Getting ready for EMR

Perspective from a hospital that’s still looking to implement an electronic medical records system

Patient volume increases every year. If hospitals stick to paper-based records, this volume also requires a larger space for storage and longer waiting time for patients.

This is where electronic medical records (EMR) come in. “It will be a game-changer in the healthcare industry,” underlines Dato Dr Hjh Selasawati Bt Hj Ghazali, CEO at Hospital Raja Perempuan Zainab II (Kota Bharu).

For a hospital that is yet to implement EMR, the system is a welcome solution to reduce the burden of manual records storage. In an interview with Hospital Insights Asia, Dr Selasawati talks about how she sees EMR to benefit hospitals and how hospitals can prepare to adopt this technology, especially in a setting like Malaysia.

Ease of data transfer

Malaysia’s Ministry of Health’s announcement of going for full EMR for all public hospitals and clinics is a top-down project. The government chooses the first hospitals to implement it.

In lieu of EMR, Hospital Raja Perempuan Zainab II uses a patient management system called Sistem Pengurusan Pesakit (SPP). “It is basically for internal data management and is available in other selected government hospitals in Malaysia,” says Dr Selasawati. SPP has basic patient data information. It is used by doctors to request further tests from the laboratory, check patient records, and generate statistics like the number of inpatients and outpatients for the past year.

But SPP is not the same as EMR. “SPP is just intra-hospital, thus, can be used only within the hospital,” Dr Selasawati explains. “EMR will enable us to exchange patient data with other hospitals especially when the nationwide implementation is completed. I consider it a single tip technology that allows us to save time, and have more efficient and speedy transactions.”

“Patients are transferable from one hospital to another,” she adds. “And for this to happen, there should be a continuity of information.”

If a patient is transferred to another hospital, for example, it’s just not practical to have the patient fill out new forms and repeat a laboratory or radiology test. “Our hospital is a tertiary state hospital so we receive patients from step up and step down cases. When we transfer patients to other hospitals, the patient data should follow with the patient.” This can only be efficiently done when medical records can be transferred electronically.

Preparations along the way

There are certain criteria before a hospital is selected to implement EMR in the earlier stages. Dr Selasawati has high hopes for Hospital Raja Perempuan Zainab II to be one of the first hospitals in the country to adopt this. But she also knows there are challenges that need to be overcome.

First is the infrastructure. This is why Dr Selasawati understands why EMR implementation is done in phases. “We shall start with something that is most doable and then proceed with upgrades as time goes by.”

Second is system stability, a huge concern for the hospital. “I want the EMR to offer safety and security. We cannot afford the system to be down for a long period of time as we want to do away with patients waiting for hours for consultation.”

If the system is unstable, the hospital has no choice but turn back to a business contingency plan using a manual system, as is the case at Hospital Raja Perempuan Zainab II. “We have to be prepared in case of technical failures, especially the instability of internet connection, electricity breakdown, and inadequate hardware,” the CEO remarks.

Growing as a team

For EMR to be a successful venture, “we have to grow as a team”, this is what Dr Selasawati reminds her employees. Staff’s acceptance is not much of a problem, she argues, because there is always the initial stage which is the adjustment stage. But after a time, they become used to it and find out it’s helpful in doing their tasks in a more convenient, fast, and efficient way.

What matters more is the continuous training of staff and rationalising the importance of integrating EMR into their workflow. “When we install the system, we have a scope of the process, but after some time, there’s always a dynamic where we need to add more and more processes in the working modules.” Hence, users must be kept aware of how the system works.

Hospital administrators play a significant role in keeping the process going. “We need to inculcate to customise the behavioural changes and the mindset towards embracing this technology in our employees’ practice. We have to have everybody embrace it.”

Dr Selasawati believes that Malaysia’s health ecosystem is already moving toward the full EMR direction. There are some things that need to be tackled and addressed, but for her, these shouldn’t stop the movement towards EMR.

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