Ms. Hoang Thi Hanh (Gieng Day, Ha Long, Quang Ninh) was discovered to have up to 13 colon polyps after showing symptoms of abdominal pain and changes in defecation. Even though the biopsy results were benign, she still wanted to go to a higher-level hospital for a re-check. In early October, her daughter took her to Viet Duc Friendship Hospital to see a leading professor in gastroenterology. 

At this time, the doctor asked for the results of the lower-level examination to see if a repeat endoscopy was needed, but Hanh did not have any documents with her. Her daughter called the doctor for examination at Quang Ninh Provincial General Hospital. The doctor explained that this was an electronic medical record and sent the results via Zalo to Hanh. 

“With the linked electronic medical records, doctors at Viet Duc Friendship Hospital have looked very carefully and have no diagnosis different from the local one. The doctor only prescribed medication to take and made regular follow-up appointments,” Hanh said. 

Ms. Hanh's daughter said that she had a history of colon disease for many years. In previous times, due to not being able to keep documents, each time she went for a check-up was very difficult because she could not remember the previous check-ups, indicators, nor results to see if the polyps got bigger. However, over the past 2 years, thanks to electronic medical records, she no longer needed to struggle with paper documents. All information is clearly understood by the doctor on the electronic medical record. 

“The diagnostic results of the provincial doctor coincided with the central doctor. Next time, I can be assured that my mother will monitor it locally,” Hanh’s daughter shared.

Since 2020, Quang Ninh Provincial General Hospital has been officially applying digital signatures and electronic medical records to replace paper medical records, becoming the first hospital in the province to pioneer in this field of digital transformation. 

According to Master, Specialist II Doctor Trinh Van Manh, Deputy Director of the Department of Health (former Director of Quang Ninh General Hospital in 2015-2021), this is one of the first 10 hospitals in the country to apply electronic medical records. To date, 100% of conditional documents have been digitised, patients' medical records are digitally signed and the results are linked to the database of the Ministry of Health and the Vietnam Social Security. The hospital also has many useful software to support patients such as scheduling examinations and looking up results online, non-cash payments, smart kiosks, etc.

With strong digital transformation in the health sector, the Quang Ninh Province unit is now approaching the “three Nos” criteria: no queuing, no paperwork, and no cash payment. Quang Ninh currently has 5 units qualified to implement electronic medical records/paperless hospitals (Provincial General Hospital, Bai Chay Hospital, Obstetrics and Paediatrics Hospital, Hai Ha District Medical Centre, Tien Yen District Medical Centre) out of a total of 58 hospitals that have deployed electronic medical records nationwide. In the fourth quarter of 2023, the province will appraise 2 more units so that Quang Ninh Province will have 7 units achieving paperless hospital status.

As the first district medical centre in Quang Ninh to deploy electronic medical records to completely replace paper medical records, specialist doctor II Bui Manh Hung, Director of the Hai Ha District medical centre, said electronic medical record helps patients who come for medical examination as they only need to bring their health insurance card, citizen identification card, or smartphone with the VSSID application installed to scan the code. They will get a number and register for medical examination at kiosks that automatically distribute numbers. 

All medical examination order information is updated on the examination waiting screen in the corresponding rooms. All patient clinical examination results are updated on the hospital's network system connected to all departments and rooms.

“Electronic medical records help patients avoid having to store paperwork when going for medical examination and treatment. It is also convenient for doctors to exploit the patient's medical examination and treatment history to prescribe appropriate and effective treatment regimens," Dr. Manh Hung shared.

To gain advantages for people in medical examination and treatment, Quang Ninh's health sector has made strong digital transformation steps. Many indicators have exceed national targets.

The results of the first six months of the year showed positive numbers: The total amount of cashless payment transactions in the entire industry reached over 60%. Software has been created, managed, and stored by health agencies and units for administrative and health information for 1,387,913 people (reaching over 94%). 3,248,375 prescriptions have been linked, 266 facilities have been granted codes on the National Prescription System for medical examination and treatment facilities, 2,063 prescribers have been given codes to prescribe, and 150 medical facilities have prescribed and linked daily prescriptions to the national prescription system.

