•• 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.

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• 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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• 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

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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.

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• 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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• 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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• 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.

•

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• 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.

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• 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

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• 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).

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• 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.

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• 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.

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