Going digital in the era of constant change

Quick access to reliable and accurate information, Dr Han Boon Oh observes, is key to more efficient care and fewer medication errors.

What we know ten years ago is obsolete knowledge. Change is inevitable, and thus, uncomfortable. But the healthcare industry need not flinch, especially at a time when patients have increasingly complex medical needs.

Dr Han Boon Oh, Deputy Chief Medical Informatics Officer and Associate Consultant of General Surgery (Breast and Endocrine Surgery) at Ng Teng Fong General Hospital, National University Health System in Singapore, navigates through these complexities with fast access to medical information. In an interview with Hospital Insights Asia, he shares how updated information is critical in providing care and preventing medication errors.

Better care and higher physician confidence

“Information is crucial in providing care,” Dr Oh emphasises, “since I was a student, I have been enjoying the convenience of UpToDate® and now I am using the app on my smartphone to have quick access to medical information I need.”

For doctors to come up with the best clinical decisions at the point of care, the information they must have at their fingertips have to be accurate and credible. Links to referenced publications, peer-reviewed journals, and recently published discoveries help care providers evaluate the available information, thereby allowing them to make quick but precise decisions for patients.

Relying on evidence-based medicine practices

Medical breakthroughs, new drugs, new clinical trials, and newly debunked healthcare myths are important information that has to be readily available. A doctor cannot rely on “what he knows” just because “it has worked before and for other patients” because, like drugs, information changes over time, too. Otherwise, patients are at risk of serious harm, additional cost, and longer treatment. In the long run, hospitals and physicians carry the burden of an inefficient and inferior quality of care.

But with easy access to up-to-date information, physicians at Ng Teng Fong General Hospital, Dr Oh believes, will be more confident about their clinical practice knowing they are able to give the best treatment for patients.

Dr Oh, for instance, gets to know what’s new in surgery as well as the latest recommendations for surgical topics like groin hernia repairs. UpToDate®, he shares, provides the most recent landmark publications divided into various subspecialties, The “Practice Changing Updates” section in UpToDate highlights selected specific new recommendations that may have a significant and broad impact on practice,  and “this is one of the main things [he] like[s] about using this resource.”

Likewise, in the time of COVID-19, doctors know what to do because they have the updated research and guidelines for appropriate care.

Reducing medication errors

Errors are not an option in healthcare. Hospitals cannot afford to lose patients because these mistakes are generally preventable. Hospitals likewise do not want to lose revenue; these errors already cost the industry more than $42 billion.

There is an overwhelming number of available medications, and this is both good and bad news for physicians, especially when treating an ageing population. This group of patients has increasingly complex medical needs, therefore, multiple medications that need to work concomitantly and safely are prescribed.

Again, solutions proven to have worked several years ago may no longer work today. Physicians, therefore, benefit from having accurate drug information at their fingertips to prevent medication errors and help patients avoid long hospital stays, serious harm, and unnecessary cost.

This is where Ng Teng Fong Hospital sees the advantage of using Lexicomp®, which provides evidence-based referential drug information. With a few quick taps, pharmacists, nurses, and physicians can search for drug information for common medications. The tool also proves useful in making the best and safest drug decisions for each patient.

While there are other factors associated with medication errors, it cannot be taken for granted how quick access to credible and evidence-based information can elevate the standards of care expected from care providers.


About UpToDate® and Lexicomp®

Lexicomp® drug information and UpToDate® treatment recommendations are developed by a multidisciplinary team of clinical experts to speak with one voice so your various team members can be united and confident in their decision making.

Lexicomp® and UpToDate® decision support provide:

  • The latest evidence, synthesized for use on the frontlines
  • Expertise from specialists and subspecialists
  • Daily surveillance and practice-changing updates

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How Nagoya University Hospital uses up-to-date information to their advantage

Updated information takes the quality of care at Nagoya University Hospital to a whole new level. It improves patient outcomes, clinicians’ skills, and overall quality of care.

We’re living in the information age; every question has a lot of answers and every answer is accessible with but a click. But information, oftentimes, is overwhelming that we aren’t able to optimise its use. Nagoya University Hospital rejects this pessimism as it turns to credible information to fulfil its role as a world-class hospital that promotes a high quality of care.

Japan’s first National University Hospital to receive accreditation from the Joint Commission International (JCI) as a world-class institution, Nagoya University Hospital shares how they use up to date rather than outdated information to enhance decisions, improve clinicians’ skills, and deliver efficient patient care.

