EMR

Because Singapore is such a small country, it is feasible to do what they have done with their EMR.  Every public government funded hospital or clinic uses the same program, creating a National Electronic Medical Record.  At each institution, there is a local log in that lets you see information from only that institution.  But the software allows you to log out and switch to another institution to view notes, labs, and more.  Yesterday one of my patients was urgently transferred from Changi General Hospital (local community hospital) to us for work up for cancer and sepsis with pneumonia.  We didn't order a chest x-ray yet but the transfer summary noted that she had one done at Changi General before the transfer so we were able to log into their system and review that image.  That allowed us to see the extent of the infection and weigh our options much faster.

The downside is that the vendor they chose to provide the EMR is limited in functionality.  It can only really display labs, imaging, and initial or final notes (like an H&P or discharge summary for hospital visits).  Everything else still has to be hand written so progress notes or specialty consult notes are sometimes hard to track down.  I'm surprised they haven't made the switch to a fully integrated EMR like Epic or Cerner yet.  It's obviously very expensive but I think it'll help provide a more complete picture of the patient that is accessible anywhere in the hospital.  In a few years, they might get there but for now I'm still just riding the elevators all over the hospital campus.