Tuesday, July 03, 2007

Letter To Media

I have sent a letter of feedback to one of the papers. The issue is about hospitals not releasing and sharing patients' information and data on their past and current medical report. Instead patients are required to produce and declare all of their medications ever issued to them upon admitting into hospitals. Against the background of our current technological advancement, this move certainly looks ancient and out-of-time.

The letter has been published yesterday, with some admendments by the publishers themselves.


I refer to the report of Alexandra Hospital (AH) adopting this 'medical reconciliation' from the United States, that enable doctors and hospitals to compare the complete list of patients' current or even past home medications issued.

I am certainly perplexed to hear that at this point in time, with our current technological advances, doctors are still requesting patients to bring all of their medications to hospital for the purpose of verification and updating into the "national electronic medical record system". This contrast is even greater given the fact that should AH not adopt this system, "patients would have to be interviewed on their medical history upon admission", and upon AH's initiation, "other healthcare institutions have adopted the system", suggest strongly the weaknesses inherent in our present medical systems.

For all one knows, MOH has launched an Electronic Medical Records Exchange (EMRX) in 2004, linking all restructured hospitals, polyclinics and national centres in the Singapore Health Services (SingHealth) and National Health Group (NGH) clusters.

While AH may not be in the loop of this information-sharing, it is still sad to see that hospitals and health institutions not releasing and sharing information among themselves; information which may be trivial for the doctors but vital for the patients as, in your report revealed, saved on the cost of medications and reduce complications in the course of examination.

While family members coming forward to declare all medications would be a positive move, complications can arise when patients whom are aged or disabled to communicate, or homeless and without family support aren't ready to fulfill this responsibility. Vital information is thus lost along the way, with more time and effort incurred for verification of past medical histories and records. This inevitably pushes the burden back onto the doctors and health institutions concerned.

MOH should step in and ensure that all healthcare institutions have access to patients' database built on a national level, leaving no doctor and hospital out of the loop. Where assessment of patients is concerned, doctors should rely on this database as the primary source of information, complementing with the physical declaration of past medications. This certainly reduces the man-hour required for verification of medicines, duplication of medicines issued and tests conducted, and increases the safety level where drug allergies are involved. At the end of the day, the overall operating costs for the institutions are lowered, with patients benefitting hugely from this simplified system as well.

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