Building a National Electronic Medical Record Exchange System - Experiences in Taiwan: Integrating My Number Card and Health Insurance Card

Building a National Electronic Medical Record Exchange System - Experiences in Taiwan: Integrating My Number Card and Health Insurance Card

In 2009, the Taiwanese government approved a three-year plan to accelerate the implementation of electronic medical record (EMR) systems in healthcare institutions. Under this plan, patients in Taiwan can access all their important medical records from the past six months in any hospital by signing a consent form and using their health insurance IC card and the physician's medical professional IC card. The establishment of the National Electronic Medical Record Exchange Center (EEC) is the key focus of this plan. The hospital's information system is connected to the EEC through an EMR gateway. The hospital converts the past six months' medical records in the EMR system into standardized files and stores them in the EMR gateway. The most important function of the EEC is to generate an index of all XML files on the EMR gateways of all hospitals and clinics, providing search and retrieval services to hospitals and clinics. The implementation of inter-facility EMR exchange system faces several challenges, but it has the potential to improve access to medical records, reduce wasted healthcare resources, and enhance the quality of care.

On the other hand, in Japan, a study group examined the integration of My Number Card and Health Insurance Card. The My Number Card serves as a tool for secure and reliable personal identification in a digital society, and it is considered the most crucial infrastructure for promoting digitalization across society. The aim is to provide every citizen with the card and, based on their consent, allow healthcare institutions and pharmacies to access their past medication and specific health examination information. This integration eliminates the need for patients to explain their medication history comprehensively to physicians, enabling more appropriate healthcare based on past health and medical data, such as preventing polypharmacy and drug interactions, at a lower burden. Additionally, it eliminates the need for switching or renewing insurance cards due to job changes or relocation, exempts payments exceeding the personal burden limit, reduces the return of receipts due to incorrect qualification information, reduces staff confirmation work, and decreases outstanding payments. The government recognizes the importance of effectively communicating these benefits to the public and healthcare professionals to gain understanding and support for the integration of My Number Card and the Health Insurance Card. Online qualification verification through the My Number Card is expected to become the foundation of future healthcare digital transformation (DX). Furthermore, integrating the identification system for medical examination cards and public expense medical recipient cards with the My Number Card is anticipated to bring even greater benefits and convenience to citizens and healthcare providers.

Both Taiwan's experience with the National Electronic Medical Record Exchange System and Japan's consideration of integrating the My Number Card and Health Insurance Card highlight the potential benefits of digitalizing healthcare information and improving access to medical records. They both emphasize the importance of secure and reliable identification methods, such as IC cards, to facilitate data exchange and enhance healthcare delivery. By connecting healthcare institutions through electronic systems and enabling seamless access to patients' medical records, the quality of care can be improved, and unnecessary healthcare resource utilization can be reduced. Additionally, the integration of identification cards with health insurance cards provides convenience to patients, reduces administrative burdens, and ensures accurate qualification verification for reimbursement purposes.

Based on these experiences and considerations, here are three actionable pieces of advice for countries looking to implement similar systems:

1. Prioritize the establishment of a centralized electronic medical record exchange center: A centralized system allows for efficient indexing and retrieval of medical records across healthcare institutions, ensuring seamless access to patient information.

2. Promote the benefits of secure identification cards: Clearly communicate the advantages of using secure identification methods, such as IC cards or My Number Cards, to healthcare professionals and the public. Highlight the convenience, accuracy, and efficiency that these cards bring to healthcare processes.

3. Emphasize the potential for improved healthcare outcomes: Showcase how the integration of electronic medical record exchange systems and secure identification cards can lead to better healthcare outcomes, such as reducing medication errors, preventing polypharmacy, and enhancing care coordination.

In conclusion, the experiences in Taiwan with the National Electronic Medical Record Exchange System and the considerations in Japan regarding the integration of the My Number Card and Health Insurance Card demonstrate the potential of digitalizing healthcare systems and improving access to medical records. By implementing secure identification methods and establishing centralized systems for data exchange, countries can enhance the quality of care, reduce administrative burdens, and promote better health outcomes for their citizens.