As the world grows more connected, there is a consciousness growing around environmental care and sustainability. There is no exception for The Hong Kong Polytechnic University (PolyU). While actively promoting a green culture on campus, the University has been executing sustainability and eco-friendly principles across campus developments and daily operations. This value of care for the environment is one that links directly to the care that clinicians and staff from PolyU’s University Health Service (UHS) have for their patients.
A clinic that operates on sustainability principles must be environmentally friendly and offer medical care that is efficient yet able to meet patient needs. “We embrace sustainability as a core organizational value, and have committed significant efforts and personnel to support this,” said Dr Howard Kwong, Senior Medical Officer of UHS. “In particular, we are looking into ways to cut down paper usage, and we have factored this into our operational practices. We are happy to see rewarding results now.”
An ordinary healthcare facility is likely to consume enormous amounts of paper. Becoming a paper-lite clinic seems to be a myth. “We used to rely on paper in the past. Traditional paper-based medical record system means possibly uncountable loads of sheets of paper as associated with each patient record across consultation, prescription, tests and laboratory services reports, health check-ups reports and other documentation on specialist services. If we maintain everything on paper documentation and hardcopy files, it would be something so undesirable as the amount of paper we need would be so huge. Also, there are many other drawbacks associated with a paper-based document system,” Dr Kwong added.
Thanks to revolutionary technologies, UHS made its way forward and started the ‘going paper-lite’ journey with the introduction of Enterprise Content Management (ECM) Service into its operations some years ago. The ECM system, maintained by the Information Technology Services Office (ITS), provides a centralized repository for UHS to efficiently store and retrieve patients’ records. It took UHS a bit of time to apply the ECM system. The staff there worked hard to ensure that everything was on the proper track. They spent time working with ITS colleagues to customize and deploy the ECM system to fit their needs. They worked with their external agents in the medical record digital conversion exercise, scanning and digitalizing very old medical records. They paid efforts in streamlining the entire operation flow. They made stringent tests to ensure data and storage security to its highest level.
By rolling out the ECM system, UHS welcomes a number of accomplishments. A move to electronic media to store medical information helps in saving paper significantly, especially when the clinic accepts some 90,000 visits annually. Simultaneously it brings convenience to clinicians to trace the most current version of documents and patient information electronically and promptly. Clinicians and staff can be worry-free of the possible loophole in writing, copying and delivering paper-based information such as inpatient pharmacy order processing or some tests reports. Clinicians use the computers and type when they are with the patients, resulting in better efficiency and higher accuracy in the medical diagnosis and prescribing. To those frontline staff at the reception counter, they no longer need to be annoyed with stacking the cabinets of paper files when space was at a premium. They need not spend time digging out each patient’s file from the ocean of documents. Patients need not wait too long before meeting the clinicians and panic about missing their information.
Medical records turning electronic is not the single measure to drive paper reduction. UHS also looks into streamlining the workflow when the valid university users covered by medical insurance programme register at the reception counter. Some time ago, these patients were required to present their healthcare or medical insurance cards at the reception counter, and to sign the medical vouchers as an evidence of receipt of the medical services they receive. Each medical voucher came in 3 sheets of paper, intended for retention by the patient, the clinic, and the insurance policy agent. It is not difficult to anticipate the amount of paper needed for printing these vouchers, and the space to store them properly. UHS introduced the electronic signature board to replace the signing on hardcopy medical vouchers upon registration in July 2016. “We were determined to do so, but we had to admit that we were a bit anxious about the stakeholders’ response at the beginning. We had to convince them and to encourage them to sign on the electronic signature board with comfort. We had to let them know our reasons behind,” Dr Kwong recalled. The practice was a huge success eventually. The processing time required to complete each registration procedure was much shortened, and it only needs 10 seconds each now. The clinic needs not fight for space to keep all the signed or unused medical vouchers, and that directly saves a lot of paper.
Paper resource management accounts for the largest part of the sustainable concept in the clinic. But that’s not the end of the story. More thoughts are invested into other practices that drive more conscious paper use. UHS staff members are investigating into printer settings and adjustments when generating reports to use less paper. They are exploring with partnering medical facilities on using electronic transfer and communication instead of transporting paper print-outs. Inside the clinic environment, staff members are distributing less pamphlets or paper-based promotional materials than before. Electronic notices and digital signs are the better counterparts. UHS also eyes on eliminating plastic waste and it is no longer proactively offering those small and white plastic bags for medication.
“There are tremendous opportunities for including eco-friendly practices in our design and operations, and we have to prioritize. One of our near-term goals is to conduct our patient satisfaction survey in digitized formats instead of printing out the questionnaires,” Dr Kwong concluded.
Effectively implementing green practices presents a unique challenge to all healthcare facilities. Nevertheless, it also allows them to realize many benefits and to improve cost efficiencies and the quality of care for their patients. PolyU’s UHS has poured resources to support its sustainability efforts, and is about to enjoy the fruits of its labour.