Public Private Partnership Development in Hong Kong · 2008-06-02 · Healthcare Services in Hong Kong • Population -6.86 million / 1,104 km • 41 Public Hospitals/Institutions

Public Private Partnership Public Private Partnership Development in Hong KongDevelopment in Hong Kong

Dr K M Choy Dr K M Choy Chief Manager (Service Transformation) Chief Manager (Service Transformation) Hospital AuthorityHospital Authority6 May 20086 May 2008

Healthcare Services in Hong KongHealthcare Services in Hong Kong

• Population -6.86 million / 1,104 km

• 41 Public Hospitals/Institutions and 12 Private Hospitals

• 4,500 Doctors in HA

• 5,000 Doctors in private

What models What models work for HK ??work for HK ??

Hong Kong GovernmentHong Kong Government’’s s Healthcare Reform Consultation Healthcare Reform Consultation Document Document (March 2008)(March 2008)

PPP PPP ……

Achieve Savings and Enhance Achieve Savings and Enhance CostCost--EffectivenessEffectiveness

Enable the Optimal Use of Enable the Optimal Use of Human ResourcesHuman Resources

Facilitating CrossFacilitating Cross--Fertilization Fertilization of Expertise and Experience of Expertise and Experience and Healthy Competition and and Healthy Competition and CollaborationCollaboration

Chapter 3

Multi-partite Medical Centers of Excellence

Service Purchase

Engaging Private Drs in Public Hospitals

Hospital Development

Public Private

Patient Record

Cataract Surgeries Programme

Tin Shui Wai PPP Pilot Programme (Family Medicine)

North Lantau Hospital (Phase 2)

Service Purchase Hospital Development

PPI ePR

The Economist, March 29th 2008

…. His notions of the future remained unswervingly radical. Sir Arthur knew that outlandish ideas often became reality. But they provoked, he wrote, three stages of reaction. First, “It's completely impossible.”Second, “It's possible but not worth doing.” Third, “I said it was a good idea all along.”

Sir Arthur C. Clarke

Electronic Patient Record Sharing ProjectElectronic Patient Record Sharing Project

Progress To DateProgress To Date

All HK private hospitalsOpen to all HK private doctorsLaunched in 3Q06– 10,000th patient recruited

on 11-6-07– 25,000th patient recruited

by April 08

All HK private hospitalsAll HK private hospitalsOpen to all HK private Open to all HK private doctorsdoctorsLaunched in 3Q06Launched in 3Q06–– 10,00010,000thth patient recruited patient recruited

on 11on 11--66--0707–– 25,00025,000thth patient recruited patient recruited

by April 08by April 08

PrivateSectorPrivatePrivateSectorSector

ePRePRePR

Copy Patient Record

Copy Patient Copy Patient RecordRecord

Operational Model of PPIOperational Model of PPI--ePRePR

PPI-ePRPPIPPI--ePRePR

SecuritySecuritySecurity

Secure Platform with FIREWALL Secure Platform with FIREWALL and ENCRYPTIONand ENCRYPTION

1. Token1. Token2. User 2. User passwordpassword3. Patient key3. Patient key

Patient receives Patient receives SMS informing of SMS informing of access to recordaccess to record

AwardsAwardsAwards

Recognised in Asian Hospital Management award ANDGold Award in Hong Kong ICT Award 2007

ACNielsen patient surveyThe project received very high level of satisfaction at 82%, with

one-quarter (25%) of respondents stating they were “very satisfied”with it while another 57%, “satisfied” with it.

Likert Scale 1 to 5 (1=very unsatisfied, 5=very good)

Clinician Satisfaction

Likert Scale 1 to 5 ( 5=very satisfied)

Policy Address 2007

“We take pride in our current health care system … We will develop a territory-wide, patient-oriented electronic health record.”

