The Healthcare Information and Management Systems Society (HIMSS), in conjunction with CHIK Services, organised AsiaPac08 at the Hong Kong Convention and Exhibition Centre, attended by more than 1,500 health information technology professionals. It offered healthcare IT leaders throughout the region valuable insights from their peers who have successfully advanced the delivery of healthcare through IT.

Highlights of the conference included illuminating keynotes by industry leaders on trends, practical application and management of healthcare IT in the region. Keynote speakers included Dr. York Chow, SBS, JP, Secretary of Food and Health, Government of the Hong Kong Special Administrative Region; Shane Solomon, Chief utive, Hong Kong Hospital Authority (HA); Tan Sri Dato’ Dr. Abu Bakar Suleiman, President, International Medical University, Kuala Lumpur, Malaysia; and Dr. Andy Wiesenthal, Associate utive Director for Clinical Information Support for The Permanente Federation, USA.

The conference included more than 50 education sessions and 50 exhibitors on the exhibit floor. In the 3-day conference, attendees had the opportunity to attend three keynote sessions, Thought Leader Sessions, education sessions and e-sessions covering four different tracks, clinical leadership and governance; ehealth; EHR, EMR, EPR, PHR; IT strategy and innovation.

During the conference, HIMSS joined the other individuals and corporations in helping the victims of the recent earthquake in China. “The tragic earthquake that hit Sichuan last week has deeply saddened everyone in the region,” said Steven Yeo, HIMSS Vice President and utive Director, Asia Pacific, in a news release issued during the conference. “A disaster of this magnitude needs help from all corners of the world to provide assistance to the earthquake victims. HIMSS has donated US$ 10,000 to the Hong Kong Red Cross relief to help alleviate the suffering of the people in Sichuan.”

Dr. York Chow, SBS, JP, Secretary, Food and Health, Government of the Hong Kong Special Administrative Region and Shane Solomon, Chief utive, Hong Kong Hospital Authority (HA) opened the conference with a welcome address. They expressed recognition of the transformation of healthcare delivery throughout the world with the adoption of health IT.

A physician who worked in the public hospital system for 30 years before becoming the Secretary for Food and Health in Hong Kong in 2004, Dr. Chow said that “four key factors in action” helped the Clinical Management System in Hong Kong succeed:

• Strong leadership
• It being a healthcare project, not an IT project
• It being a bottom-up process rather than top-down development process
• The Clinical Management System, which is designed, developed and implemented, through a close and seamless partnership, by a team of IT-minded clinicians and IT-experts with health informatics exposure.

“An electronic health system, with a population-wise and territory-wide electronic health record system at its core, is the vision that is being sought after most in health informatics,” said Dr. Chow in his opening keynote address. “It (the system) serves as a fundamental infrastructure underpinning healthcare transformation, removing the boundaries between different healthcare professionals who are providing different levels of care in different sectors, enabling them to work as a team to bring quality health care to patients. Building toward that vision is what you will see in this conference and exhibition.”

Mr. Shane Solomon of the Hong Kong Hospital Authority discussed the business value of the HA’s information technology system, which was rolled out in 1995 with direct clinician documentation and order entry. The HA operates 90% of the hospital beds in Hong Kong through 41 hospitals, and delivers 7.9 million specialist outpatient attendances each year and 4.8 million primary care clinic attendances with 122 clinic sites. This system is the only source of subsidised medications in Hong Kong.

In his presentation, Mr. Solomon noted that health IT has helped provide “universal access to hospital care at a very low cost to the patient and to society.” The HA is 95% dependent on government funding, but still delivers universal access to healthcare and a GDP spending on public healthcare of 2.8%.”  In addition, the HA IT system is home-grown with an annual cost to the HA system of 1.96% of its total annual expenditure.

While these figures present the quantitative overview of the Hong Kong Hospital Authority, Mr. Solomon noted that “there is more that IT will do to transform healthcare.” He suggested a co-production approach to healthcare, where “you should not only be able to read your own health record, but you will contribute to creating it. I can envision patients monitoring their vital signs at home, such as their blood pressure, weight, and blood glucose levels, entering this information into their own health record, where it will be graphed, with information about what action needs to be taken by the patient if it is outside the normal range.”

