trend
No
significant
trend
Ranked as
Relatively
Unimportant
(50%)
Matches focus
and mission of
the hospital/
organisation
No
significant
trend
Ranked as
Relatively
important
(61%)
Ranked as
Relatively
Important
(73%)
Ranked as
Relatively
Important
(57%)
Ranked as
Relatively
Important
(91%)
No
significant
trend
Ranked as
Relatively
Important
(50%)
Ranked
as Most
Important
(50%)
Increase
efficiency of
the Human
Resources
Ranked as
Relatively
Important
(95%)
No
significant
trend
No
significant
trend
Ranked as
Relatively
Important
(67%)
No
significant
trend
No
significant
trend
Ranked as
Relatively
Important
(18%)
No
significant
trend
We have end-
of-the-year
budget to
spend
Ranked
as Least
Important
(95%)
No
significant
trend
No
significant
trend
No
significant
trend
Ranked
as Least
Important
(48%)
No
significant
trend
Ranked
as Least
Important
(33%)
No
significant
trend
Increased
quality of
patient service
Ranked
as Most
Important
(86%)
Ranked
as Most
Important
(83%)
Ranked
as Most
Important
(59%)
Ranked as
Relatively
Unimportant
(86%)
Ranked
as Most
Important
(39%)
No
significant
trend
Ranked
as Most
Important
(67%)
No
significant
trend)
Differentiate
ourselves from
other hospitals
No
significant
trend
No
significant
trend
No
significant
trend
Ranked
as Most
Important
(48%)
Ranked
as Most
Important
(23%)
No
significant
trend
Ranked as
Relatively
Important
(56%)
No
significant
trend
Matches
strategic
initiatives to
insure a proper
"balanced
scorecard"
Ranked as
Relatively
Important
(95%)
No
significant
trend
Ranked
as Least
Important
(40%)
Ranked
as Least
Important
(48%)
Ranked as
Relatively
Important
(68%)
Ranked as
Relatively
Important
(37%)
Ranked as
Relatively
Important
(89%)
Ranked
as Least
Important
(67%)
Most important Relatively important Relatively unimportant Least important
u Figure 12 – Ranked importance of implementing major IT projects.
27. 24 I 34
For each item, respondents needed to rank it on a scale of 1 to 7,
corresponding to a scale of ‘Most Important’ to ‘Least Important’.
When responses varied and the data points were scattered across the
scale,thisisindicatedintheTableas‘Nosignificant trend.’Wherethere
was a significant trend in the data, the percentage of respondents
that had chosen that particular ranking is provided.
The Table reveals how most respondents considered ‘Increased
quality of patient service’as the ‘Most Important’measure of whether
an IT project should be implemented. This is sensible enough, as a
healthcare organisation’s mission is, after all, to serve patients. A very
surprising result was that 86% of respondents from The Philippines
measured improved patient service as Relatively Unimportant. Nearly
half of the respondents from The Philippines ranked ‘Differentiate
ourselves from other hospitals’as Most Important.
Although there was general consensus on what was Most Important,
there was no such trend in what was considered Least Important.
From the Chinese respondents, nearly 90% considered an ROI of 2
years as Least Important. The Hong Kong respondents were similar,
with two-thirds giving the same rank. ‘Matches strategic initiatives to
insure a proper “balanced scorecard” was something the Malaysian
and the Philippines respondents felt was Least Important. Half of
the respondents from Singapore and a third of respondents from
Thailand felt that ‘We have end-of-the-year budget to spend’ was
Least Important.
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28. 25 I 34
CURRENT CHALLENGES – BREAKING THROUGH
THE IT BARRIER
In the previous section, seven areas for discerning between IT
projects were ranked with regard to the organisation, yet these
were not necessarily indicative of what respondents personally felt
needed specific improvement. In the following section, respondents
were sampled to find out which areas they were more interested
in. Again grouped by country, results in Figure 13 show respondent
interest in terms of patient or physician satisfaction; cost savings
and ROI; public image; quality and efficiency of care; and more.
As in the previous section, respondents were highly focused on
improving the Quality of Service, with Malaysian respondents
rating patient satisfaction higher. This is a surprising finding, as one
could assume that reaching high patient satisfaction is the priority.
However, taken from the service provider’s perspective, improving
the service quality could be a technical or operational improvement
that may be more tangible than focusing on patient satisfaction,
much as that was considered very important.
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100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
Patient satisfaction
Physician satisfaction
Cost savings
Public image
Quality of service
Efficiency of care
Return on investment
Other
u Figure 13 - Improvement area of interest (% of respondents by location).
