Vietnam’s hospitals at the early stage of going smart
According to the latest white paper by YCP Solidiance, an Asia-focused consultancy firm, titled A Look Forward: How Digitalization is Transforming Vietnam’s Healthcare System, the country’s hospitals are in the early phase of going smart. While public hospitals aim to improve their operational efficiency and medical outcomes, private hospitals are making a digital push to enhance their value proposition.
Current developments: Public hospitals
As of July 2019, 100% of public hospitals have installed hospital information system (HIS). While some hospitals have an internal information technology team to develop HIS internally, the majority (>92%) utilize solutions developed by local IT companies such as FPT, Links Toan Cau, Dang Quang, and OneNet, amongst others, the white paper reported.
The adoption of Picture Archiving and Communication System-Radiology Information System (PACS-RIS) is very low (<10% of total hospitals) across healthcare providers nationwide. As of July 2019, only 20 public hospitals have successfully implemented PACS-RIS. Laboratory Information System (LIS) adoption is relatively high at central-level hospitals, with 36 out of 49 hospitals having implemented the system, whereas the adoption is slow at lower-level hospitals.
Until mid-2019, 14 public hospitals have implemented the EMR system. Although hospitals have yet fully converted from the paper records to electronic records, the initial benefit of reducing time spent on writing medical reports has been reported. A doctor working at a provincial hospital suggested that EMR system potentially saves up to 25% of the total hospital's cost from reducing costs of storage, staff, and administrative fees.
Private hospitals: Making a digital push to enhance value proposition
Compared to public hospitals, many private hospitals have relatively advanced health management systems. This is mainly due to three factors. Firstly, higher-income patients demand and have demonstrated a willingness-to-pay for transparent, convenient, modern and high-quality healthcare services.
Next, foreign-invested hospitals with international management standards invest heavily in digital platforms including HIS, LIS or PACS at the early stage of establishment. Finally, local private hospitals perceive digitalization as a must-have factor to maintain their competitive position in the market, especially with the increasing entrants of foreign hospitals.
Large private hospitals such as Hoan My Hospital, Victoria Healthcare and Vinmec Hospital, are operating as hospital chains with multiple locations across the country. Hospital chains have incentives to continually upgrade their digital infrastructure not only to effectively manage the hospital branches but also to reinforce their status of international standards. The implementation of digital platforms at these private hospitals is less complicated compared with public hospitals due to standardized systems across individual hospital branches.
Challenges for further digital adoption in Vietnam
The white paper also pointed out three main challenges that are impeding Vietnam’s hospitals in further digital adoption. There are limited digital capabilities of healthcare professionals and patients as well as financial constraints. For instance, IT departments at public hospitals are mainly responsible for operation and maintenance of hardware and software systems, so their focus is on short-term goals rather than long-term digital adoption.
Unclear and complicated administrative processes are also a dampener to digital adoption. One clear example is the requirements related to digital signature for national health insurance reimbursement, a challenge hindering EMR implementation. Digital signatures - to be registered by all doctors and nurses involving in the medical process - would need approvals from two different departments, the Electronic Health Administration under Ministry of Health and the Vietnam Social Security.
In addition, health identification, a prerequisite factor for Medical Health record (MHR), has not been implemented in Vietnam as the Ministry of Health only recently introduced the guidance on creating, using and managing health ID number since September 2019.
System integration is also a challenge, given the limited data conformity, as well as cybersecurity issues. Even though central and regional governments have issued guidance on implementing, there are currently no national standards, especially data output standard. Each organization has its own standard limiting inter-hospital connections. Data security concerns cause healthcare providers to be reluctant in storing patient information on cloud and/or sharing their network with outsiders.