Taiwan Adventist Hospital (TAH) had been dealing with problems of paper medical records, reading of handwritten contents as well as lack of storage space and poor records management for many years. This project was initiated to resolve these issues. Also, as part of the paperless strategy and to satisfy the exchangeable electronic medical record (EMR) program initiated by the competent health authorities, TAH adopted ProMedicord from IISI as its EMR solution. Extensive efforts have been undertaken to create a scalable EMR management platform so that medical records could be digitalized and stored accordingly to achieve standardization and common applications of EMR.
Medical codes are the important link of the overall EMR establishment project. For example, the health standard ICD-9 code and LOINC code used by medical institutions as well as department and medicine codes used at the hospital level represent important elements within EMR. EMRs in Taiwan make use of Logical Observation Identifiers Names and Codes (LOINC) for various clinical applications. The hospital must first convert every medical test and diagnostic codes into the global standard LOINC code so that the resulting EMR would be able to meet the relevant conversion standards. Hospital employees and staffs must therefore learn how these codes match. This could prove to be a major challenge to staff members who don’t have experience with this international standard. Professional courses and consultation provided by specialized teams would be required to familiarize hospital employees with this system and complete the tasks accordingly.
EMR management undergoes many process steps from writing, signing, to filing. Each CDA document would have at least one author and one target. More processes would require attention at the management level. For example, each document corresponds to actual hospital process. What content must be included within a medical record, when does it need to be converted, signed, etc. —these issues involved a lot of discussion to be clarified and implemented. During the project process existing hospital processes were optimized, matched, and linked to meet the needs of the hospital’s internal process management as well as the requirements posed by international standards. The end result is a comprehensive, safe, smooth, and standardized workflow.
Before introducing ProMedicord, the hospital must first confirm its visions and implementation plan. Hospital management must be actively committed to the process. As they are implemented, the projects will become part of future healthcare services. With the support of hospital management and relevant personnel, IISI was able to ensure that every target set for this project was achieved.