Singaporean and Thai respondents felt the ROI was a concern, and
this was correlated to responses regarding improved cost savings.
This may have been a result from a higher skew in the respondents
coming from the executive office, people whose professional
concerns are likely tied to such financial performance measures.
29. 26 I 34
The highest-ranked score was seen in the group from China, where
two-thirds felt that improvements in quality of service was needed
most, compared to a score of less than 10% for patient satisfaction.
This result may have come from the pragmatic desire to deliver
adequate or satisfactory care, given Mainland China’s current
challenges that were discussed above.
Finding the Paper Trail in an Age of Innovation
Whereas past technological innovations delivered better and
faster means of paper and image reproduction, the current trend
is leading towards paperless or digital technologies. In the previous
sections, the study attempted to describe who decided what IT
projects would be implemented, and what were the aims and the
medium-term objectives. In the following section, illustrated in
Figure 14, responses were taken to better understand what the
current environment is in the healthcare organisations, especially
in light of paper-based record keeping.
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China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
u Figure 14 – Indication of an organisations dependence on paper-based processes to manage internal workflow
and patient care (% of respondents by location).
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Yes, we’re still dependant
No, we aren’t
Clearly, hospitals and other such organisations are still heavily
dependent on paper-based processes to manage workflow and
patient care. Surprisingly, respondents from technologically
advancedcultureslikeHongKongandSingaporewereoutperformed
by respondents from The Philippines and Mainland China. That
respondents from Mainland China, South Korea and Taiwan were
about evenly split, as opposed to the other respondents, seems
inconsistent with perceptions of lacking infrastructure (e.g. in
Mainland China) or advanced healthcare (e.g. South Korea) and
may deserve further investigation.
30. 27 I 34
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Thefollow-upquestioninthestudywaswhetherornotpaper-based
patient records were responsible for added errors or increasing
risks to patients. Naturally, human error could also be involved
when digital processes are used instead of paper-based ones, but
many such IT innovations have been designed to reduce or remove
the human-error factor. Figure 15 below illustrates responses to
this question, recording the perceptions that human error plays
in record keeping and the relation it may have to increasing the
risk to patients.
Again, it is interesting to note that respondents from China, The
Philippines and South Korea had similarly matched results, and were
somewhat evenly split on the question. Respondents from Malaysia
and Singapore were closely matched in that risk to patients did
increase when patient data were paper based, and these results were
closely matched by Hong Kong respondents. That all the respondents
from Thailand felt the risk was real indicates the strong favour
towards moving to a more digital platform, as since nearly 90% of
Thai respondents had indicated that their healthcare facilities were
essentially dominated by paper-based processes.
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
u Figure 15 – Whether or not manual paperwork contributes errors and increases risks to patients
(% of respondents by location).
Yes
No
31. 28 I 34
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By comparing the findings of the previous sections, an even stronger
correlation emerges. Figure 16 below reveals the relationship
between the dependence on paper-based processes to manage
internal workflow and patient care, and whether or not manual
paperwork contributes errors and increases risks to patients. This
is especially telling, as it shows what IT executives and staff feel is
missing, if at all, and what may be needed to fill that gap.
All respondents from China, Hong Kong, Malaysia and Taiwan that
had a dependence on paper-based processes indicated that this was
what contributed to errors and increased risks to patients. In other
words, for these respondents, this outdated dependence invariably
led to error. Similarly strong but not absolute agreement was seen
in respondents from The Philippines, Singapore and Thailand and
South Korea, with the relatively lowest fraction of three-quarters
of respondents from The Philippines were in agreement that
that organisational dependence on paper-based processes has
contributed to errors.
China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
120
100
80
60
40
20
0
u Figure – 16 Agreement that organisational dependence on paper-based processes has contributed to errors
(% of respondents by location).
32. 29 I 34
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China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
u Figure 17 – Whether or not the organisation implemented, or is in the process of implementing,
Electronic Record Management (% of respondents by location).
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Yes, completed
Yes, in progress
No, but we plan to implement
No, and we have no plans to
implement
Next, as shown in Figure 17, results were gathered regarding paper
versus digital-format record keeping. From the Chinese respondents,
for example, where roughly half said their processes were paper
based, it was observed that about half of the respondents reported
that their organisation had or was in the process of implementing
an ERM. Similarly, nearly 40% of respondents from The Philippines
and 62% from South Korea reported that their organisation had
completed the roll-out of an ERM system. As well, around 80% of
respondents from Hong Kong, Malaysia and Singapore reported that
their organisation was in the process of introducing an ERM. It is of
interest as well that a small but significant fraction of respondents
from China, Singapore, South Korea and Taiwan were unaware of
any plans to implement an ERM in their organisation.
