Tuesday, 15 October 2013

THE MACHINES OF MEDICINE

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The healthcare industry in this country is undergoing a seismic upheaval. And Prince Court Medical Centre (PCMC) in Kuala Lumpur, Malaysia, is at the forefront of this shift with its innovative procedures, advanced technology and integrated health management systems. We spoke with Mahenthiran Thanapal, their General Manager of Diagnostic & Allied Health Services to find out more about the future that is already here.
***Interview by Kogi Vijay, Article by Azral Hanan***
How does PCMC stand out as a trendsetter in Malaysia’s healthcare industry?
For instance, one of the major departments under my jurisdiction is the Radiology Department. Many years back, if a radiology department had a Computerized Tomography (CT) scanner, it was the talk of the town. Then of course the CT scan technology itself went through various evolutionary changes and newer machines arrived. Then there was Magnetic Resonance Imaging (MRI). Back then only the big hospitals could afford an MRI because of the huge costs and technology. If your hospital had an MRI that meant it was ahead of the curve in its own elite, niche bracket. But today things have changed. Almost every private hospital including PCMC will have a CT scanner, MRI, ultra-sound and so forth. But we also have what others do not. That means we occupy that niche bracket.
Could you give us examples of procedures and equipment that highlight PCMC’s technological edge?
In terms of private hospitals PCMC is one of the few that have PET CT technology for example. That definitely puts us in a different league, I believe. Also we’re curently one of only two hospitals that provide Tomotherapy, which is a more advanced and precise means of delivering radiation to targeted tumour or cancer cells. I think we were the first to introduce it here as well.
We even have truly cutting edge stuff like robotics, and PCMC can offer the arm robotics system. Currently, we’re probably the only ones to have that technology here within the private healthcare fraternity. Our Eye Department’s bladeless Lasik Eye surgery is also incredibly popular – with our numbers of admittances for Lasik surgery being among the highest in the world.
What else do you think makes PCMC a standard bearer for technical innovation and medical advancement?
It’s because PCMC is a totally integrated hospital. By that I mean we’re probably the only private hospital in the country to be fully wired, fully digital. We have got a Hospital Information System that is connected to an Electronics Medical Records System and also linked to various other systems in the hospital like the Radiology Information System (RIS), the Picture Archives and Communication System or PACS in short and the Laboratory Information System.
Unlike conventional means, patients these days do not have to carry forms from the clinics to the radiology department. The clinician just places an order for an x-ray investigation from his PC or work-station and this order flows digitally to the radiology department. Subsequently, the order is managed and a work-list is created in the respective imaging modality so the radiographer will know how many x-rays needs to be done, what are the indications, who is the patient; everything he needs to know is at his fingertips.
Other than saving time, what are the benefits of a fully wired hospital?
Firstly we’ve become an almost paperless hospital. It’s good for the trees as well as for our patients. Instead of files and folders they’re each given a CD. This presents our patients with a convenient space-saving solution.
Not only that but it also saves space for us too.
As we need to store data on more and more patients, this helps us save space as well. Every time a patient is done we keep the films and reports, and eventually you’ll require a huge area to store all those records if you’re using a conventional file and folder system. Although there is a ruling that medical records must be kept for at least seven years, in practice it can be considerably longer, especially for paediatrics. So long as the patient is being seen at the hospital, their records must be maintained.
That said, storage space can be a major headache for a hospital. But we’ve done away with all that. Reports are given instantaneously to patients and doctors. There are no more issues about reports being lost, missing in transit or delayed.
Is there a worry that glitches in the system could lead to inappropriate treatments and diagnosis?
We already have safety measures in place. PCMC abides by the international patient safety codes. That means that each patient has a unique identifier – an MRN. So we need to ensure that at least two identifiers must be checked – the patient’s name, MRN or his date of birth against whatever we are doing. This cuts down on the risk of mistakes and ensures that the right patient gets the correct examination or procedure and is reported accordingly. These are some of the measures we take to ensure mishaps do not occur.
Isn’t becoming fully wired an expensive exercise?
Actually, along with the minimal use of paper, going digital has also helped us cut down on some of our operating costs. We no longer need to maintain a darkroom since images are all digital, meaning no more hiring dark room technicians to process the film, and no more purchasing chemicals for cleaning and room maintenance. Those savings can go towards bringing in more digital equipment. Which in the long run is more cost effective.
Any other benefits to PCMC going digital?
We’re in sync with the other leading hospitals around the world who are all moving towards integrative systems. Especially with regard to Hospital Information System, EMR, and PACS, we’re all on the same page.
Yet, because we did it all since the very beginning, our first day in fact, PCMC has a strategic advantage. It’s easier to start everything from day one using the new system rather than begin with a conventional system and try to migrate or import to a new one later down the line. You’d have thousands of patients with hundreds of thousands of information and data items to transfer digitally from say, paper records. Imagine the amount of man power and hours required. So while others stray behind, PCMC is already light years ahead of its peers.
Is there anything exciting coming to PCMC in the near future?
We are in the process of getting a digital system machine called a Tomosynthesis. Basically breast imaging itself has gone through various stages of development. So the demand for 3D imaging is greater now than before. Talk to any radiologist, reporting breast images is always challenging – because of the tendency for one to miss small lesions or micro-calcium accumulation.
So technology has taken note. The manufacturers have tried to fill this particular gap. Hence their latest innovation is the Tomosynthesis. It’s like building in a CT scanner within the mammographic system. So, now you’ll be able to produce 3-dimensional images. Currently, that is the leading technology in mammogram. Most hospitals do not have this. PCMC is actually moving towards acquiring this state of the art imaging modality.
To what extent do you see technology replacing human medical practitioners in the next 5-10 years?
I think there is no way technology can replace the human element; a medical practitioner is definitely essential. Technology itself, whether imaging modalities or medical equipment, are actually complementary rather than substitutes to the human medical practitioner.


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