Authors (including presenting author) :
LI WY(1), LEE LYL(1), CHAN JCC(1), TSE JWY(1), WAN PKT(1)
Affiliation :
(1) Information technology and Health Informatics Division, Hospital Authority Head Office
Introduction :
Scoliosis is a condition characterized by abnormal sideways curve of spine. It is most often diagnosed during adolescence, and has the potential to worsen as children continue to grow and mature. In severe cases, scoliosis could impair the functioning of internal organs and necessitate spine surgery. Therefore, regular spinal examinations play a crucial role in maintaining child’s spinal health. Early detection could initiate treatment sooner and potentially eliminate the need for surgery. A healthcare provider that refers over 10,000 children and teenagers for spinal x-ray assessment yearly, has recently revamped its clinical information system to leverage the advantage of health record sharing feature via eHealth platform (EHRSS). Before this change, it relied much on the physical movement of x-ray reports and films for clinical assessments. With the new approach, clinical users can view spinal electronic x-rays reports and films prepared and uploaded by external contractors through an electronic viewer in their workstations within the same clinical information system, making the process more efficient and timely.
Objectives :
To digitalize the x-ray viewing workflow by enhancing features related to enrolment, exam ordering, indication of the readiness of electronic x-ray reports and films from EHRSS, and allow system users to view medical records through a new module.
Methodology :
To facilitate EHRSS registration via online enrolment process. To enhance the format of x-ray referral letter by adding QR code that contains investigation order number and the necessary information for uploading the medical record to EHRSS. To ensure the return of medical records from outsourced X-ray contractors via EHRSS. To update the referral case status automatically in the clinical information system. To shortlist the clients for review and launch an electronic viewer for x-ray assessment.
Result & Outcome :
In this project, we collaborated with the users, utilizing the EHRSS sharing platform to establish a new closed-loop route of digitalized spine X-ray assessment which is now operational with several key enhancements implemented. First, the EHRSS registration process was streamlined during the annual enrolment exercise, resulting in a significant increase in the EHRSS registration rate among participants using the electronic enrolment platform. Additionally, the X-ray referral letter was modified to include a QR code, simplifying the registration workflow for outsourced X-ray contractors, and smoothing the return of reports and films with unique client information. Comprehensive end-to-end testing was conducted to ensure that X-ray reports and films were effectively returned from the outsourced contractors via EHRSS. This return successfully triggered a new status which indicates the readiness of X-ray reports in the clinical system. Doctors could then utilize the filtering feature to shortlist the X-ray reports and films for prompt assessment.
Furthermore, a new module featuring an electronic viewer for X-ray films has become available across 12 centres. To ensure seamless adoption, relevant training was provided to clinical staff. In conclusion, these enhancements have been successfully implemented in 12 centres and already over 1000 reports had been returned to the system shortly after the revamp. The new digital workflow not only improves the accessibility and swiftness in obtaining X-ray exam results but also paves the way to minimize manual workflow in the long run.