According to the Director of the Provincial Department of Health Nguyen Trong Dien, 94.3% of local people have been connected with electronic health records. Medical facilities have upgraded medical information management software (HIS/LIS/PACS/EMR) at hospitals and medical centres. The information management systems of communes, wards and towns in managing health information and medical examination and treatment have been upgraded. The application of Artificial intelligence (AI) has supported diagnosis and treatment in several specialties. 

“These are the results of strong digital transformation in the health sector of Quang Ninh Province, to manage and monitor health, remind patients of medical examinations and treatment schedules and help them connect data in the best way for each medical examination and treatment, without stored paper copies”, said Dien.

Mong Cai, one of the leading localities in the province, has 100% of medical examination and treatment facilities with health insurance, fully equipped with QRcode reading devices on chip-embedded citizen identification cards or VNEID applications, connected to computers using the Internet.

From the beginning of the year to August, the rate of people receiving medical examinations and treatment using chip-embedded citizen identification cards reached 8,597 out of 11,310 visits (reaching 76%). The non-cash collection and payment of hospital fees reached 24%.

People receiving medical examinations at healthcare facilities with 100% health insurance have been linked to the electronic health records of the entire population, higher than the province's target.

Do Duy M. (65 years old, from Gieng Day Ward, Ha Long City) was once treated for coronary artery disease. However, instead of having to transfer to a higher-level hospital for a check-up, this time, he was completely assured of treatment at Quang Ninh Provincial General Hospital, as this unit received the transfer of important nuclear medicine application techniques in cardiology in 2019. “When I get an on-site medical examination, I can keep records and do not have to transfer my medical examination results or travel long distances. There is no greater happiness than having health care right in my locality”, M. shared. 

In 2019, Quang Ninh Provincial General Hospital became the first provincial hospital in the northern region to deploy nuclear cardiology techniques, that were transferred from 108 Central Military Hospital.

Most recently, the Provincial General Hospital’s doctors have put Rapid artificial intelligence (AI) software into stroke treatment, bringing effective intervention to patients. H.V.N (50 years old in Ha Long) had a stroke in the 12th hour and was hospitalised with hemiplegia and had a poor prognosis. The patient received a computed tomography (CT) scan and the images were sent to the image storage and management system of Quang Ninh Provincial General Hospital, which was integrated with Rapid software, to accurately quantify the core area of infarction and damaged area. In just over two minutes, Rapid sent calculation results to each doctor in the stroke group of Quang Ninh Province.

“With only a CT angiogram of the brain, it is impossible to assess whether the patient is capable of recovery or not, if intervention is performed to remove the thrombosis. Normally, for patients who arrive at the hospital after six hours or whose stroke time cannot be determined, doctors will not intervene to remove the thrombus because of the high risk of a brain haemorrhage. However, based on Rapid’s assessment, the doctor decided to use rTPA (Alteplase) in combination with removing cerebral artery thrombus”, said specialist level 1 doctor Ngo Quang Chuc, Head of the Department of Radiology under Quang Ninh Provincial General Hospital.

Quang Ninh General Hospital is one of the two hospitals in the north, pioneering the implementation of Rapid software in stroke emergency care and has applied it to over 260 patients. 

Waking up after a stroke, M. happily said: “In my drowsiness, I thought I could no longer be alive. Medicine now is amazing. If I did not receive timely emergency treatment in my hometown province, I would probably be dead.”

In recent years, many specialised medical techniques and new techniques from central hospitals have been applied to treatment in Quang Ninh General Hospital, helping medical staff master high and difficult techniques, with local people benefiting from high-tech medical services right in their home province and saving treatment costs.

According to Nguyen Trong Dien, by the end of 2022, provincial-level hospitals have implemented nearly 50% of the techniques of central-level hospitals, accounting for 85% of the techniques list of central hospitals. Meanwhile, hospitals at the district level have conducted most of the techniques according to the classification.

