Digital hospital

November 2010 IT infrastructure

Selayang Hospital is the world’s first paperless and filmless hospital.

At the recent Cardex expo held in Sandton, Dominic Haazen, a health policy specialist from the World Bank, gave a presentation to industry stakeholders on IT systems for National Health Programs. With the much-discussed approach of South Africa’s own National Health Insurance programme, IT applications and related case studies will be crucial study for all involved.

Part of the presentation dealt with a description of one success story – Selayang Hospital in Malaysia, regarded as “the world’s first paperless and filmless hospital”. This hospital contains 960 beds, 22 operating rooms, 1200 PCs, 200 printers, 75 NT servers and four X-servers. The site began operations in September 2001.

The hospital provides a good example of an integrated e-Health policy, entailing the use of information and communication technologies (ICT) to improve the health status of patients and the functioning of the health system. However, it also means change management, as the process of health care delivery and management changes.

The Selayang Hospital system integrates clinical, administrative and financial systems. Within this, the clinical system includes the Hospital Information System (HIS) and the Picture Archiving Communication System (PACS).

Clinical – hospital information system

HIS includes person management, scheduling, order management, clinical documentation, and pharmacy, lab and radiology information systems.

Clinical – picture archive communication system

PACS system is interfaced with X-ray machines.

Administration and finance system

The administration and finance system is integrated with the HIS so that any chargeable procedures or tests performed on the patients will automatically trigger the generation of the bills.

Overall, integration is not only between software applications but also between applications and equipment. Patients’ medical records, guidelines and clinical protocols are instantly available and can be assessed in one integrated workstation at any place and at any time in the hospital, provided that the user has the proper authority to access the information. Further to this, patients themselves can access the system to schedule appointments.

Making this new paperless and filmless hospital system a reality involved a complete re-engineering of the established, and therefore tried-and-tested, clinical and business processes usually employed in a medical facility such as this. It was noted that there was a heavy end user involvement in developing the new processes.

Measureable results

Measured in 2004, three years after operations at the facility began, the impact of the new systems was listed as the following:

* A 40% time reduction in admission, and a 70% time reduction for discharge.

* An 80% time reduction in reviewing patient records.

* Finally, 90% of the physicians stated that they preferred working with the system compared to the previous approach.

Some text quoted verbatim form Dominic Haazen’s presentation slides. Measureable results source – Haazen.

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