33. 30 I 34
it. For electronic files, however, the guidelines
aren’t as clear. If electronic copies are kept, he
said it was fine as long as they can’t be modified.
Electronic files can be changed rather easily, so
from a legal standpoint, information access and
protection needed to be addressed.
Asfarasheisconcerned,thegreatestareainneed
of improvement for ERM solutions was in the
area of accurately and automatically capturing
information stored on documents. For now, as
part of the legal requirement, the organisation
was still warehousing the older patient records
in paper offsite. Moreover, his hospital tries
as much as possible to input the data into a
structured database without the need to scan
the documents.
Thus, the top-three most important
factors deciding the hospital’s future plans for
IT investments were to get clear identification at
theadmissionslevel.HongKonghasthe electronic
HKID , but, for example, as many women are now
coming over from Mainland China as visitors and
changing their visa permits every three months,
their identification documents keeps changing.
Getting a clear means of identifying and tracking
patients is a major issue.
Anothercriticalfactorwasaroundsharing patient
information across the hospital – an integration
issue that created errors and redundancies he
wished weren’t there. The third factor regarded
security access. The hospital has patients who
need or want increased security or protected
access, and this was an area he definitely wanted
to be enhanced. Nevertheless, the overarching
challenge remains to create a workflow wherein
patient information gets affectively logged and
parcelled for later use.
Hong Kong CIO at a private hospital
From our conversation with a Chief
Information Officer in Hong Kong’s healthcare
sector, the greatest impact to date has been
seen in customer service. One example is with
queue display, letting people at admissions
know how long they are going to wait. This
relatively straightforward utility has reduced
intake stresses simply by letting people know
where they are in the queue.
Surprisingly, this CIO did not feel that current
scanningtechnologiesofferedenoughwithinthe
healthcare context. As things stand, documents
are essentially captured as image files, leaving
much of the records incomplete and impossible
to make sense of in an automatic manner,
thus needing further data entry. Many Hong
Kong hospitals, like Hong Kong Sanatorium
and Hospital, Hong Kong Baptist Hospital and
others, do include scanning in their processes,
however they are limited in terms of how
deeply the technology can capture and classify
the information. At his hospital, for example,
there remains a need to help staff capture and
classify the information within patient records.
Physicians typically shy away from excessive
data entry, and yet to segregate and aggregate
information with current technologies requires
an excessive amount of such manual data entry.
Part of this has come from the difficulties in
managing patient records, especially with regard
to storage. This has also engendered issues with
integration – will information be freely shared
within different departments? From his
experience, Hong Kong has clear guidelines on
how to process paper-based information, both for
keepingpaperrecordsandhowmany yearstokeep
Insights
34. 31 I 34
Making the Jump and Getting Connected
The study then measured the length of time that departments
were required to keep patient records, even after they were stored
digitally. As many organisations from around the world are faced
with decreasing storage space for their patient records, the move
towards digitisation of records clears physical space, which in many
organisations is at a premium.
Figure 18 below illustrates the responses, with only a very few
reporting that the organisation was required to store the information
for less than two years. A small fraction of Singaporean respondents
reported that they were duty bound to keep the records for less than
1 year. The great majority of respondents reported that they were
legally bound to keep the records from 4 to 10 years, and it is supposed
that some may even need to keep them for longer periods of time.
China Hong Kong Malaysia The
Philippines
Singapore South
Korea
TaiwanThailand
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
u Figure 18 – Time period legally required to keep patient records, even after being stored digitally
(% of respondents by location).
Less than 1 year
1-2 years
2-4 years
4-10 years
We are not legally required
to keep a hard copy of
patient records
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180
160
140
120
100
80
60
40
20
0
u Figure 19 - Why multifunction devices have not yet been connected to the network (respondents by location,
multiple selections allowed).
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Getting Networked – Connectivity in Healthcare
In the final part of the study, participants were asked why they
thought multifunction devices (MFDs) were not yet connected
to the organisation’s IT network. By MFDs, researchers meant
copiers, printers, scanners, email utilities, all linked to archives, data
repositories and all-in-one information/IT solutions. Figure 19 below
provides a percentage breakdown by location, showing which 4 or
more reasons could be used to explain the lack of an MFD platform.
