•• HIC 2017
•
• Melbourne, Australia
• 25 - 27 July 2016
•
• Title: An Australia-China case study:
• System Integration (SI) support for electronic medical record (EMR) systems.
•
• Authors:
• Bernard Crowe
• Partner
• Bernard Crowe and Associates, Canberra.
•
•
• Henry Zhuang
• Managing Director
• AusAsia Health Innovation Centre, Brisbane.
•1
2
• Introduction
• In China the use of Electronic Medical Record (EMR) systems,
including radiology images and reports, has developed on a
departmental basis over the last decade.
•
• Hospitals in China have encountered several obstacles including
fragmentation and duplication between diverse software systems;
these “information islands” impede data sharing.
• A suggested two part solution to the problem of data sharing would
be based on:
• the availability of an integrated EMR
• the availability of experienced System Integrator (SI) EMR support
capability.
• There is extensive experience in the area of EMR SI support in
Australia.
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5
• Critical shortage of multi-disciplinary talents in healthcare institutions
– Average IT FTEs in Chinese hospital is 9 (tertiary 12, below tertiary 5)
• ──Survey on China Hospital IT Status 2014-2015(CHIMA)
– Average IT FTEs in American hospital is 39
• ──25th Annual HIMSS Leadership Survey
6
7
China Studies Centre at Uni of Sydney
• The University of Sydney has a long
history of engagement with China, and
has been Australia’s leading university in
this respect. In 1979, it was the first
university in Australia to welcome Chinese
students after the Cultural Revolution.
There are now almost 6000 Chinese
students studying at the University of
Sydney.
8
• The University of Sydney announced at a
ceremony in Beijing that it will open a
centre in China in May 2016. For the first
time in the University's 165-year history,
an offshore site will be established in
Suzhou, China. The new centre will serve
as a research and education hub for the
University to increase intellectual
exchange and collaboration between
China and Australia.
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10
• The 2015 China Australia Free Trade
Agreement (ChAFTA) provides an
opportunity for the exchange of skills and
SI experience in EMR to the benefit of
both countries.
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14
• Technology Brief
•
• The technology brief is being implemented by AAH to:
•
• - localize an overseas EMR product to meet market requirements in China,
• -provide support for the EMR product by a local partner in China acting as
a Systems Integrator.
•
• The EMR system selected by AAH is both fast and responsive to meet the
particular requirements of the need for high throughput of patients in
extremely busy hospital departments and outpatient departments in
China.
•
• As well, the EMR has the ability to provide a finer granular view to
management to identify current bottlenecks and improve profitability and
efficiency.
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• SI capability
•
• An objective of AAH is to establish a dedicated EMR SI capability
in Shanghai managed and staffed by experienced bilingual
(English/Mandarin) Chinese IT professionals
•
• The SI centre would be based in the Shanghai development park
with modern computer hardware, and third party access to secure
cloud computing services in China.
•
• A further objective of AAH is to resolve data sovereignty issues.
•
• There are known restrictions on the use of patient health
information in China.
•
19
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21
• SI service
• The establishment of a dedicated SI service would support hospital
IT staff to maintain software with screens in simplified Chinese to
ensure that the EMR system is flexible and can be adapted to
local hospital requirements.
• The objective of the brief is that the Shanghai SI centre should be
supported by a SI centre in Brisbane Australia managed by
AAH with an understanding of the support requirements of EMR.
• The AAH Brisbane SI centre would act as a repository of expertise
and would counter the current excessive staff movement in
China.
• An objective of the AAH project is to increase understanding in
Australia of the requirements of the China EMR market to assist
with the future marketing of Australian products.
•22
23
• Implementation processes
• The technology brief is currently under
development by AAH.
•
• Initial discussions by AAH with prospective staff
and partners were held in Shanghai during
January 2016.
• Work is proceeding at AAH with the aim of SI
implementation as a pilot during late 2016.
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• Conclusion - outcomes and lessons to be learnt
•
• The AAH dual approach using both Australian and
China resources to EMR system integration (SI) support
is based on:
• - an understanding of China health requirements
• -supported by local knowledge of China’s political
imperatives
• - legislative requirements,
• - the privacy and security environment essential for
delivering cloud based EMR health solutions in China.
•
26
• An outcome of the technology brief will be the
formal evaluation by AAH of the performance of
the establishment of dedicated SI centres for
EMR in Shanghai and Brisbane.
•
• The aim of the evaluation by AAH is to
determine if the provision of Australian based
support for EMR can achieve the aim of
improvements in hospital data sharing in China.
27
• To :Prof Chen Jingyu
• Chairman Beijing Association of
Maternal and Child Health
• Proposal for evaluation and
implementation of Maternal and Child
health Virtual Community called
“MommyNet” in Beijing.
• Authors: Henry Zhuang and Bernard
Crowe, AusAsia Health Innovation
28
29
• Background
• Prof Chen Jingyu has approached AAH
for assistance to develop the concept of a
virtual support community for new
mothers in Beijing in order to meet an
urgent social need. He anticipates one
million births in Beijing over the next 3
years and is seeking ways to provide
support to new mothers at home.
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• AAH has had extensive experience in
Australia over the last 20 years in both the
design of health information systems for
children’s hospitals and with the
evaluation of pediatric telehealth systems.
AAH has also developed strong links with
China during the management of
international conferences between senior
executives of Australian and Chinese
maternity hospitals over many years.
32
• Concept proposal by AAH “MommyNet Beijing”
• The concept developed by AAH to meet Prof Chen’s
requirements has been called “MommyNet Beijing” and
is as follows:
• An internet based virtual community to support new
mothers and babies in the first instance, gradually being
expanded to cover maternal and child needs up to the
age of up to 16 years of age.
• Access to be via land line or mobile phone 4G
“MommyNet Beijing” App. Basis of use to be low cost
estimated RMB 5 a day, with 100 per cent government
subsidy for the estimated 20% of maternal population on
low income who are currently without mobile phone
access. 33
• Design features of “MommyNet Beijing”
• A simple to use mobile phone app involving the
following services:
• Decision Support for medical problems : Provides
structured answers to common questions as in: “ What
do I do if my baby is running a high temperature?”. App
leads to best practice guidelines eg standards for
normal range of temperature by age , sex,weight and a
simple decision tree of suggested actions. Also provide
answers to common questions about medication eg
“What are the side effects of giving over the counter
medications such as asprin?”
34
• Directory of local medical services:
Location of mother determined by GPS.
App shows directions to nearest
chemist/doctor/community nurse/ with
contact number and name of contact and
email. ( Ref:Telstra Health Health Connex
National Provider Directory Service
module developed for Australia).
35
• Directory of Community support services:
similar to medical services but wide
ranging including child minding services,
fitness classes, enternainment tv shows,
shops specialising in childrens’ clothes
and toys, mothers tea and chat groups ,
churches , psychological support and
counselling services.
36
• Concept Evaluation
• Concept of “MommyNet Beijing” to be
evaluated by AAH involving fully funded
trial over period of six months covering
use of V1 “MommyNet Beijing” by
approximately 1 per cent of the Beijing
maternal new mother/baby population
estimated at 20,000 mothers.
37
38
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