To complete the scanning of available old medical records of all the patients within 1 year, it was necessary to employ extra 4 persons overtime each day 7 days a week.
Budget was also allocated to purchase a server, hardware, and scanners for all outpatient units and inpatient wards.
The hospital IT team, with 7 IT personnel, monitored the system and developed related software. Initial hardware investment cost, mostly scanners, was relatively low but the benefit was worthwhile and suitable for developing countries. The cost of initial investment may deter the implementation of initiative. Using DigiCards changed the working culture tremendously but still retained the familiar practice of physicians. With the help from assistant nurses with document scanning, the medical records were always updated in real time.
For the key benefits, DigiCards system increased the efficiency and effectiveness of hospital's management and services in the following aspects.
After the initiative, the time taken to retrieve medical record was reduced thereby minimizing patient waiting time. The clients’ benefit was apparent in a steady reduction of service cycle time from 2.5 hours in 2006 to 1.1 hours in 2010. The reduction in patient waiting time contributed greatly to the increased clients' satisfaction. After project implementation, statistical data from clients’ satisfaction survey at out-patient department showed that satisfaction increased significantly from 2008 to 2011: 81.9%, 82.1%, 88.0%, 90.5%, respectively.
Simplifying work process and medical record processing steps also significantly increased workforce satisfaction. Satisfaction survey of physicians and nurses increased from 49.8, 62.1, respectively in August 2009 at the beginning of implementation to 85.0, 95.0, respectively in April 2011.
Scanning of patient records also improved medical record retrieval. After the DigiCards initiative was launched, the medical retrieval rate at outpatient departments increased from 50% in 2008 to 100% in 2011. (No medical record loss!!!). The digital records facilitated interdepartmental consultations. Because of rapid access to medical record from any place in the hospital, patients received faster services and interdepartmental consultations could be accomplished with minimal delay. This would be most beneficial in the emergency department patient with the immediate medical record retrieval.
The initiative improves the quality of care because all healthcare professionals were able to access patient history, treatment-related information including drug allergy and patient follow up. The communication between physicians and nurses was greatly enhanced. Nurses could prepare patients before examination by physicians faster and pharmacists could immediately aware of physician diagnosis and drug prescription. The system reduces medication errors and greatly increases patient safety.
Moreover, simple and simultaneous access to medical records via DigiCards system allowed physicians, specialists and researchers to compile and analyze data leading to an improvement in clinical training and research.