Procurement issues
IT issues
Lack of centralised vision
during purchase cycles
Organisational issues
All of the above
Other
When it comes to leveraging on the power of new IT devices and
the benefits that they deliver to a department, having access to
network functions is among the top benefits. Part of what makes
today’s capture-and-storage devices so appealing is that once the
information has been stored in a central repository, it can later be
accessed and cross-accessed by multiple users and for multiple uses.
Hence, identifying resistance points or reasons why these devices
haven’tbeenfullyexploitedishelpfulforreducingwaste,streamlining
patient-data retrieval processes, and more.
From the respondent data, it would seem that the greatest factors
hampering connectivity in the healthcare organisation relates back
to procurement and technical issues. In many cases, simply getting
the technology in house is the main barrier, and in many other
cases departments must find solutions that will specifically help the
organisation within its context. A review of the data suggests that
much as staff may want new technology and see it as a means to
reduceinefficiencyandmitigatepatient risk,thereremainsthebarrier
of getting the hardware and software and ensuring that it actually
works ‘on the ground’.
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that would unify multiple departments and
that aimed at acquiring both new systems and
deliver better training.
AttheheartoftheITeffortwerethetechnologies
to replace the mounds of paper that were
physically piling up. Record keeping has been
especially challenging as diagnostic tools have
progressed, and making the transition from
paper-based processes to the latest IT is what he
will be focussing on in the coming two years.
Even just getting the obvious advantages, let
alone the full potential from their new ERM,
has been an issue. He believes that now that
the hospital has a clearer path with targets
for both IT and HR, they will see significant
improvements in the near future.
IT Director at a private hospital in
the Philippines
When we spoke with an IT Director at a private
hospital in Manila, he identified the issue of how
to reduce errors in record keeping as the greatest
area of concern. On the one hand, the facility was
introducing new technologies very aggressively,
yet there was still an excess occurrence of
problems in information gathering. This has led
to compounding issues down the line.
Having come from the commercial sector, he
found it surprising to see how hard it was to
get a “clean bill of health” with regard to the
hospital’s ERM. On this point, he was happy to
report that the hospital will be implementing
an updated programme in the coming year, one
Insights
Of note, respondents from Malaysia, Singapore and South Korea
identified ‘Lack of centralised vision during purchase cycles’ as
a possible source of organisational inertia on the matter. This is
especially interesting when matched to the responses of who was
most responsible for decision making around IT acquisitions. Given
that IT Departments, which generally have the technical knowledge
needed to decide what is needed and how to use it, aren’t charged
with the task of leading the organisation, it would seem that it is
up to the CEO and the Executive Office to rise and lead in a more
concerted effort.
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CONCLUSION
PlanningAhead–IsAsia’sHealthcareSectorReadyfortheFuture?aimed
at describing and capturing the fractured image of IT in healthcare
in Asia, especially under the major changes that are anticipated to
follow in the coming medium to long term. As healthcare costs and
needs from a bigger, older and more discriminating population rise,
so too will the challenges bloom for public and private healthcare
organisations. Not only will physicians, nurses and support staff need
to have the technical skills to serve their patients, but so too will the
administrative and operational systems also need to work smoothly
and efficiently.
From the results, the following conclusions were found:
• Healthcare professionals across the region and organisational
hierarchy see ERM as a critically important area of concern,
where new technologies and customised solutions to patient
information must be adopted. Where some countries have
adopted more comprehensive IT platforms, they are being used
and valued. In countries where these networked ERM solutions
have not yet been adopted, the need remains.
• Healthcare professionals from across the organisation in both
private and public sectors recognise that outsourcing is one way
of quickly adopting and launching solutions, but the need to have
these solutions customised to the local context is crucial.
• There remains much room for improvement when it comes to
adopting scanning and imaging technology to convert paper forms
into digital formats. In both the public and private sectors, although
there are many cases where ‘paperless’ systems are in place, they
hardly work across the organisation or on the national level.
• Quality Management around data collection, institutional
transparency and improved ERM processes was the most
important strategic concern for the future.
• Increased risks to patients are believed to come from errors
associated with workflows and processes that remain dependent
on manual inputting across paper-based methods.
• IT Departments play the greatest role in deciding how IT budgets
will be spent for local decisions within an organisation, yet for
greater implementation it is up to the Department Heads and
the Executive office to set the vision. If organisations haven’t
yet scaled up to meet the challenge, it may be due to a lack of
effective leadership or resistance to change, even if the benefits
are clearly perceived.
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