The Hospital Authority has set five priority strategies for the next two years, putting the authority on the right path towards 2020 when patients will be much more in control of their health and have a wider range of service options.

The five priority strategies are:

* clinical innovation leading to more choices for patients;

* creating informed patients through electronic health records;

* gaining a consensus on the authority's "core service offering";

* creating a "people plan" for the authority; and

* introducing a new internal resource-allocation system.

Speaking at the Hospital Authority Convention 2007 today, the authority's Chief Executive Shane Solomon said the Government will raise the authority's operating funding by 2.4% and offer an additional $500 million for equipment modernisation this year.

Integration important

He pointed out integrating the care delivered by multiple specialties will become more important as the patient population ages.

"Instead of going to different Hospital Authority specialists to have their multiple chronic conditions treated, Hong Kong citizens will increasingly rely on the family doctor who knows them well and can help them manage their inter-related health issues," Mr Solomon said.

"Patients in the year 2020 will know what to expect from the authority. The 'core service offering' will be well known by all Hospital Authority citizens and it will include pledges on waiting times and include proven new technologies and treatments, be of high quality and well founded in evidence. Additional choices beyond the authority's core service offering will be available but this will require patient co-payment."

Electronic record

He envisaged that by 2020, all Hong Kong citizens would have an extract of their own electronic health record telling them about their past vaccinations, the results of previous health-screening tests, their allergies, pathology and digital X-ray results. It would also chart key aspects of their health to point to warning signs, such as blood pressure, weight, and cholesterol levels.

On clinical innovation, Mr Solomon said there are a number of high-priority areas, such as new programmes that keep people out of hospital through secondary prevention, expanding community mental-health services, new models of primary healthcare, building up of sub-acute services, more public-private initiatives that offer more choices, and use of electronic service delivery.

Unique opportunity

"Hong Kong has a unique opportunity to be the first in the world to offer its whole population access to their own electronic health record. We need to fast track the next stage of the Hospital Authority's clinical-management system so that the wealth of patient information can be easily adapted to the wider Hong Kong environment.

"The authority's electronic patient-record pilot project needs to move quickly to demonstrate that the private sector can safely access patient data, with tight privacy controls," he added.

Mr Solomon is also mindful of the need to gain public consensus about the authority's core service offering.

"Decisions about the authority's core service offering should be made openly, engaging the wider community. These decisions take the form of what will be 'self-financing' or how long someone will wait for a service - the performance pledge to the community."

People plan

Turning to the need for a people plan for the authority, Mr Solomon said the priority action areas are reducing doctors' working hours, addressing nurse workloads, proposing career progression for key professional groups, introducing flexible employment terms, and building up leaders at all levels of the authority.

"Reasonable workloads can only be achieved if the authority's internal resource allocation system funds the services actually delivered by our staff - the number and type of patients treated. Money should follow the patient in the Hospital Authority," he added.

"This moves away from the historical rollover resource allocation method, with all its unfairness and poor incentives for efficiency. So this year we will commence work on a new internal resource allocation model for the authority which will be based on activity adjusted for patient case mix."

The authority's chairman Anthony Wu said innovation is what makes a healthcare system tick.

"With Hong Kong clearly at a crossroad, the Hospital Authority must keep modernising and innovating to contribute to a sustainable way forward," he added.