Lessons and realisations on EMR since 2018

A look at how Bumrungrad International Hospital transformed patients’ hospital experience to an EMR-enabled journey with Dr Adjhaporn Khunlertkit, Division Director for Health Information Management and Operation Analytics and Transformation

How many times have your patients complained about their hospital journey: a one-hour hospital visit extending to a half-day; laboratory tests to be scheduled for another day?

Bumrungrad International Hospital understands the value of a patient’s hospital experience. Thus, the Thailand hospital started its EMR-enabled journey in 2018. If you’re a patient, your appointment prior to the visit is booked with EMR. Once inside the facility, you’ll be registered through EMR. Your doctor will access your patient record through EMR. Your diagnosis, treatment plan, medication, and bills are generated from EMR.

“One EMR system connects all departments,” describes Dr Adjhaporn Khunlertkit, Division Director for Health Information Management and Operation Analytics and Transformation at Bumrungrad, as she tells Hospital Insights Asia about how the whole patient journey is transformed with the implementation of EMR and urges hospitals to push for a well-functioning hospital information system.

Source of truth

“We use EMR as the source of truth,” Dr Khunlertkit says. Bumrungrad’s vision is to “provide world-class holistic care with innovation” by 2022. “To enable care with innovation, we need to start digitising core processes. We, thus, start implementing a unified digital information platform.”

Information is necessary for providing care. “Complete, accurate, concise, and timely” information, for her, is key to enhancing the quality of patient care.

Physicians use information to diagnose and treat patients. Nurses monitor patients and provide information to physicians for optimal treatment decisions. Pharmacists rely on information to assess prescriptions. All other disciplines are, more or less, the same.

A seamless flow of all these necessary information is possible with electronic medical records. This, in turn, allows clinicians to make more informed decisions.

Best system design

Maintaining a health information system like EMR is never simple, just as with other technologies today. Dr Khunlertkit advises hospitals to start with a clean set of data: “Start your maintenance from the get-go. Make sure your system always contains a clean set of data.” The key is to use user-centred design to encourage users to use the system as they’re intended to.

“The platform has to be efficient because care providers don’t have the luxury of time,” Dr Khunlertkit recommends. It should also be simple and flexible: simple enough to enforce documentation standards for more concise and complete data input, and flexible enough for users to customise.

“Equally important is to equip the system with advanced technology,” she underscores. Up-to-date literature aids clinical decisions. Medical and diagnostic errors can be prevented when data is presented in a logical format, and cutting-edge technology alerts clinicians for potential errors.

Change management

Dr Khunlertkit knows that transitioning to digital is never easy. “My responsibility as a team lead is to set and align the vision, strategy, and roadmap towards Bumrungrad’s digitisation.” Implementing EMR, and other digital platforms, means adjusting both practices and processes, she says. “Adjusting only one of these two always leads to a failed implementation.”

Both hospitals and vendors have to find balance. “It should be a top priority as there is no such thing as a ‘one size fits all’. A change agent is responsible for understanding users’ perceptions, and being knowledgeable of EMR design’s purpose. This way, you’ll have a win-win situation.”

But changing people’s mindsets are always the hardest. For the change management expert, the strategy of starting with open-minded users works. The others then follow. 

“I communicate thoroughly and regularly with those who are not too keen to get on board with the new system,” Dr Khunlertkit reveals, “but I barely find pure resistors; sometimes, they are yet to see the benefits of the system, thus, the reluctance.”

Trust justifies cost

Several hospitals are hesitant to adopt EMR because of the cost. Bumrungrad focuses on what it can provide rather than its return on investment (ROI). “You will never get to implement EMR if you use ROI to justify for such investment.”

Instead, the justification should be the “trust that the system could bring to both care providers and patients,” emphasises Dr Khunlertkit. “There is definitely more to the EMR than just monetary value. Numerous literature has proven how a well-designed health information system improves patient safety and the quality of patient care.”

For Bumrungrad, EMR is a significant step forward to achieving its vision by 2022. A smooth patient journey and topnotch quality of care are the wins from all hiccups with implementing the system. After all, Dr Khunlertkit believes that “if there is a will, there is a way.”

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