ASIA News

Traditionally, value in healthcare has been viewed from the perspectives of hospitals and healthcare providers, but this has shifted to the patient-consumer. 

The HIMSS Thailand National Digital Healthcare Workforce Development Initiative (WDI) was officially launched on the opening day of the HIMSS AsiaPac 2019 conference on October 7 in Bangkok, Thailand. This Initiative sees the development of a three-year work plan to address the demand of patients for digital healthcare services in light of the Thailand 4.0 digitisation journey, as well as healthcare tourism being one of the key economy drivers. Eight Thai hospitals have agreed to come onboard to be part of the HIMSS Thailand National Digital Healthcare WDI. They are:  Bangpakok Hospital Group Khon Kaen University Hospital Faculty of Medicine Siriraj Hospital, Mahidol University Hua Chiew Hospital Vejthani Hospital Principal Healthcare TPP Healthcare Ramathibodi Hospital Through this collaboration, HIMSS will focus on elevating the digital competency in the Thailand Healthcare workforce through the adoption of Healthcare IT certifications like Certified Professional in Healthcare Information & Management Systems (CPHIMS) and Certified Associate in Healthcare Information & Management Systems (CAHIMS) for capacity building in Healthcare Information core competency and Digital Health technology capabilities. The Permanent Secretary of the Ministry of Public Health, Dr. Sukhum Kanchanapimai, was the guest of honour at the conference opening, and he spoke about Thailand’s ongoing efforts in promoting telemedicine, such as the pilot telemedicine project that was implemented in rural areas in eight provinces, which Healthcare IT News reported in March this year. As part of the HIMSS Thailand National Digital Healthcare WDI, HIMSS also announced its intention to enter into a memorandum of understanding (MoU) with True Digital Group, a subsidiary of True Corporation, a leading communications conglomerate in Thailand, to create a HIMSS Digital Health Centre @ True Digital Park. Managing Director and Executive Vice President of HIMSS International Bruce Steinberg and Ekaraj Panjavinin, Managing Director of Digital Solutions at True Digital Group, were on-stage to talk about the collaboration during the opening of the conference. A total of five vendor partners have also come aboard: Abbott and GE Healthcare as Knowledge Partners, Elsevier and Philips as Industry Partners and AXA as Supporting Partner. The purpose of the HIMSS Digital Health Centre is threefold: to encourage more collaboration between different stakeholders in the industry, to accelerate the digital health workforce development and to create more exposure for digital health solutions in general. The collaboration of HIMSS together with local stakeholders in the Thailand healthcare ecosystem with a concerted effort to develop the Thai digital healthcare workforce bodes well for the future of digital health in the country.

The use of AI in medical imaging or Picture Archiving and Communication System (PACS), such as GE’s Centricity Universal Viewer, can be a great way to reduce the ever-increasing workloads of radiologists and clinicians, since AI is particularly effective in detection and segmentation of any irregularities in imaging data and providing radiologists/clinicians additional diagnostic confidence. However, this is easier said than done and many healthcare organisations/hospitals, depending on their existing infrastructure and data maturity, may find it daunting to implement AI applications in their PACS systems.  Common challenges in implementing AI applications to PACS systems “One of the common challenges faced by healthcare organisations/hospitals in looking to implement AI applications to their PACS systems is the handling of multiple point solutions of algorithms without a consistent way to implement these AI solutions into the overall workflow,” said Omar Sunna, Director, Global Product Management, GE Healthcare. It is essential for healthcare organisations/hospitals to understand the performance, impact, and expected outcomes from the various algorithms in AI solutions prior to placing them into the production workflow. Understanding that Pneumothorax impacts nearly 74,000 Americans every year, GE healthcare has recently introduced an AI algorithm that could help radiologists prioritise the review of critical cases. This algorithm was designed to identify pneumothorax on a chest X-Ray and notify a radiologist to this potential finding, the expected outcome is to speed up the timely diagnosis of a potentially life-threatening condition.  Another challenge for healthcare organisations/hospitals will be for them to understand which AI solutions are going to be the most impactful to the overall reading workflow and patient care, given the wide plethora of options available in the market. “There is a need to have a pre-production evaluation mechanism to all clinicians to examine the overall accuracy and repeatability of the AI solution before promoting into clinical practice and integrating the algorithms in their clinical workflow,” added Sunna. Tips on building a tool kit for radiologists for imaging analysis/diagnosis Sunna recommends that radiologists stay focused on patient outcomes as part of their selection of AI tools for their workflow and ensure that the solutions that are adopted are not just “point” solutions for a given output, but systemically implemented as part of the larger workflows in a healthcare setting.   “This means that the AI solution is not just presented to the viewer as additional views for the radiologist but has a number of solutions that can be implemented in the workflow to help drive proper critical condition triage, prioritise the right examinations to be read, and close the loop well with the clinicians about how to best convey this information in a rich report,” he said. Ideally, the implementation of AI solutions in PACS systems would provide the radiologist additional diagnostic confidence and also to help triage critical cases in order to have them read by the right radiologist at the right time.   Observations on the future developments of PACS and imaging solutions in healthcare Having almost two decades of experience in the field of PACS and imaging solutions in the healthcare industry, Sunna believes that the use of AI will progressively become the standard of care to ensure that certain patient clinical conditions are well understood at the time of diagnosis.   “There will also be continued efficiency gains in terms of identifying clinical conditions and automatically placing these findings into an enriched, structured report so that the clinicians can effectively consume a richer set of diagnosis. In addition, there will be an expansion of AI solutions into both Digital Imaging and Communications in Medicine (DICOM) imaging findings and also, looking at multiple disparate sources of data to enable better clinical decision support,” he explained. Omar Sunnar is the speaker for Keynote Plenary 8 - GE Artificial Intelligence for Clinical Care - Powered by Edison at the upcoming HIMSS AsiaPac19 Conference in Bangkok, Thailand. His session is scheduled from 10.30am-11.15am on October 9, 2019 at World Ballroom B, Level 23. GE Healthcare is a Diamond Sponsor for the HIMSS AsiaPac19 Conference. Their booth is located at G1 at the Exhibition Hall, Level 23. 

