Application of EMR still stagnant

Although electronic medical records (EMRs) are a part of digital transformation, the conversion from paper medical records to EMRs in many places has been stagnant.

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Medical staff at Ho Chi Minh City University of Medicine and Pharmacy Hospital check patient treatment history information through electronic medical records

According to statistics from the Ministry of Health, only 70 out of 1,800 public and private hospitals nationwide have switched from paper medical records to EMR, and no special-class hospitals have made the switch. Although electronic medical records (EMRs) are a part of digital transformation, helping hospitals shorten the time for medical examination and treatment procedures, reduce costs, and improve the quality of treatment, the conversion from paper medical records to EMRs in many places has been stagnant.

Tired of sitting in the crowd in the waiting area in front of the ultrasound area of Ho Chi Minh City-located Gia Dinh People's Hospital, holding a stack of papers including ultrasound results, heart ultrasound, X-ray and paraclinical results from the previous month, 65 year old Nguyen Van Nam in Tan Binh District looked at his son who was queuing to pay for an electrocardiogram. He moaned that each time he goes for a checkup, it is a hassle to have to carry a pile of cumbersome paperwork. Some results from months ago are also required by the doctor to bring for comparison. It is very inconvenient if he forgets to bring it.

Many patients have been suffering from the situation like old man Nguyen Van Nam so it is easily seen every day in most medical facilities. Although the Circular 46/2018/TT-BYT stipulates that hospitals must complete EMR by December 31, 2023, a recent assessment shows that the conversion from paper medical records to EMR at medical facilities is still very slow.

Deputy Director Nguyen Truong Nam of the National Center for Medical Informatics under the Ministry of Health said that the country has nearly 1,500 public hospitals and more than 300 private hospitals, and nearly 70,000 private medical facilities at doctors’ houses, but currently only about 70 medical facilities have officially announced to abandon paper medical records.

According to data from the Ministry of Health, only three public hospitals in Ho Chi Minh City have implemented EMR, including Ho Chi Minh City University of Medicine and Pharmacy Hospital, Nguyen Tri Phuong Hospital, and City Children's Hospital. The structure of EMR is divided into three stages comprising of digitization of medical records, data creation and management, and EMR data interconnection. Most hospitals have implemented stages 1 and 2, but interconnection requires many factors such as infrastructure, requiring large investments. This is an obstacle to completing the transition to EMR and abandoning paper medical records, said Mr. Nguyen Truong Nam.

Being one of the first medical facilities in Ho Chi Minh City to implement EMR since 2017, Assoc. Prof. Nguyen Hoang Bac, Director of Ho Chi Minh City University of Medicine and Pharmacy Hospital, believes that through the utilities of EMR, the treatment for patients is always transparent, clear, and avoids any medical errors in the health care field. The subsystems of the EMR software are built completely and interconnected with each other to serve not only professional and administrative work but also to better care for patients.

According to Mr. Nguyen Truong Nam, the average cost for a provincial hospital (300-500 beds) to invest in EMR implementation is from VND10 billion or more. For special-class hospitals such as Cho Ray Hospital, Bach Mai Hospital, Viet Duc Hospital, K Hospital, this cost is much higher. For the implementation of EMR, it is necessary to complete infrastructures, information technology applications for hospital management, imaging diagnosis, laboratory tests, and other applied auxiliary systems and EMR is the last step. The high investment cost has caused many hospitals to have plans but cannot implement synchronously but only implement in parts to reduce costs.

Sharing about the difficulties in implementing EMR, Dr. Mai Duc Huy, Deputy Director of Saigon General Hospital in HCMC, said that the hospital has completed EMR at a basic level. He added that currently, there are many new regulations on information security, digital signatures, and standards for electronic data storage. For the quick implementation and limited shortcomings and compliance with the criteria, the Ministry of Health and the Ho Chi Minh City Department of Health need to organize study tours to learn from experiences at hospitals that have successfully implemented EMR so that other hospitals can learn more experiences, Dr. Mai Duc Huy said.

Assessing the current status of EMR implementation in Ho Chi Minh City, Assoc. Prof. Nguyen Anh Dung, Deputy Director of the Ho Chi Minh City Department of Health, said that through the assessment of EMR implementation, hospitals have been bumping into difficulties in information technology infrastructure, personnel, risks of patient data security, and investment costs.

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