BNH Hospital, the first international private hospital in Thailand, has fully gone paperless following its implementation of an integrated HIS and EMR system.
Founded by King Rama V 127 years ago as a modern hospital for foreign expatriates, BNH now provides tertiary-level care known for its Spine Center and Mother and Child care.
25-year journey
It was only over two decades ago the hospital began using electronic records, BNH assistant director Dr Apichai Chaiyaroj told Healthcare IT News. When it opened a modern building in 1999, it adopted MedTrak to record data in finances and laboratories while all other medical records remained on paper.
Then around 2011, it ran the Health Object program which had most doctors do outpatient diagnosis entry and medication orders for almost a decade. It was in 2016 when BNH started encouraging doctors to enter medical records into the HIS.
A year later, the clinical documentation tool Quippe by Medicomp Systems was implemented. The BNH IT and medical records teams retrofitted the tool to the needs of the doctors and nurses. "From 2016 to 2019, we had driven all nurses’ outpatient records and about 70% of doctors’ outpatient records to be entered in Quippe. As for inpatient records, we only had 20%-30% of doctors’ records on the system, while most of the nursing records were on it," shared Dr Chaiyaroj.
Going all the way
Eventually, the HIS reached its peak and "could not develop further." Given that, and the new policy of the hospital group it is under, BNH decided to transition to a different system.
"The aim was to go all the way with an EMR. We initially focused on our main users, and got key doctors on board to make it most suitable for our culture," said Dr Chaiyaroj, who led the EMR change management program with cardiologist Dr Natthinee Mattanapojanat and informatics nurse Sareeyanan Sasiyabhand. They worked with InterSystems and IT consultant Lansing to prepare for this transition.
Following the initial implementation of the new EMR system (it adopted InterSystems TrakCare), BNH observed 100% clinician adoption – as compared to the 70% adoption rate of the previous system.
"The result was satisfactorily rewarding. Once we went live, all doctors tried and eventually used the new TrakCare for both inpatient and outpatient records," Dr Chaiyaroj noted.
Besides record keeping, BNH can now also analyse imaging data for lung cancer and heart disease screenings.
According to InterSystems, BNH uses the most up-to-date local version of TrakCare with no customisations, allowing it to innovate more easily.
"We are looking forward to using more structured data for further use. With the current AI availability, I believe we can go even further," the assistant hospital director said. The hospital also looks to expand closed-loop medication management, integrate mobile devices, and explore data analytics.
THE LARGER TREND
BNH's adoption of TrakCare also comes as other hospitals in the Samitivej Hospital Group, which it is a part of, have deployed the integrated HIS and EMR system to standardise data management. Samitivej Hospitals is part of Bangkok Dusit Medical Services, the biggest private hospital operator in Thailand.
Other private hospitals in Thailand have digitised hospital and medical record keeping in recent years. Last year, Bangkok Hospital ditched the paper and manual management of patient flow for AI-powered self-service kiosks, while its check-up department also transitioned to a digital system.
In the same year, Princ Hospital Suvarnabhumi, part of Principle Healthcare Group, was validated for the highest stage of the HIMSS Electronic Medical Record Adoption Model, demonstrating advanced EMR capability.
Siriraj Piyamaharajkarun Hospital launched late last year an AI-driven pathology information system, featuring smart forms and speech-to-text AI that simplify data entry.
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Dr Chaiyaroj's responses have been edited for accuracy's sake.