“Patient-driven care also benefits clinicians – they will be able to use their time more efficiently since contextually relevant information will be presented to them,” said Dr Vinod Seetharam, Chief Medical Officer, Asia, DXC Technology.

Last week, GE Healthcare officially launched the Edison AI platform in Shanghai, China at its Digital Ecosystem Forum event. GE also signed a Memorandum of Understanding (MoU) of strategic partnership with five local software development companies: Shukun Technology, Yizhun Medical AI, YITU Technology, 12Sigma Technologies and Biomind.  Under the MoU, GE will cooperate with the five software vendors to develop the platform's applications in China. THE LARGER TREND GE Healthcare’s Edison platform was first introduced at last year’s Radiological Society of North America annual meeting in Chicago in November. The platform is touted as a way to help hospitals derive more value from their technology. Earlier this month, the US FDA gave clearance to the Critical Care Suite platform, which was developed in partnership with UC San Francisco and powered by GE’s Edison AI tech. The suite can help radiologists prioritise cases involving collapsed lungs. ON THE RECORD “I am very excited about GE Healthcare's strategic cooperation with five of China's top digital healthcare companies. Our strategic partners have software products of high maturity, the Edison ecosystem we are building with our partners is an important step in the digital transformation of GE Healthcare,” said Dai Ying, Chief Innovation Officer of GE Healthcare China, in a statement.  Cathy Fang Cong, vice-president of YITU Technology, said: “One company might find it hard to handle the massive data generated during the healthcare process. The integration will innovate applications to better serve people's medical needs.”

Up to 10 patients a day are using an in-house solution to book their outpatient appointments online with Hutt Valley District Health Board (DHB). uBook is a referral management centre developed by the DHB and supported by its IT team. It allows patients to make or change their own appointments online. On average, five to 10 appointments are booked daily and three to five appointments are changed. Numbers have been steadily increasing since it was introduced in 2011. The DHB says uBook was created to enable patients to have more control over the outpatient booking process. “Having this service has meant more people show up for their appointments on time and we have heard from patients who use the system that they like it and the control it gives them,” a DHB spokesperson said. Patients receive a letter with a unique identifier, inviting them to log on to the uBook portal. The identifier only allows them to book into a correctly specified clinic and within a clinically appropriate timeframe. Most outpatient appointments for services in the general outpatients department are available on uBook, while radiology, orthopaedic and some Ear, Nose and Throat (ENT) appointments are not currently available. Hutt Valley DHB associate director of allied health, science and technical Paul Rigby says the portal is great for patients as “they can identify at their convenience an appointment that suits them. “It’s a real enabler of individual choice and if people can choose their appointment time, they’re less likely not to come,” he explained. Patients are also given the option of calling in to the department if they cannot or do not want to book online. This article first appeared on eHealthNews.nz. 