Chapter 4

“Our long-term vision is to develop a territory-wide information system for healthcare professionals in both public and private sectors to enter, store and retrieve patients’ medical records …”

to facilitate the best use of resourcesfor the transition of patients between different levels of care, between the public and private sectors

Cataract Surgeries ProgrammeCataract Surgeries Programme

ObjectiveObjective

Increase Cataract Increase Cataract throughputthroughputExpand patient choiceExpand patient choice

Over 7,000 patients will benefit from the programme

Lengthening Public Waiting ListLengthening Public Waiting List

0 2 years 2 years waiting timewaiting time

61 61 monthsmonths

+5,000+5,000net per yearnet per year

Cataract Surgeries ProgrammePrivate sectorPublic sector

16,00016,000per yearper year

Expanded Choice through Expanded Choice through CoCo--paymentpayment

Individual co-payment

(with maximum cap of $8,000 on cataract surgeries package)

Fixed subsidy of $5,000

Service DeliveryService Delivery

Service PackageService PackagePrePre--op assessmentop assessmentOperationOperation2 follow ups2 follow ups

Public Private

Patient Record

Progress electronically captured in PPI ePR System

Programme Rolled outProgramme Rolled outOn 20On 20--22--20082008

Invitation

4,000 patients invited75/110 private doctors supported

Programme UpdateProgramme Update

Private Sector + HAPrivate Sector + HA 758 + 48758 + 48== 806806

-- deceaseddeceased -- 1414

== 27%27%

No. of Invited PatientsNo. of Invited Patients 4,0004,000-- undelivered packsundelivered packs -- 347347-- surgery donesurgery done -- 539539-- poor healthpoor health -- 5252-- not for OTnot for OT -- 1818

== 30303030Take Up Rate Take Up Rate 806 / 3030806 / 3030

Invitation to 1Invitation to 1stst Batch of PatientsBatch of PatientsTake up Rate Take up Rate (as at 27 Apr 08)(as at 27 Apr 08)

Programme UpdateProgramme UpdateResult Result –– Progress of Enrolled PatientsProgress of Enrolled Patients

0

100

200

300

400

500

600

700

800

1 2 3 4 5 6 7 8

Week after Issuing Letters

Acc

. No.

of E

nrol

led

Patie

nt

0

50

100

150

200

250

300

350

400

Acc

. No.

of P

atie

nts

Enrolled 1st Pre-op Subsidy Logged Surgery Completed

Experience GainedExperience Gained1.1. Electronic Cataract Profile in PPIElectronic Cataract Profile in PPI--ePRePR is is

in smooth operation. Private doctors in smooth operation. Private doctors pioneering inputting clinical data in PPIpioneering inputting clinical data in PPI--ePRePR..

2.2. Surgeries can be arranged in short Surgeries can be arranged in short period of time. Many patients could period of time. Many patients could receive their surgeries 2 weeks after receive their surgeries 2 weeks after replying to HA.replying to HA.

3.3. PatientPatient’’s Choice facilitated.s Choice facilitated.4.4. Communication and admin support are Communication and admin support are

essential. essential.

Tin Shui Wai PPP Pilot Programme (Family Medicine)

Present Mode of OperationPresent Mode of Operation

$45

GOPC

PPP Pilot ModelPPP Pilot Model

Private Doctor

$

Max 10 attendances per year

Patient Record

Monitoring and verification by PPI

ePR

$45Co-payment

Subsidy

Patients to be invited in Phase 1Patients to be invited in Phase 1

Living within Northern Part of TSW Living within Northern Part of TSW Follow up at TSWGOPC for more than 1 yearFollow up at TSWGOPC for more than 1 yearChronic diseaseChronic diseaseStable conditionStable condition

North Lantau HospitalNorth Lantau Hospital

“…“… consideration should be given to pursuing consideration should be given to pursuing PPP in hospital development in the future, PPP in hospital development in the future, which could take the form of which could take the form of coco--locationlocation of of public and private hospital facilities at the public and private hospital facilities at the same site same site …”…”

Chapter 3

CoCo--locationlocation

Enable coEnable co--ordinated ordinated planning and avoid planning and avoid duplication of duplication of equipment and equipment and facilitiesfacilitiesEnables mutual Enables mutual purchase of services purchase of services and sharing of and sharing of supporting facilities e.g. supporting facilities e.g. diagnostic services and diagnostic services and facilitiesfacilities

Public

Privat

e

13(part)

25

4.87 H

ectare

22

Public

Phase 1: Public Hospital 160 in-patient bedsAmbulatory Care (AED, Out-patient Service, etc)Community CareBasic Diagnostic and Treatment facilitiesBasic Support Services

Complete in 2012

““prudent assessment prudent assessment of the feasibility of of the feasibility of introducing PPP in the introducing PPP in the North Lantau Hospital North Lantau Hospital ProjectProject””

Thank YouThank You