Successful Implementation of Terminology Binding in Hong Kong Hospital Authority.

Terminology binding has been adopted in Hong Kong Hospital Authority to link terminology component to clinical information models. This linkage facilitates structured data capturing and streamlines clinical workflow. With information models and data representation standards in place, data interoperability and data integration can be maintained for seamless patient care delivery.

Realizing the Benefits of Managing Health Appointments via Mobile Application: Start of the Journey.

The Hospital Authority of Hong Kong ("HA") launched an interactive mobile application "BookHA" intending to use innovative technology to support healthcare delivery. "BookHA" provides an 'easy and convenient' alternative for patients to book specialist clinics along with the current methods - in-person or via fascmile. Patients, clinical staff, and the corporates benefit from this initiative as evidenced by the utilization figures, and the findings from patients surveys and staff surveys.

Terminology Adoption in Family Medicine Service - Start of Journey.

A proposal on terminology adoption for the Problem and Encounter Reason capturing in the Hong Kong Hospital Authority Family Medicine Module was suggested. Given the complexity of the project, mapping had been conducted as preparatory work in the early phase of development.

Is it Possible to Make Everyone Talk in the Same Language?

Speaking the same language is a vital pre-requisite in verbal communication. The same applies in sharing health information among medical professionals in rendering care to patients. The Hospital Authority of Hong Kong developed its own clinical vocabulary table (HACVT) for clinicians to document diagnoses and procedures directly in the Clinical Management System (CMS) since 1996. HACVT is referenced to international classifications and reference terminologies, with local terms added and is built according to the principles of terminology management [1]. This poster describes the process of data standardisation within the organisation in the past years to achieve data interoperability through different adoption methods of HACVT.

Quality assurance of LOINC mapping for laboratory tests - a local experience with people, process and technology.

In Hong Kong Hospital Authority (HA), the Electronic Patient Record (ePR) module of Clinical Management System, implemented since 2003, bring together all the information from various clinical module and hospitals into a single corporate wide, longitudinal, integrated record. Nowadays there are billions of laboratory test results stored in the web-based ePR where laboratory results being shared with the HA clinicians for patient care. In order to produce interoperable laboratory data in the ePR, the HA adopts LOINC (Logical Observation Identifiers Names and Codes) as the reference standard for laboratory tests. Every local test codes have been mapped with LOINC code where possible. Thus, the accuracy of LOINC mapping for laboratory tests in the HA is imperative. This paper describes a quality assurance program of LOINC mapping for laboratory tests conducted in 2011/12. With the use of right people, right process and right technology, we reviewed over 28,000 local test codes and there are around 2,400 distinct LOINC concepts mapped and defined in the system.

Building electronic forms for elderly program: integrated care model for high risk elders in Hong Kong.

In Hong Kong, elderly patients discharged from hospital are at high risk of unplanned readmission. The Integrated Care Model (ICM) program is introduced to provide continuous and coordinated care for high risk elders from hospital to community to prevent unplanned readmission. A multidisciplinary working group was set up to address the requirements on developing the electronic forms for ICM program. Six (6) forms were developed. These forms can support ICM service delivery for the high risk elders, clinical documentation, statistical analysis and information sharing.

Development and maintenance of a controlled vocabulary via an electronic collaborative platform.

The development of electronic health records and clinical information systems has been progressing at a quickened pace in recent years. With such change, the use of standard vocabulary has aroused much interest. However, classification code sets are developed for their distinctive purposes, no single vocabulary set could satisfy the needs of all specialties; moreover, local customization would be inevitable. This poster describes how a controlled vocabulary with contribution from frontline clinicians was set up in Hong Kong Hospital Authority (HA). The adoption of an electronic maintenance portal with collaboration of representatives from all institutions would also be discussed. The use of such table has helped to maintain the interoperability of captured data between departments, specialties and institutions.

A territory-wide electronic health record--from concept to practicality: the Hong Kong experience.

In Hong Kong, a pilot project is being undertaken to implement a web-based electronic patient record system to allow integrated, real time patient based information to be shared in clinics, private and public hospitals. Such sharing aims to ensure that complete and accurate healthcare information is available to citizens' multiple points of care through a stable IT system. A challenge is to share this electronic information whilst ensuring privacy and security. Hong Kong has achieved its initial goals and pioneered in building a territory-wide electronic health record (EHR). This paper will outline the tasks involved, approach, method used and initial review of the pilot project. Barriers to implementation are discussed and critical success factors are identified.

Principles-based medical informatics for success--how Hong Kong built one of the world's largest integrated longitudinal electronic patient records.

Since 1994, the Hospital Authority has been developing and deploying clinical applications at its constituent 41 hospitals and 121 clinics. The Clinical Management System (CMS) is now used by over 4000 doctors and 20000 other clinicians on a daily basis to order, document and review care. The territory-wide Electronic Patient Record (ePR) has given clinicians an integrated, longitudinal, lifelong view of a patient's record. Today the CMS and ePR form an essential clinical and management tool to the Hospital Authority. The CMS handles two million clinical transactions per day, and the ePR has over 6TB of data covering 57 million episodes for 7.9 million patients. This paper describes how the HA has taken a principles-based approach to Medical Informatics to achieve its success in the enterprise-wide deployment and deep utilization of a comprehensive clinical information system.

Building a womb-to-tomb health record in Hong Kong--an application of information architecture.

The Hospital Authority developed the Information Architecture (IA) model in 2002 to support a fast, robust, flexible and accurate electronic patient record (ePR) to meet the high-tempo health care environment in Hong Kong. With several successful applications in sharing data that were created for the same patients in various systems, the IA model was further developed to extend the longitudinal ePR to include one's fetal data as entered in the mother's record. This paper describes how various IA elements: Section, View, Form, Group, Entity, Content, Document supports the building of a true womb-to-tomb ePR for the HA patients. The future focus of Information Architecture in the HA will include building a Information Architecture Management System and linking the ePR with other patient records in the community.

The Hong Kong Hospital Authority's information architecture.

Since 1994, the Hospital Authority has been developing and deploying clinical applications at its constituent 39 hospitals and clinics. The Clinical Management System (CMS) is now used by over 4000 doctors and 20000 other clinicians to document and review care. Since 1999, the territory-wide integrated Electronic Patient Record (ePR) has given clinicians a longitudinal view of the data collected through the CMS and its adjunct systems. The ePR currently has nearly 3TB of data covering 44 million episodes for 6.4 million patients. This paper describes the Hospital Authority's Information Architecture, which allows the ePR to accept and integrate any clinical information from any internal or external system. The ePR operates in a high volume and high performance environment, yet only requires low maintenance, while still retaining the information structure and semantics required for advanced applications.