The Minister of Health Malaysia, Datuk Seri Dr Dzulkefly Ahmad, in one of his remarks said, the Ministry of Health (MoH) is committed to ensure that the electronic medical record (EMR) system can be realised within three to five years in all hospitals and clinics nationwide. Noting that the EMR system is one of the basic and fundamental digital infrastructure for building a digital health ecosystem, he said the system would allow for the entire clinics and hospitals to be integrated. It will then enable the health facilities to achieve a seamless level of patient information services and systems, with no obstacles or barriers to accessing patient information. Fortunately with EMR, MoH will be able to enhance the effectiveness of health services in terms of patient care and management. Part of the MOH Malaysia’s ICT Strategic Plan is to achieve a standardised digital health agenda and the vision is for an integrated healthcare system to provide comprehensive health services to the people. An integrated healthcare requires information that flows from different systems and various sources but interoperability between information systems still remains a challenge. Therefore, promoting the use of health informatics standards that is recognised internationally is important in pursuing this vision. “In Malaysia, we are continuously developing and managing standards with international benchmarking. Among the standards implemented include the Malaysian Health Reference Data Model (MyHRDM), Malaysian Health Data Dictionary (MyHDD), ICD, ISO TC 215, LOINC and SNOMED CT,” said Datuk Dr Noor Hisham Abdullah, Director General of Health Malaysia. Benefits of SNOMED CT adoption – locally and regionally As one of the most comprehensive medical terminology standards, SNOMED CT is an international standard and validated clinically through a rigorous process. One of the main advantages of SNOMED CT is its comprehensive clinical concepts and relationships, which enable a wider range of analyses of healthcare data that could not be done previously. “We have troves of health data waiting to be analysed and with the advancement of technology and also SNOMED CT, all of these data can be used and analysed by clinicians and healthcare policymakers to further improve the services and patient outcomes,” Dr Noor Hisham explained. In the Asia Pacific region, the SNOMED CT community is also growing with members in countries such as Australia, Brunei, Hong Kong, India, Kazakhstan, New Zealand and Singapore. With a growing community, member countries can share their views and experience, particularly in the implementation of SNOMED-CT in their own countries – the exchange of ideas and collaboration will further improve the quality of healthcare services of the member countries. With increasing numbers of participating countries, the journey towards interoperability of patient data and improvement of service delivery for treatment across borders can be achieved faster. “SNOMED CT is more than just about comprehensive clinical terminology standards. It is also about the community behind it. Within the SNOMED CT family, we have an abundance of shared knowledge and experience between experts from the SNOMED International committee and also member countries,” said Dr Noor Hisham. SNOMED implementation in Malaysia and its impact According to Dr Noor Hisham, MOH Malaysia is interested in analysing health data and utilising it for evidence-based decision making and planning at the highest level. SNOMED CT allows for improved data analytics at the Ministry through the development of MyHarmony and Malaysian Health Data Warehouse (MyHDW). MyHarmony is a feature of MyHDW that has the ability to deal with unstructured data.  Through using MyHarmony with SNOMED CT, more information from free-text utilising the SNOMED CT structure can be generated, reducing the effort needed to collect data in a structured manner such as in registry and indicator reports.  Another benefit of using MyHarmony with SNOMED CT is the ability to generate new information by retrospectively running new queries on old discharge summary records, which reduces the effort and time to collect data in a prospective manner when new questions arise, such as for indicator reports that often change on a yearly basis.  Information can be delivered in a timelier fashion through using MyHarmony with SNOMED CT and this enables clinicians and health managers to plan and take action without waiting for a yearly report which can take one to three years.  Future plans for SNOMED-CT in Malaysia “Firstly, we want to expand the usage scope of SNOMED CT with MyHarmony. Currently, we are in the middle of developing the dental procedure reference dataset. We are looking into extracting the data on dental procedures by analysing the procedure data written in free text by dental clinicians. We are also planning to expand SNOMED CT’s usage for drug and Traditional Chinese Medicine (TCM). We look forward to work with the vendor community to increase the awareness of SNOMED CT, and hope that more vendors will utilise SNOMED CT in their products and benefit from its functionalities,” shared Dr Noor Hisham.  The SNOMED CT Expo 2019 will be held in Kuala Lumpur, Malaysia from Oct 31 to Nov 1. Malaysia’s Minister of Health, The Honorable YB Datuk Seri Dr Dzulkefly Ahmad will deliver the conference opening plenary. More details about registration can be found here.

An interview with Richard Staynings, Chief Security Strategist, Cylera.

“Most hospitals tend to make the mistake of selecting infeasible EHR options despite knowing their constraints. Sometimes, seeking a third party’s advice who is in a neutral position would be useful,” said Heungro Lee, Partner, VAIIM Consulting Group. 

The benefit of the shared care plan is that a patient’s care plans will be consistent if they move within the region, and new clinicians involved in that patient’s care can view and edit the plans.