Nestled on the northern coast of Borneo, Brunei is a small nation housing a cutting-edge healthcare information system.
Designed to deliver universal health benefits to a population housing over 420,000 citizens, the Ministry of Health Brunei (MOHB) has created a ‘one patient, one record’ system through a partnership with DXC Technology.
Billed as a “first-of-its-kind milestone” in healthcare, the implementation of an agile health-information management system now contains health records of every citizen across the country.
With healthcare and medical services provided by the federal government, MOHB - which oversees Brunei’s four government hospitals and 60 health centres and clinics - sought to implement a "comprehensive" healthcare information system.
The aim was to create a system capable of spanning the country’s health facilities, ensuring every health record was easily accessible to physicians and other healthcare professionals "anywhere, anytime".
“We realised that our goal would be no small feat,” recalled Dr. Ahmad Yazid, an intensive-care physician and medical superintendent of the Raja Isteri Pengiran Anak Saleha (RIPAS) Hospital, housing more than 600 beds. “So we needed a partner with technical knowledge and dedication.”
Consequently, MOHB aligned with DXC for the provision of IT support and technical expertise through the creation of a system named Bru-HIMS - Brunei Health Information and Management System.
DXC engineers designed the system to run on DXC’s Enterprise Management software and to integrate with nearly a dozen pre-existing MOHB systems, including appointments, outpatient management and clinical care. Following less than two years of work, Bru-HIMS went live.
To improve its chances for a successful implementation, Dr Yazid said MOHB introduced Bru-HIMS on a "district-by-district basis", with the roll-out also including user training, readiness roadshows and symposiums.
In addition, DXC provided training for every medical professional, with Bruneians encouraged to register for the system, alongside a public web portal.
Dr Yazid said Bru-HIMS’s real-time data integration and replication capabilities now allows Bruneians - in addition to their healthcare providers - to gain access to a "single, consistent record" of their healthcare information.
To register for the system, Bruneians can use a mobile app that runs on smartphones, leading to 90 per cent of the population registering so far.
“Patients appreciate knowing that wherever they go, their healthcare records can be retrieved quickly and easily,” Dr Yazid explained. “When they visit a clinic or hospital, they need bring only an ID card to access their single medical record, which includes lists of prescribed medications, the results of past X-rays and other tests, and reports from previous visits.
“Patient safety is protected, too, as an audit trail with a unique patient number is available for any investigation report."
For physicians, Bru-HIMS helps to eliminate misplaced or missing notes, solve the problem of illegible handwriting, minimise duplicate tests, improve the management of medication stock, and - by allowing access a single patient record anywhere, anytime - generally improve both diagnoses and care.
“The system enables the clinics and hospitals to operate more efficiently and effectively to meet our patients’ expectations,” Dr Yazid said.
In addition, Bru-HIMS offers enhanced mobility solutions designed to hep clinicians support their patients from outside hospitals or while traveling.
A planned feature will let Brunei’s “flying doctors” - physicians who serve the roughly 10 per cent of the population living in areas so remote that they can be accessed only by helicopter - provide telemedicine online.
“We’ve worked well together from the beginning,” Dr Yazid added. “DXC has listened to our needs as a client, delivered the software, trained the users and improved the program based on user feedback.”
According to Dr Yazid, DXC’s Enterprise Management system underpins the Bru-HIMS solution, providing full integration of enterprise health records and hospital information systems.
Furthermore, the solution ensures automation of all hospital workflows across patient management, clinical documentation, referrals, including areas such as pharmacy, laboratory and radiology.
Delving deeper, Dr Yazid said Bru-HIMS transactions are fully synchronised across multiple databases and system nodes using real-time workflows across multiple care settings. Integration with a drug database provides clinical decision support while also ensuring patient safety.
“Patients benefit from easier access to resources, while care delivery is safer because error rates have been reduced through electronic prescribing,” Dr Yazid said.
Bru-HIMS also delivers advanced business intelligence reporting for management reviews, enabling MOHB to measure and improve program effectiveness and costs.
Further functionality added recently includes better scheduling and improved device integration. Among new planned features are an information system for dentistry and the ability to analyze collected data to plot future expansions and enhancements.
“This is still a work in progress,” Dr Yazid added. “By working together with DXC, we are progressing well toward our goal.”