“The province has developed hundreds of new techniques from the central-level hospitals, especially in emergency resuscitation, open heart surgery, cardiovascular intervention, obstetrics, oncology, brain and spine surgery, joint surgery, screening research and prenatal diagnosis. In the eighth Provincial Technical Innovation Festival (2020-2021), the health sector had 15 out of 33 projects and solutions winning prizes, including three first-place prizes, three second-place prizes, four third-place prizes, and five consolation prizes. Eight individuals were honoured as Outstanding Scientific and Technological Intellectuals,” Dien said.

To date, Quang Ninh has received the transfer of over 2,100 modern techniques. Medical examination and treatment facilities in the province have applied many scientific and technical advances in diagnosis, treatment, and health care for patients.

“Our doctors are constantly supplemented with new and advanced treatment regimens for the treatment of complex diseases, which previously required referral to central hospitals, contributing to saving many lives and improving the quality of medical examinations and treatment for local people,” Dien noted.

Since 2019, Bai Chay Hospital has also effectively operated a smart operating room system, integrating Navigation positioning and mobile CT systems, in complex spine surgeries.

In addition to updating advanced techniques, medical facilities have also continuously improved the quality of their medical examination and treatment services, along with the bedside manner of medical staff, while enhancing hospital quality management in order to achieve patient satisfaction. According to the Ministry of Health's hospital rankings in 2022, five hospitals in the province were rated “Very good”, four units at “Good”, 13 units at “Fair”, and six units at “Average”. 

Notably, two hospitals in Quang Ninh — Quang Ninh Obstetrics and Paediatrics Hospital and Quang Ninh Provincial General Hospital — have been recognised for meeting the International Standardisation Organisation’s ISO 9001:2015 and ISO 14001:2015 standards.

Do Thi Lai, a 75-year-old woman from Tien Yen District who has diabetes and blood pressure, is happy to receive dedicated medical care and no longer has to worry every time the doctor asks about the results of her previous examination.

“Recently, I haven’t needed to bring or remember the results of previous examinations when I go to the hospital, because the doctor now only needs to look at the medical record to get the results. There are many ethnic people in this remote area, and they receive careful and enthusiastic healthcare. Everyone is happy about it,” Lai said with a smile.

As Quang Ninh is a province with diverse terrain, including remote areas, borders, and islands regions, the provincial healthcare sector has worked to narrow the medical boundaries between different areas.

The sector has actively deployed the Telemedicine remote medical examination and treatment platform, which connects local medical facilities with 11 central hospitals, to improve human resource training, the quality of examination and treatment consultation with. Each year, the healthcare facilities in Quang Ninh Province receive an average of 500 sessions on training and technology transfer from higher levels via Telemedicine platform. The number of medical staff attending these sessions is estimated at 1,200 people. The number of techniques transferred online is about 186.

The provincial hospitals are assigned to monitor and provide around 20 online training sessions to lower level hospitals in the province.

“Thanks to technology transfer, the quality of medical examination and treatment in localities has significantly improved. Many techniques, such as laparoscopic surgery, retrograde lithotripsy, hip arthroplasty have been transferred to improve the efficiency of medical service provision and better the quality of people's lives,” said the Director of Quang Ninh Provincial Department of Health.

The Health Department has assigned four major provincial hospitals to provide comprehensive support for healthcare centres in remote areas by sending health workers to such centres to assist with medical check-ups and emergencies.

One of the key policies to guarantee good healthcare services for people in remote areas is dispatching doctors from provincial hospitals to district hospitals and from district hospitals to local healthcare centres for a specified time. The rotation of doctors has helped to ensure that all healthcare centres in communes have doctors on duty.

In the past year, Quang Ninh built two new hospitals to enhance healthcare services: the Hospital of Geriatrics and Function Recovery and the Hospital for Lung Diseases.

According to Director of the Quang Ninh Department of Health Nguyen Trong Dien, in order to enhance the quality of health check-up and treatment, the health sector still has a lot to do to synchronise the quality of healthcare from the provincial to local levels and carry out advanced techniques so that people can enjoy the best primary healthcare services without having to visit hospitals at higher levels.

No longer needing to carry with them the health books and worry about the skills of local doctors, many are happy that they can now enjoy the best healthcare services right in their localities. It is an achievement of Quang Ninh’s health sector in retaining patients and such a trust will continue to be extended when more and more advanced techniques are being updated and carried out at the local level.