Realigning care with the newest evidence

Evidence guides decision-making. We see this not only in hospitals and clinics but also in police investigations and court proceedings. Doctors cannot just decide on a treatment policy “just because other clinicians use it” or “just because they have previously used it for another patient.”

To avoid unnecessary harm and risks to patients, clinicians need to use evidence-based practice, but this is not just about using any evidence available. Rather, it asks for the use of most updated and current evidence. As we all know, the only thing constant in the world is change. What we know to be an effective vaccine or medication a few years ago may not work today.

Without adequate access to up-to-date information, physicians are in trouble for variability in care which can negatively impact patient outcomes. Contrast it with when all clinicians have access to the same medical knowledge, therefore, can collaborate underneath a shared reliance on updated evidence.

No need to know everything

The clinical mind can only take so much information. It also forgets, makes mistakes, and says ‘enough.’ Dr Takeshi Kondo from Nagoya University Hospital’s Department of General Medicine, also a training instructor at two other hospitals in Aichi prefecture, highlights how access to the latest treatment options, clinical successes, and medical findings are key to “deepening doctors’ and trainers’ knowledge.”

In the educational conferences he holds, Dr Kondo sees the wide use of UpToDate®, a clinical tool by Wolters Kluwer, which allows participants to investigate relevant cases, symptoms, treatment methods, and images in order to come up with the best diagnosis.

The same evidence-based resource has been in use at Nagoya University Hospital since 2009 and Dr Kondo has been relying on it for more than 10 years prior to joining the hospital. Through the years, he has observed how UpToDate® helps elevate Nagoya University Hospital’s status as a hospital that plays the lead role to “diagnose cases that are difficult to determine in other hospitals, to examine all possible treatment methods, and to determine the right direction.”

While clinicians always need to continue sharpening what they know, they don’t need to stretch their brains past what they can hold. Evidence-based clinical resources are able to provide them with the most current and relevant information they need to guide their medical decisions.

Patients deserve what’s best

We cannot underscore this enough, but patients require the best care hospitals are able to provide whether they’re inpatient or in visiting medical care. Today, time is no longer an excuse not to thoroughly investigate a patient’s medical history and symptoms to come up with the correct diagnosis.

In the field of visiting care, for example, quick research for more information about a disease is already possible with technologies like smartphones and tablets. Electronic health record systems, too, have proven vital to easily review what drugs a patient has taken, his allergies, his past diagnoses. Patient records are indispensable to making future decisions, Dr Kondo believes.

The accessibility of all such information allows healthcare providers to avoid medication errors. Patients then are given the treatment they deserve based on their preferences and their symptoms.

Making an excuse for slovenly medical care can no longer be justified at a time when information is at our fingertips. Patients expect better outcomes and physicians are expected to use the latest and the most accurate information there is. Updated evidence can just be the key to achieving both.

About UpToDate

More than 1.9 million clinicians in 190+ countries rely on UpToDate® to make the best care decisions and stay abreast of contemporary standards in the workflow and on-the-go. UpToDate is the only resource associated with improved patient outcomes and hospital performance, and studies show that clinicians who use UpToDate change their decisions 30 percent of the time.

More than 7,100 world-renowned physician authors, editors, and reviewers use a rigorous editorial process to synthesize the most recent medical information into trusted, evidence-based recommendations. Every day, clinicians view topics covering 25 specialties over 1.6 million times. For more information, visit https://www.uptodate.com

On Asian healthcare’s digital transformation and better quality of care

Norman Deery, Vice President of Clinical Effectiveness, Wolters Kluwer Health APAC, affirms that Asia is all-geared up for a digital revolution in healthcare, and identifies the challenges and opportunities for its realisation.

The future of healthcare is digital, and Asia is poised to take a huge leap to realise its healthcare system’s digital transformation. Norman Deery, Vice President of Clinical Effectiveness at Wolters Kluwer Health for Asia Pacific, believes the region is primed for this as evidenced by the wide adoption of advanced clinical decision support systems during the pandemic. More than 500 thousand UpToDate® users, and a significant number from Asia Pacific countries, have accessed its COVID-19 content topics. 

Deery worked for 30 years in the information technology industry prior to joining Wolters Kluwer, thus, has an excellent understanding of the blueprint underlying digital transformation. Shifting to the healthcare industry because of that “wonderful sense of achievement from helping people and improving the quality of life for others”, Deery shares his vision for a patient-centric health system for Asia – one that could also be prompted by technological innovation.