Borrowing a business strategy from the Toyota Production System (TPS), two presenters offered case studies from Alexandra Hospital in Singapore that used the Toyota approach, which says that:

• the customer is the heart of the organisation’s
  philosophy.
• the organisation continuously reflects and learns.
• the organisation sees processes end-to-end and removes silos.

Dr. Tan Yung Ming, Product Development Manager, Health Group, Singapore, and Chew  Kwee Tiang, Chief Operating Officer, Alexandra

Hospital presented “Lean Healthcare IT systems: The Toyota Way” and demonstrated how this approach can be transferred to healthcare organisations. They shared how the hospital used this philosophy in reviewing and revamping the hospital websites, its health screening service and the development of the IT system.

For example, healthcare processes are often complex and not streamlined. Thus, they explained, an EHR system implementation and development can be challenging because applying technology over inefficient processes can amplify underlying problems and lead to project failures.

“TPS principles can be used to analyse and streamline these processes before any system is designed or implemented. By studying all processes end-to-end, the goal is to create a continuous flow so that any hidden issues can surface.”

Interoperability in healthcare became a universal focus of the conference, with presenters discussing how sharing of patient health information through technology can improve healthcare delivery and reduce medical errors. One speaker who provided an update on global health IT standards was Dr. Yun Sik Kwak, Medical Informatics, Kyungpook, National University, Republic of Korea.

As Chair, HL7 Korea, Dr. Kwak discussed, in one session, various HL7 standards, such as V2.X and V3 that have been introduced to help establish integrated and connected health information systems. Dr. Kwak is also the Chair, ISO/TC215, Health Informatics, (Republic of Korea). He, with Audrey Dickerson, Secretary, ISO/TC215 Health Informatics (USA), and Manager, Standards Initiatives, HIMSS, presented current developments for health IT standards by ISO/TC215, Health Informatics. Both HL7 and ISO are separate but collaborative standards development organisations (SDOs) that recognise that developing countries depend on standardisation for some of their IT infrastructure in hospitals and in their clinics, for health IT systems and devices. In addition, telemedicine has been used as a consultant network in some countries, especially China, where the network is advanced to assist local doctors with diagnosis.

“International standards are used locally for the betterment of patient care,” said Dr. Kwak. “It is important for developing countries to see what works in other countries so that they may try to implement the same types of technology in their own healthcare setting. These countries have completed their initial work in health IT that is good for patient care.”

Don Newsham, Co-Chair WG9 and CEO, ISO-TC215 and COACH, Canada, and Elizabeth Hanley, Senior Project Manager, Human Services, Standards Australia, Australia, discussed “Navigating the Sea of E – Health StandardsThe Harmonised Way” in their education session. With standards development organisations (SDOs) throughout the world in operation for more than 10 years, Newsham and Hanley presented the collaborative approach of three standards organisations that came together to harmonise their efforts. “CEN/TC 362 and HL7 agreed to collaborate in the spirit of mutual appreciation, respect and openness to seek pragmatic solutions to obtain unification of their set of standards for healthcare communication and to make the results globally available to ISO” said these speakers in one of their slides. This alignment is not to develop standards or change SDO accredited processes, accountability or mandates. Instead, through the collaboration, they have organised a joint working group to develop an integrated work program.

The call for ubiquitous healthcare, where quality patient care is available for patients of all ages throughout the Asia Pacific region, surfaced as one of the consistent and relevant themes at the conference. As the population ages throughout the world, the demand for quality healthcare delivery to maintain the health of and treat the maladies of these individuals increases.

In his presentation, “E-Health in Developing Countries: the Philippine Experience,” Alvin Marcelo, MD, offered insights on developing the much needed health information technology for underserved areas. Dr. Marcelo is Director, National Telehealth Center, University of the Philippines, Manila. He cited human capacity, not infrastructure, as the major challenge in putting this system together because of the increasing migration of health workers to other countries. As a result, a severe lack of health providers exists in many parts of the Philippines.

Dr. Marcelo outlined the strategies used, such as open source software and SMS/MMS tele-referrals, a simplified technology that demands less tech support. “Health workers in developing countries comprise an important sector for ICT training,” said Dr. Marcelo in his presentation. He said that mobile devices play “an important role in rural health systems,” and that “appropriate participatory training strategies on practical work-related applications increases success in embedding e-health in their workplace.”

