It seems to me that today, there is still a rather popular yet inaccurate perception among the public that we have not capitalised the use of IT in the health service sector. At least people feel that we are not doing as much as our overseas counterparts.

Of course, some doctors in the private practice, who do not like writing with keyboards or reading messages on LCD monitors, still prefers to use pencils and papers to write down their observations and prescriptions.

But I am sure many of you know that this is no more the habit of most of the doctors in the Hospital Authority, which is already employing a central Clinical Management System, for data processing and data sharing. The system has certainly greatly improved the efficiency of the whole consultation process.

Without having the doctors type the names of many common drugs, which are shown on the computer screen in a user-friendly way for their selection just at a click on the "mouse", I think the system at least saves much efforts of our staff in the dispensary in reading those very stylish penmanship of some of their medical colleagues!

IT in health service

The Clinical Management System is just one of the many outcomes of our continual efforts in integrating IT in health service and promoting eHealth. In fact, the role of IT has immersed in many different aspects of our health service in the past decade or so, gradually making our service more accessible to the public.

A recent well-known occasion is our award-winning attempt to merge the police criminal investigation system called Major Incident Investigation & Disaster Support System, with the Hospital Authority's clinical e-SARS system and the Department of Health's Case Contact Information System for the contact tracing work of the suspected SARS patients in 2003. This is a clear evidence of the health authority's preparedness of braving innovative ideas on the use of IT in health service whenever it is necessary.

In fact, Centre for Health Protection of the Department of Health has been a keen advocate in empowering the public with the power of the Internet, which has become a key interface for many of their health promotion programmes like the Men's Health Programme and the Cervical Screening Programme, not to mention the recently launched HealthyHK portal, which is a web-based trove of health statistics supported by the Public Health Information System of the department.

One-stop e-channel

The Health Portal System, which is being built by the department, will be a one-stop e-channel to disseminate health information to health professionals, health promotion partners and the public, and to facilitate collaboration with key partners for the improvement of health literacy in Hong Kong. Active steps are being taken to finalise the contents, the collaborating partners and funding arrangements.

The Hospital Authority is no stranger to technology as well. The development of the Picture Archiving & Communication System technology, which is being used among public hospitals, allows vast amount of digital images of huge file size to be stored, transferred and retrieved electronically. It also enables clinicians to review patient images via ordinary clinical workstations in wards, and minimises manual errors during the process.

We have the infrastructure for further development of health informatics in Hong Kong: state-of-the-art information and communication systems that is already developed in both the public and private sectors, and healthcare workforce which is receptive to new technology. Perhaps the question we should be asking ourselves now is "What are the priority areas?", or "To which direction should health informatics be developed to serve the most urgent needs of the public?" Taking into account the situation of Hong Kong, there are at least two areas which the Government will continue with its efforts.

Family medicine development

First, it is the development of family medicine. It has been our hope that every citizen should choose a family doctor and keep a long-term, personal medical record, because the record would enable doctors to take proper care of citizens no matter where they go. Prevention of disease would also be more effective because records would provide information such as patients' age and family history.

Although 85% of people seeking outpatient services go to the private sector, many private doctors do not keep good records of their patients' medical history. This phenomenon may have been fuelled by the fact that many patients have the habit of jumping from doctor to doctor to seek different opinion on a single problem, a practice that is already wasting resources.

In this aspect, I understand that the Hospital Authority is introducing in stages a patient-held medical record system in all general out-patient clinics within the next two years. This serves to open up opportunities to improve communication of patient information among various health service providers in the community and facilitate better interface between the public and private sectors. I hope the lead provided by the Hospital Authority would stimulate private practitioners to follow suit, particularly in the development of family medicine.

The Hospital Authority is also planning to extend its Clinical Management System and computerised outpatient administration system to the remaining general out-patient clinics to achieve better integration of patient information between primary care and other specialist outpatient services.

With medical records becoming more portable and accessible at the primary care settings, I believe that such enhancement in these services would also effectively reduce the burden of other services like the accident and emergency and allow a more proper deployment of public resources.

Disease prevention aid

The other priority area which would also be benefited by the use of health informatics is the disease prevention work we have been doing.

On this front, we have been developing the Communicable Disease Information System. The system aims to build upon the strength of various systems successfully developed and put in use during the SARS time, and is designed to provide real-time data integration of the Clinical Management System in Hospital Authority, and the laboratory and public health disease surveillance systems of the Department of Health. It would also assist outbreak investigations and disease surveillance conducted by both Hospital Authority - within the public hospitals - and Department of Health - in the community.

To further facilitate disease surveillance work, the Communicable Disease Information System will collect communicable disease related data from private and public healthcare sectors, ambulatory and hospital services and from other non-medical institutions. The system further includes an infectious disease portal for data collection from private clinical sector and will facilitate the dissemination of intelligence on communicable diseases to the healthcare professionals and the public.

The Communicable Disease Information System is expected to bring a number of advantages to our public health work. For instance, there will be more comprehensive information and timely health advice for the public, which will be generated based on the enhanced surveillance and data management systems. Infectious disease outbreaks or unusual clusters will be timely detected, after which early warning can be made, and other prompt responses can be initiated as necessary. These will ultimately contribute to the overall protection against infectious diseases.

We are currently looking at the scope of Communicable Disease Information System and seeking outside consultancy help to identify quick deliverables. We cannot wait as infectious diseases can strike anytime just as tsunamis can shake the world without warning.

Support crucial

To make all these initiatives, and many others, happen, it is most crucial for us to have the support of the private sector. As I mentioned a moment ago, it is fortunate for us to see that many of the practitioners welcome and are prepared for the change-the change to integrate more eHealth element in their service-because this is a real paradigm shift that is actually happening in not just here, but many other places around the world.

For instance, I know that there has been an increasing number of private practitioners who have made use of the new e-notification system, a user-friendly post-SARS product, for reporting notifiable diseases to the Department of Health.

So may I take this opportunity to appeal to our partners in the private sectors to embrace the change and always look for opportunity to enhance your service with IT, link your work up with systems of the public sectors, and to work hand-in-hand with our health authorities to further the development of eHealth in Hong Kong.

No matter you are a general practitioner, or a clinical system engineer, your advice would be appreciated and considered; your co-orperation during the roll-out period of either the Hospital Authroity's patient-held medical record system or the Department of Health's Communicable Disease Information System would be of paramount importance to us in making our health service more efficient, and in raising the quality of care and health promotion.

Of course, there would be ethical and legal issues in respect of confidentiality of information and privacy which may arise when things develop, but that should not stop us from braving innovative ideas which could bring hopes to our patients and at the same time safeguard their dignity and privacy.

At the last visit to Hong Kong, the Canadian Health Minister Ujjal Dosanjh has informed us that Canada has set a target of transforming most of their patient records into electronic format by 2011. With our joint efforts, I also look forward to achieving the same eHealth level in early next decade.

Permanent Secretary for Health, Welfare & Food Carrie Yau gave this speech at the Telecommunications InfoTechnology Forum 'Health Informatics in Hong Kong' on April 7.