Accuracy and safety are key concerns when it comes to healthcare, and one hospital in Bangkok has included IT in its development.
Robotic drug dispenser.
At Ramkhamhaeng Hospital, when a patient sees the doctor, their ID card will be scanned together with their file. Double scanning ensures that the right person is connected to all forms of information. If either the ID or the files are not scanned, the doctor cannot prescribe medicine.
When the doctor enters the prescription to the computer system, the prescription will be automatically sent to the pharmacy room. In the case of medicine dispensing or vaccinations, if they are correctly matched with the patients, the system will allow the doctor or the nurse to do administer the treatment, but if they are not, it will set off an alert.
Ramkhamhaeng Hospital has applied barcode and QR code scanning to ensure the right treatments are offered to the right patients, according to the hospital's deputy managing director Dr Siripong Luengvarinkul.
Ramkhamhaeng Hospital Group, the country's second largest, covers 28 hospitals such as Synphaet General Hospital, Chiang Mai Ram Hospital, Vibhavadi Hospital, Lanna Hospital and Sukhumvit Hospital, where the environments are different. Some require service fees and also serve foreign patients, while some are social security hospitals and support the 30 baht Scheme.
Ramkhamhaeng Hospital has implemented an Image EMR (Electronic Medical Record) system that allows doctors to keep patient records in image files so they can quickly and efficiently retrieve documents and images. The system connects to the traditional computer system so the doctors can read the patients' medical history. The Image EMR has been implemented in the paediatrics departments of Ramkhamhaeng, Lanna, Vibhavadi, Synphaet and Chiang Mai Ram, and over next few months, the system will be rolled out group-wide. In the meantime, the hospitals use the PAC (Picture Archiving and Communication) system where instead of on traditional X-ray film, the scans are kept in digital format that the doctor can access anytime, from any exam room.
Dr Siripong Luengvarinkul, deputy managing director of Ramkhamhaeng Hospital.
Other promising technology includes robotic drug dispensers that the group implemented four or five years ago. The drug dispenser is controlled by a computerised system, which runs at the inpatient departments of Ramkhamhaeng Hospital, Synphaet General Hospital, Chiang Mai Ram Hospital and Lanna Hospital.
Instead of doctors serving medicine to patients in a small cup, the robotic drug dispenser organises the medicine according to the doctor's prescription, then seals the unit dose. Every single dose appears with the patient's name, the drug name, the barcode and the QR code. The routine check will be done again by a nurse by scanning the patient and drug barcodes before giving the medicine to the patients. The system was tested for two months before being put into practice and the accuracy rate is 100%.
"Ramkhamhaeng Hospital is now studying applying the system to outpatients, but patients must be able to choose to have the automatic drug dispenser or the present manual system", said Dr Siripong.
Vaccination is one of the most error-ridden areas in medication, according to the doctor. Ramkhamhaeng Hospital has improved its process by keeping vaccines in the pharmaceutical room and has pharmacists stay close to the paediatric outpatients. Here too, there are double verifications; checks for whether the drug is correct and the nurse then checks the patient name again. Before injecting, the barcode of the patient's ID must be checked with the barcode of the medicine pack.
Now a third party, Joint Commission International, examines the quality of the hospital to ensure accuracy. The hospitals now have a longer period to actually take care of patients, during which doctors can access their data faster.
The group is now in a period of strengthening its network. The deputy managing director said that once the system of one hospital has proved itself useful, it can be duplicated into others and knowledge can be transferred among the group. The stability of the hospital systems is comparable to a banking system and in the future, all information will be in digital format, as with banks.
"The ultimate goal is to [ensure] the patients have good quality treatment. IT is just a tool that lets us reach that goal. Technology helps us to better take care of the patients," said the doctor.
In addition, Ramkhamhaeng Hospital is now working on a smartphone app to help patients reserve a place in the queue to see a doctor, which will be complete over the next few months. With this app, people will also be updated on their place in the queue so they can plan what time they should leave home for the hospital. Patients will need to register with the hospital and download the app via Google Play.
IT serves as part of the hospital's infrastructure in delivering the best quality care to patients. Here, the core system is handled by Dell, from the data centre and networking, down to staff access to data.
Anothai Wettayakorn, regional director Indochina at Dell Asia, said the system design is based on the principles of total cost of ownership, ease of use, scalability and data protection. The number of servers at the hospital has been decreasing as they have been consolidated by the digital network, which will also be applied to the Cloud system very soon.
IT and healthcare are inseparable, and both will increasingly merge. The back-office system will be transferred to the front system such as EMR and telemedicine. The outcome is that patients have more confidence in their treatment, and they have a better quality of life and healthcare.
The Picture Archiving and Communication System allows doctors to access patients’ records in digital format.