Elisabeth Harding, Director, Legal & Governance, University Hospital, Dubai Healthcare City, United Arab Emirates, explained that “privacy legislation is not about keeping things ‘private’ or ‘secret’ but about ensuring that information is used consistently with the purposes for which it was obtained.” She also noted in her presentation that individuals must be aware of these purposes, which can best be accomplished by thinking privacy of healthcare data as “safely managing health information” or “information protection.”

The conference closed with keynote presenter Dr. Andrew M. Wiesenthal, Associate utive Director, The Permanente Federation. Kaiser Permanente is the largest nonprofit health plan in the United States with 8.7 million members, 13,000+ physicians, and 159,000+ employees. The integrated health care delivery system serves eight regions that include nine states and the District of Columbia with 32+ hospitals and medical centres and 435+ medical offices.

He presented an overview of the EHR implementation at Kaiser and his perspective on the lessons learned throughout this process, which began in 1997 as a corporate goal of Kaiser Permanente. His assessment of what worked and didn’t work is not US-centric. Dr. Wiesenthal, as many speakers throughout the conference, indicated that “deploying an EHR is a strategy, not a goal. The Kaiser Permanente HealthConnect is more than just an electronic medical record, said Dr. Wiesenthal. “It is a complete health care business system that will enhance the quality of patient care,” a statement that offered a fitting close to the conference so focused on delivering beneficial information on that very topic.

“I am impressed that there are so many entities in Asia that are moving aggressively toward the adoption of the electronic health record for the people that they are responsible for in their healthcare organisations,” said Andrew M. Wiesenthal. “I was pleased to be part of the conference since I felt I had something to offer to those attendees who were managing similar activities in implementing healthcare IT. This type of information exchange was valuable because I had a clear sense that the attendees at HIMSS AsiaPac08 were there to learn from each other.”

When not attending education sessions, attendees visited the exhibit floor to learn more about healthcare IT solutions. The more than 50 HIMSS AsiaPac exhibitors endorsed the conference citing attendees were decision makers who were eager to learn more about their products and services. The traffic flow was constant over the three days of the exhibition as interested buyers uated software and hardware solutions that ranged from Homecare to EMR/Clinical Systems used in Hospitals. More than 75% of the exhibitors have secured space for AsiaPac09 while the remaining companies have provided verbal commitments to participate in this conference in Kuala Lumpur.

“It is exciting to be involved with HIMSS in the AsiaPac conference and see it growing,” said Steve Reinecke, MT, Global Director, Health Care Industry, Ergotron, Eagan, Minnesota, USA. Ergotron was one of the exhibitors at AsiaPac08. “I look forward to further interactions with HIMSS Asia in the future.”

HIMSS asked attendees to uate their experience at the conference. Dr. Rekha Batura, a hospital administrator at Tata Memorial Hospital, in Mumbai, India, said that the conference was “stimulating.”  “It gave me a lot of available IT strategies and software solutions and showed me that interoperability is possible with the available software. The conference also increased my awareness about what other hospital systems are doing and the tools they use to do it.”

Conference attendees also indicated that the networking was a valuable asset of HIMSS AsiaPac08. “I have made significant contacts,” said Dr. Peter Del Fante, CEO, Adelaide Western General Practice Network, Australia. “The thought leaders sessions and experience from health informatics were very good. Networking with key people is very important to further our future
work and project.”

HIMSS Asia has begun planning for the 2009 AsiaPac Conference and Exhibition in Kuala Lumpur, Malaysia. The Hong Kong conference was the second HIMSS AsiaPac held in the region with the first meeting held in May 2007 in Singapore, Thailand.

“The benefits of healthcare IT, as an effective equaliser in the delivery of quality patient care, became even more apparent during the HIMSS AsiaPac08 Conference & Exhibition,” said Yeo. “The conference brought together many stakeholders throughout the region, and from across the globe, who shared their knowledge, innovations and challenges in the information technology in healthcare.

HIMSS Asia looks forward to continuing the relationships forged at this event and to building new alliances throughout the region.”

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