ASIA News

The RTLS will enable the tracking of patients, visitors and staff in an outbreak, for rapid and reliable contact tracing so that necessary actions can be taken quickly to curb onward transmission.

A chat with Dr Ian Chuang, Chief Medical Officer, Elsevier.

Waitematā District Health Board (DHB) in New Zealand has developed a Digital Academy to train its clinical IT leaders of the future. Robyn Whittaker, clinical director innovation at the DHB’s Institute for Innovation and Improvement (i3), said clinicians do not get taught change management as part of their training, but those who can lead IT change are an “invaluable resource.” “These leaders are incredibly important as the translators between the IT people and clinical workflow,” she said. “We need to think about growing that group of clinical IT leaders, and there’s not a lot of really practical hands-on clinical IT change management and leadership training, so we decided to do it ourselves.” The first cohort of 12–15 people to go through the academy will be by invite only and from a range of clinical roles. “It’s for people who work clinically and have a real interest and passion for IT, but feel they need to learn more before they can usefully contribute,” explained Whittaker. In mid-September, they will attend a one-week block course co-developed by the National Institute of Health Innovation (NIHI) at Auckland University and DHB staff. The NIHI and DHB staff will both teach parts of the course, and the DHB is hoping to have external experts contribute as well. Course participants will spend time in different parts of the hospital to learn how other areas work and what IT systems they use. “It’s set up so the group can have really good, robust discussions during the week and continue to learn from each other as they go on,” Whittaker said. There will be a formal assessment at the end, and participants will receive a certificate if they pass. The plan is to run one course annually. Whittaker said feedback from the first group will help to further develop and refine the programme during the week and for the future. “We are trying to learn from the successes of other programmes, like the NHS Digital Academy,” she added. While Waitematā’s academy is aimed at a different level of leader from the NHS, a key message from the UK is that self-directed learning and the network it creates are of great benefit. Whittaker hopes to be able to offer those who complete the course the chance to become one of three digital academy fellows in 2020, who would work part-time on clinical IT projects in i3. She said there is a lot of work to be done in this space, especially with the implementation of the Northern Region Information Services Strategic Plan, which will involve a large amount of change. “It’s so important that these projects are seen to be about clinical change, not about IT,” said Whittaker. This article first appeared on eHealthNews.nz. 

In his 16 years with Seoul National University Bundang Hospital, Dr Rong-Min Baek served in key executive roles in both clinical and managerial areas, from department chairman to Chief Medical Officer and Chief Science Officer.

Taipei Veterans General Hospital, a national first-class medical centre and a teaching hospital located in Beitou, Taipei, will utilise the Philips IntelliSite Pathology Solution to transform its pathology tissue examination to digital diagnostics, the Dutch health technology giant announced yesterday. The Philips IntelliSite Pathology Solution allows tissue samples to be remotely viewed within a virtual pathology network across hospital locations, thereby helping TPVGH to establish Taiwan’s first fully digitalised pathology department. WHY IT MATTERS Using the Philips IntelliSite Pathology Solution with the Ultra-Fast Scanner, TPVGH will now be able to digitise tissue samples so that pathologists can review, interpret, analyse, and share digital images. The Image Management System that is part of the Philips IntelliSite Pathology Solution allows them to instantly consult colleagues or conveniently present images during multi-disciplinary team meetings, without the need to physically transport pathology slides or tissue samples. In addition to clinical use, the digital images will be stored in image repositories and used to teach pathology students, or used for medical research, including cancer research. THE LARGER TREND Last month, South Korea’s Seoul St. Mary’s Hospital introduced a digital pathology system that aids in the diagnosis of cancer, also utilising the Philips IntelliSite Pathology Solution, Healthcare IT News reported.  ON THE RECORD “Philips Taiwan continues to help Taiwan in realising intelligent and advanced healthcare solutions,” said Richard Hu, General Manager of Philips Taiwan in a statement. “Digitalising pathology so that tissue samples can be viewed remotely, wherever they are needed, will not only enhance laboratory efficiency and quality but also improve patient safety.”

Jehangir Hospital, a 350-bed hospital in Pune, India, along with its research arm Jehangir Clinical Development Centre (JCDC), last week announced that it will join Clinerion’s Patient Network Explorer platform. Clinerion is a global data technology service company headquartered in Switzerland, while JCDC has over 60 principal investigators and conducts on average 25-30 clinical studies at any point of time. The Patient Network Explorer platform helps partner hospitals be visible to pharmaceutical companies seeking suitable patients and sites for their clinical trials. Queries based on trial protocols may be sent to partners to assess the count of eligible patients in their electronic health records. All patient data is de-identified and remains under the control of the hospital and inside its IT infrastructure.  However, Clinerion’s patented technology also enables authorised trial staff at the hospital to re-identify the patient for the purpose of trial recruitment, while maintaining strict personal data privacy standards. THE LARGER TREND Earlier this month, Clinerion partnered with Germany’s Dresden International University to offer their Master’s students access to a subset of real-world data from Clinerion’s Patient Network Explorer platform to formulate as evidence in their research. According to Clinerion’s website, their global network of partner hospitals that power their Patient Network Explorer platform is currently at 39.  ON THE RECORD “We at JCDC are delighted about partnering with Clinerion as there is an ideal alignment of Clinerion’s innovative technology and our clinical research expertise,” said Pathik Divate, CEO at JCDC. “We are excited about harnessing the power of this technology to leverage our diverse patient population and bring in further efficiency in patient recruitment.” “The population of India is significantly under-represented when it comes to participation in clinical research. Patient Network Explorer can cut a path through the forest, leading sponsors to the institutions and clinicians who can support clinical trials at an international level of expertise and facilities. This collaboration with Jehangir is just the first step in enabling a global population of eligible patients which reflects the diversity of the world, itself,” said Ian Rentsch, Clinerion's CEO.

