The transition from paper-based records to a fully integrated Electronic Medical Record (EMR) system is a challenging journey marked by numerous technical, operational, and cultural hurdles that must be overcome. BNH Hospital, Thailand’s first international private hospital with a history spanning 127 years, embarked on such a journey to adopt modern electronic medical record-keeping practices. Established by King Rama V for foreign expatriates, BNH is particularly recognized for its Spine Center and Mother and Child care services. This journey commenced over two decades ago, highlighting the evolution of the hospital’s information management systems and their eventual milestone in fully transitioning to EMR.
Initial Steps and Challenges at BNH Hospital
BNH Hospital began its journey toward electronic records over 25 years ago, during which advancements in technology and shifts in policy played crucial roles in shaping its course. In 1999, BNH took the first significant step by implementing MedTrak, a system focusing on financial and laboratory data management. Despite this advancement, the hospital continued to rely heavily on paper for medical records. This traditional method created a gap between financial and clinical data, necessitating further action to integrate systems. The Health Object program introduced in 2011 aimed to bridge this gap by allowing electronic recording of outpatient diagnoses and medication orders. However, even with this technology, complete digitization of medical records remained elusive.
The real challenge for BNH was not just technological but organizational as well. Efforts were intensified in 2016 when the hospital pushed for clinicians to enter medical records into the Hospital Information System (HIS), yet the results were uneven, with many doctors reluctant to adapt to the new system. The introduction of the clinical documentation tool Quippe in 2017 marked another effort to accelerate the transition. Despite these efforts, by 2019, only a part of the records had been entered electronically. Inpatients’ records still predominantly relied on traditional paper methods, indicating a lag in the full process transition. These ongoing efforts highlight both the complexities involved in adopting new systems and the resistance to change that can accompany such initiatives.
Transitioning to a Comprehensive EMR System
Recognizing the limitations of their existing HIS and driven by new policies within their hospital group, BNH Hospital resolved to fully transition to a comprehensive EMR system. The adoption of InterSystems TrakCare with assistance from Lansing marked a significant turning point. While previous systems had seen only a 70% clinician adoption rate, the implementation of TrakCare resulted in a 100% adoption rate post-implementation, signifying substantial progress. This transition was not merely a software change but an all-encompassing shift towards comprehensive digital record-keeping. This new system facilitated advanced data analysis, specifically for lung cancer and heart disease screenings, demonstrating immediate benefits to patient care and system efficiency.
The journey towards adopting TrakCare involved meticulous planning and execution, reflecting broader trends within BNH Hospital’s parent company, Bangkok Dusit Medical Services. This group is the largest private hospital operator in Thailand, indicating the scale and influence of these transitions. The broader trend within the healthcare sector, marked by the integration of HIS and EMR systems, underscores a commitment to improving data management and patient outcomes. For instance, other hospitals within the group, such as Bangkok Hospital, have introduced AI-powered self-service kiosks and digital systems to enhance patient flow and check-ups. These accomplishments at Bangkok Hospital and across the group signify a collective movement towards leveraging digital transformation to elevate healthcare services.
The Outcome and Future Implications
Transitioning from paper-based records to a fully integrated Electronic Medical Record (EMR) system presents a complex challenge with numerous technical, operational, and cultural obstacles to overcome. BNH Hospital, Thailand’s first international private hospital with a history stretching 127 years, embarked on this journey to embrace contemporary electronic medical record-keeping practices. Founded by King Rama V for foreign expatriates, BNH is renowned for its Spine Center and Mother and Child care services. The transition journey began over two decades ago and marks the evolution of the hospital’s information management systems. This significant milestone reflects BNH’s commitment to modernizing its practices to better serve its patients and medical staff. The move to EMR not only enhances patient care through improved access to records but also ensures greater efficiency in handling medical data. Adopting such technology aligns with global healthcare standards and prepares BNH to meet future healthcare challenges.