Digitising healthcare in Asia not only allows for efficient medical processes but also patient safety and clinical effectiveness, which are positively and consistently linked to a higher quality of care. Providing better quality of care, though most vital, is never an easy trail. In Asia, a number of apparent challenges may be addressed through innovative solutions.

Deery observes that physician ratio in the region’s emerging markets is a major problem. To illustrate, the number of physicians per 1,000 people in China is 1.9, in India 0.7, in Malaysia, Vietnam, and the Philippines 1.2, in Thailand 0.4, and in Indonesia 0.2. These numbers are way lower than what communities need considering the increase in the ageing population and the prevalence of chronic conditions and diseases.  All these challenges add to the pressure of providing quality care in the most efficient way possible.  Wolters Kluwer’s solutions help by providing trusted recommendations at the point of care, where it matters most.  A clinician can typically search, locate, and review the information they need in approximately 1 minute.

Healthcare organisations in Asia also struggle to harmonise care across the entire healthcare system. “Medicine has become so fragmented that if you have doctors, nurses, pharmacists, patients, and everyone else in the healthcare continuum all making decisions based on disparate information, you simply can’t provide high quality or very effective care,” Deery says. With an evidence-based clinical decision support tool, however, these providers could have access to up-to-date medical information to help in their decision-making. Hence, they would be able to reduce unwanted variability in care across the system through enhancing medical decision-making and patient assessments, and through proactively alerting prospective patients of issues that need medical intervention.

Another problem, not just in Asia but globally, is erroneous diagnosis and medication. The World Health Organisation reports at least 5 patients dying every minute because of unsafe care, and four out of 10 patients harmed during primary and ambulatory health care due to errors in diagnosis, prescription, and medication. With new technologies like Wolters Kluwer’s UpToDate, healthcare providers can make the best clinical decisions, supported by updated and critically reviewed evidence, to save more lives.

Even in today’s situation where patients and physicians resort to virtual consultations, evidence-based solutions can add value to hospitals. As of date, Wolters Kluwer is working with telemedicine providers in Asia to integrate the benefits of harmonised and evidence-based care to patients. Additionally, Deery mentions that they are currently incorporating their solutions, such as UpToDate, Lexicomp, and Medi-Span, with a variety of Electronic Medical Records (EMR) systems providers so as to contribute to better data management coupled with the improvement of the quality of care.

There is also increasing support from governments and healthcare providers across the region to swiftly employ digital technologies. Over the years, governments are observed to increase their healthcare spending, thereby, increasing confidence that they would give continuous support to the health sector. Healthcare providers and patients likewise show eagerness in using mobile technologies and cloud-based solutions, hence, putting pressure on hospitals to integrate such solutions into their organisations.

Step by step, Asia could transform its healthcare system towards becoming more digital, not because other regions are doing it, but because of the necessity of providing better care for patients through proven technological solutions.

About UpToDate

Researchers at Harvard associated the use of UpToDate, the only clinical decision support resource associated with improved outcomes, with lower mortality rates and shorter lengths of hospital stay. Several other studies confirm UpToDate’s impact on learning, better clinical decisions, improved quality of care, patient safety, efficiency, and mortality.

Clinical Effectiveness COVID-19 Resources Available to All

As someone who works in the front lines, how do you ensure you have the right information to give the right care?

As someone who works in the front lines, how do you ensure you have the right information to give the right care?

This COVID-19 pandemic has more than ever made us realise there are many factors against us, such as time and rapidly changing information, hence, the urgency to make decisions quickly.

How can you ensure the decisions you make are the best? Are they evidence-based?

If doctors are still expected to make sense of all clinical literature, or worse make out what others are doing by listening to the news, you lose.

What if you get an evidence-based clinical decision support tool in one click?

This is UpToDate. It is an evidence-based clinical decision support tool, where more than 6,900 world-renowned physician authors, editors, and reviewers rigorously synthesize the most recent medical information into trusted, evidence-based recommendations.

And there is no other time than during this pandemic that we need to be clinically effective, which is why updates and resources on COVID19 are made available – at no charge. Topics have been updated 100 times with 5M+ views and have helped 450,000+ clinicians.

Get your FREE Guest Pass to COVID-19 resources today.


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