Eight more district health boards (DHBs) in New Zealand will be assessed on their digital maturity using HIMSS Analytics maturity assessments over the next 12 months. The Ministry kicked off its digital health maturity model project early this year, with Southern DHB the first to complete the assessments, followed by MidCentral DHB, which is awaiting its report. All DHBs are now being offered the chance to have an assessment using four HIMSS maturity assessments: EMRAM, O-EMRAM, CCMM and INFRAM. Ministry of Health Group Manager of Digital Strategy and Investment Darren Douglass says the intention is that the remaining DHBs will have assessments in 2020/2021. The Ministry and HIMSS are holding a workshop on Nov. 20 during Digital Health Week NZ 2019 in Hamilton for those wanting to learn more about the assessment process. HIMSS Analytics Global Vice President John Daniels says the workshop will focus on how organisations can leverage the HIMSS maturity model road maps to guide their journey toward digital transformation. He has been impressed with the level of engagement from the Ministry and the DHBs HIMSS has worked with so far. “It seems everyone is on the same boat wanting to drive healthcare forward from a digital transformation perspective, and one of the big challenges organisations face is getting everyone working toward a common goal,” he said. The HIMSS assessments score hospitals and care settings on their adoption and use of electronic medical records on a scale from 0–7. At the workshop, Daniels will provide an overview of the maturity models, looking at how and why they were developed, as well as a deeper dive into EMRAM and O-EMRAM. He says the process not only identifies the gaps in maturity, but provides details around those gaps, such as what factors are preventing the organisation from having a certain capability. Daniels hopes the workshop will attract senior IT leaders, clinical leaders and industry partners as the groups need to work together on the transformation journey. “For the most part, I think the culture is there in New Zealand that will enable this sort of transformation to occur, but you need the right leadership and the people using the systems to be on board and everyone working together, as it takes a team effort,” he added. Douglass hopes that people from across the sector will attend the sessions at HINZ 2019 as their organisation may be invited to participate in an assessment. “Undertaking the HIMSS maturity assessments uses an international tool that can assist DHBs in their roadmaps for digital investment. A New Zealand glossary has been developed to ensure the assessment fits the New Zealand health environment,” he said. There will also be a session at the HINZ Conference 2019 regarding the learnings from the assessments that have been completed. This article first appeared on eHealthNews.nz. 

