Expediting the implementation of electronic medical records.

Speaking about the effectiveness of electronic medical records, Associate Professor Dr. Dao Xuan Co, Director of Bach Mai Hospital, said that after 6 months of implementation, Bach Mai Hospital has become one of the leading units in implementing digital transformation in the healthcare sector. The hospital has proactively and actively invested in infrastructure and trained human resources.

Given the diverse range of qualifications and ages of its staff, the hospital organizes "digital literacy" classes to disseminate knowledge and usage methods to all employees. As a result, staff in all departments, wards, and centers have adapted quickly and implemented their work quite smoothly in the digital environment.

Previously, all patient data (X-rays, test results, medical records) were printed on paper; now, data has been converted to electronic format, facilitating hospital management. Instead of carrying various documents (citizen ID, health insurance card, etc.), patients can now simply use their smartphones. X-ray results, test results, and medical records are all delivered via an app, reducing costs (for both patients and insurance companies) while building a comprehensive patient database (health records).

Based on the results at Bach Mai Hospital, Associate Professor and Doctor Dao Xuan Co affirmed that if all hospitals implemented electronic medical records, it would truly be a "major revolution" in the Vietnamese healthcare system.

However, by mid-April 2025, only 153 hospitals nationwide had announced the implementation of electronic medical records, eliminating the use of paper medical records. Of these, only two health departments (Phu Tho and Bac Ninh ) had implemented electronic medical records in all their affiliated hospitals. This result is low compared to the approximately 1,400 hospitals nationwide.

According to People's Physician, Associate Professor, Dr. Tran Quy Tuong, Chairman of the Vietnam Medical Informatics Association, the implementation of electronic medical records brings practical benefits to all stakeholders, from patients to medical facilities and health insurance agencies. For patients, electronic medical records eliminate the need to store paper documents when seeking medical treatment and alleviate concerns about losing test results. Combined with the implementation of electronic health records, electronic medical records enable patients to continuously manage their health information.

For doctors and healthcare workers, the rapid transfer of patient data between departments, wards, and hospitals helps avoid duplicate clinical orders (ultrasound, laboratory tests, etc.); doctors can easily retrieve patient medical records, reducing examination time, supporting timely treatment, and improving the quality of diagnosis and treatment. Information about patients' examinations and treatments is digitized, stored scientifically , and electronic prescriptions are used, contributing to minimizing medical errors.

The implementation of electronic medical records, along with electronic health records, provides the healthcare sector with complete, accurate, and timely data on people's health. This is a very large health database (big data) for the sector, and the aggregation and analysis of this data will help the sector provide timely guidance on disease prevention and control, and make better predictions and policy plans for protecting, caring for, and improving people's health because it is based on more practical and scientifically grounded evidence.

Information about patients' medical examinations and treatments is readily available and transparent, making it easier to manage health insurance costs and helping to reduce the misuse of medications and tests. Once electronic medical records are digitally signed, all information cannot be edited, ensuring the integrity of the medical record data.

Thus, the implementation of electronic medical records benefits the people, the healthcare sector, and facilitates the practice of medical professionals... Therefore, in Directive No. 07/CT-TTg dated March 14, 2025, the Prime Minister assigned the Ministry of Health to direct and urge 100% of hospitals nationwide to implement electronic medical records; to link data between local hospitals and hospitals under the Ministry of Health, and to utilize the already linked and inter-provincial data to reduce testing for the people, to be completed by September 2025.

Following the Prime Minister's directive, the Ministry of Health and the People's Committees of provinces and cities are currently directing the vigorous implementation of electronic medical records in all hospitals under their management. Experts believe that the legal framework for the implementation of electronic medical records is now relatively complete. The Law on Medical Examination and Treatment, the Law on Electronic Transactions, and other related legal documents all provide sufficient legal basis for the implementation of electronic medical records. The Ministry of Health has also issued documents with practical significance and breakthroughs in the application of information technology in healthcare and the implementation of electronic medical records.

However, the implementation of electronic medical records also faces several challenges, such as: inadequate digital platforms and infrastructure; a lack of specific guidelines on financial regulations for the application of medical information technology in general and the implementation of electronic medical records in particular; and varying skill levels among healthcare professionals.

To implement electronic medical records, experts suggest that the Ministry of Health needs to provide more decisive direction for the digital transformation of healthcare in general and the implementation of electronic medical records in particular; it should have policies and solutions to implement digital transformation in healthcare, with special emphasis on the synchronized deployment of specialized platforms, application systems, and databases as a foundation to promote the application of electronic medical records. The Ministry of Health and related units should develop and refine mechanisms, policies, legal documents, and professional guidance documents on digital transformation in healthcare in general and the implementation of electronic medical records in particular. The Ministry of Health needs to impose sanctions on units and localities that do not implement the plan according to the prescribed schedule…

According to the plan for implementing electronic medical records, the Ministry of Health requires all units to consider the implementation of electronic medical records as a top priority; heads of agencies and units are fully responsible for this work; prioritize resources, mobilize the participation of organizations, businesses and the public, and decisively implement the plan, ensuring quality, timeliness, and completion by September 2025.

Implementing electronic medical records in a substantive and effective manner will improve the productivity and quality of medical examination, treatment, and disease prevention, bringing practical benefits to patients, the public, and healthcare facilities; ensuring the interoperability and data sharing between medical examination and treatment facilities and related information systems and databases as prescribed...

Dr. Ha Anh Duc, Director of the Department of Medical Examination and Treatment Management (Ministry of Health), said that the assigned units are focusing on implementing electronic medical records. The Department of Medical Examination and Treatment Management is actively developing clinical, paraclinical, nursing, and related lists for electronic medical records, ensuring adherence to the planned schedule.

In addition, the electronic medical record framework is being urgently finalized so that each hospital can apply it to varying degrees depending on its conditions and capabilities. The Ministry of Health has determined that it will be applied throughout the entire healthcare system, from lower-ranked hospitals to those of special rank; data must be interconnected and open-source so that hospitals can add to it. Regarding the electronic medical record management software, it can be provided by various vendors, but changes to the management software must not affect data interoperability.

Deputy Minister of Health Tran Van Thuan requested that units innovate their thinking in hospital management, including the widespread application of digital transformation in management, operation, and professional work. The shift should be from an administrative management model to a modern management model, based on data, with transparency in operations and efficiency in decision-making.

Promoting the implementation of electronic medical records, electronic health records, quality management systems, and interconnectedness between units, with the goal of building a smart hospital model that meets real-time management requirements and puts the patient at the center.