Known as the ‘Father of FHIR’ and an experienced healthcare interoperability consultant, Grahame Grieve is FHIR Product Director at HL7 International. He has a background in laboratory medicine, software vendor development, clinical research, open source development and has also conceived, developed and sold interoperability and clinical document solutions and products in the Australian market and around the world. Grahame shares some updates on the current developments for FHIR and is increasingly convinced that clinical interoperability is not an Information Technology/Information Management (IT/IM) problem, but a clinical practice problem. Q. Could you tell us more about your role as FHIR Product Director at HL7 International? A. Fast Healthcare Interoperability Resources (FHIR) has two aspects – it’s a technical standard, and it’s also a community. The “FHIR Product” is really both parts, and as the product director, my role is to grow the community, manage HL7’s provision of processes that the community can follow so that it can produce technical agreements consistently, and then to integrate that growth into HL7’s business so that HL7 can flourish as the best host for the technical standard – which includes meeting its formal obligations as a standards organization. Q. Being an FHIR architect and interoperability consultant, what are some of the recent broad trends you observe in the development of healthcare data interoperability? Any insights with regard to the Asia Pacific region? A. Classically, healthcare integration within institutions has focused on a push-based messaging model – using mainly HL7, along with messaging routing and transformation services. Then a new model arose for cross-enterprise integration based on a common repository using documents (XDS/CDA). Unfortunately, these were 2 separate frameworks.  Now, people are increasingly looking for integration – a single framework using a combination of push, pull and subscription so that institutions and regions/countries can manage their data with much more flexibility, and build more integrated workflows. All the nodes in that framework should link up with both messaging and repositories as well – integration spans over time and place. In terms of Asia/Pacific – a combination of factors has generally meant that Asia/Pacific have been followers in terms of data integration, with adoption taking longer. This is both a risk and an opportunity – a risk that business manages (conservative everywhere) won’t take the risk to try building better workflows, but also an opportunity that because there’s less prior investment, the fallacy of sunk cost is less of a problem. But on the whole it seems premature to me to talk about general trends in such a wide area with great variation in culture and funding models. Q. You will be giving a keynote titled “How FHIR can really make a difference” at the upcoming HIMSS AsiaPac19 conference in October in Bangkok, Thailand. For those who are new to FHIR, what are three important things you would like to highlight about FHIR? 1. FHIR is a community and technical standard founded on the basis that openness – in both the standards process, and the health data management process – allows for great new possibilities that couldn’t arise in a closed system, and that those possibilities can transform health outcomes. 2. FHIR is the web, for healthcare. All the things that the web has meant in other industries – that can happen in healthcare.  3. FHIR is a small part of the overall picture – technical standards are only useful if they are used, and that’s a business/cultural/governance decision. There are many problems in those areas and these are big bad problems. Q. What are some of the most current developments/updates for FHIR? A. As a standard, FHIR is maturing; increasingly the standard is stable and becoming ready for large scale adoption. At a technical level, our work is mainly around building out the eco-system to allow things like large scale data extraction for analysis and research, and stabilizing the clinical summary content.  In terms of community, the set of participants is expanding quickly and we are focusing on how to scale our community processes, and collaborate much more directly with key partners such as HIMSS and IHE (we’ve collaborated with them for years, but now we need a much deeper partnership). Q. What are your thoughts on the future of healthcare data interoperability in the next 3-5 years? A. The most common question I get is ‘when will FHIR be widely deployed’. And I don’t actually know the answer to that; obviously, it will grow, but in many/most countries, how quickly that happens actually depends on key decisions made by very few people for political or business reasons, and so it’s very hard to predict how far it will go in that timeframe. I’m personally far more interested in how we as a community will come to understand that Clinical Interoperability (the ability to switch patients, teams, and algorithms/AI between different care providers) is not an IT/IM problem, but a clinical practice problem. It seems to me that change will be driven by business and wider cultural considerations and that sponsors of the changes (governments/businesses) will assume Clinical Interoperability exists. The fact that it doesn’t will prove expensive – but I wonder whether we’ll learn the right lessons.  Big questions there – but what I do see now is that people working in healthcare interoperability are going to be busier than ever over the next 3-5 years. Grahame Grieve will be giving a keynote titled “How FHIR Can Really Make a Difference” at the upcoming HIMSS AsiaPac19 conference happening from October 7-10 2019 in Bangkok, Thailand. Registration for the conference is open and more details can be found here. 

SNUH serves more than 8,000 cancer patients per year across 16 cancer specialty centres, 10 multidisciplinary cancer treatment centres, and a cancer clinical trials centre.

Representatives from the health departments of Malaysia and the Philippines recently signed a Memorandum of Understanding (MoU) to collaborate further on the advancement of the health sector in the two countries. Secretary of Health Francisco Duque III of the Philippines and Malaysian Health Minister YB Datuk Seri Dr. Dzulkefly bin Ahmad met in Putrajaya, Malaysia on July 31 to discuss the strengthening of the two countries’ bilateral ties through collaborative activities for healthcare. WHAT’S IT ABOUT Under the MoU, both countries agreed to collaborate in the areas of: primary healthcare;  reproductive health;  health education;  human resources for health development;  nutrition;  exchange of information on issues related to food safety and quality including but not limited to rapid alert systems related to imported products;  prevention and control of communicable diseases;  prevention and control of non-communicable disease;  regulatory control of pharmaceuticals; traditional medicines, herbal medicine, health supplements and cosmetic products;  medical devices;  health tourism;  health researches; and  healthcare services. A Joint Technical Working Group (JTWG), led by designated officials from the Health Ministries of both countries will be formed to facilitate and develop collaborative activities and oversee, monitor and evaluate the implementation of the said MoU on Cooperation in the Field of Health. Exchanges of information and documentation on health will also be done through this joint committee.  Both parties also reaffirmed their commitment to support each other in joint activities, such as port-port collaboration on healthcare and vaccination programme for children in Alternative Learnings Centers, as part of efforts to help realize Universal Health Care under ASEAN. RECENT DEVELOPMENTS IN MALAYSIA & THE PHILIPPINES Malaysian Health Minister YB Datuk Seri Dr. Dzulkefly bin Ahmad said in July that it would cost up to RM1.5B to implement an EMR system for the 145 hospitals nationwide in Malaysia over the next five years. In February 2019, President Rodrigo R. Duterte of the Philippines officially signed the Universal Health Care (UHC) Act into law, which guarantees equitable access to quality and affordable healthcare services for all Filipinos. However, it still remains to be seen how the UHC Act will be implemented exactly. ON THE RECORD “We both hope that the outcome of this meeting will further strengthen the ties and cooperation in the management of cross-border issues relating to the health of both our countries and across various stakeholders, and we look forward to a lasting collaboration between both countries in tackling and resolving health issues,” Philippine Health Secretary Duque concluded in a statement.