Electronic health records (EHR) made their debut in the United States in 1972. However, it took several years for hospitals to fully embrace this technology. Surprisingly, even the popular medical drama Grey's Anatomy didn't introduce the concept of complete hospital digitalization until its ninth season in 2015.

In contrast, Korea, known for its prowess in digital advancements, embraced this trend much earlier.

Seoul National University Bundang Hospital (SNUBH) claims that it is not only the first fully digitalized hospital in Korea but also the "world's first fully digital hospital," inaugurated in 2003.

“At the time of opening, the attempt to computerize charts, films, prescriptions, and paper documents was a hot topic in the medical world so we decided to challenge ourselves to go completely paperless,” said an SNUBH official who was part of the digital transformation team.

SNUBH, the first fully digitalized hospital 

SNUBH faculty members together with ezCaretech developed an integrated medical information system called the SNU Bundang Electronic System for Total Care (SNU BESTCare) in 2002 and the following year was the first large-scale hospital claiming to be completely digital.

The successful digital transformation of SNUBH served as a model for other hospitals in Korea and has influenced the broader adoption of digital healthcare practices in the country.

Approximately 50 percent of national university hospitals including Ewha Woman’s University Medical Center, Gachon University Gil Medical Center, and Keimyung University Dongsan Medical Center have already introduced this system.

Accordingly, all computer systems in the hospital, such as the electronic medical record (EMR), prescription delivery system, medical image storage and transmission system, management information system, mobile system, and smart hospital solutions, are integrated.

According to SNUBH, its hospital information system has become the standard leading the Korean IT medical field, and BESTCare 2.0 was also exported to hospitals under the Ministry of National Defense of Saudi Arabia in 2014, and entered the U.S. in 2017, the UAE in 2018, and Japan in 2019.

The hospital also succeeded in developing a mobile EMR in 2012 enabling continuous patient monitoring from mobile phones.

Now, at all large-scale hospitals in Korea, a similar level of digitalization can be expected.

SNUBH’s medical information system BESTCare 2.0 was also certified by HIMSS EMRAM Stage 7 for three consecutive years.

“In Korea, a CDA-based interoperability system has been established and used nationwide since 2006 through continuous efforts by SNUBH together with the Ministry of Health and Welfare (MOHW) and we are participating in the MOHW standardization project promoting the use of HL7, FHIR, and International Standard Code for health information system,” said Lee Ho-young, Chief Information Officer of SNUBH.

Based on 20 years of big data accumulated since its opening, SNUBH has established an ecosystem with companies that develop AI solutions by utilizing the expertise of its members.

Lee further explained that during Covid-19, SNUBH established a non-face-to-face outpatient care system, developed an eICU, and a collaborative network with medical centers in Gyeonggi Province.

He also added that the hospital built a smart bedside station version 2.0 for each bed, enabling non-face-to-face rounds, non-face-to-face drug reimbursement, and discharge settlement.

The enabling environment for Korea’s digitalized hospitals

Government agencies such as the Ministry of Health and Welfare, the Ministry of Science and ICT, and the Health Insurance Review and Assessment Service (HIRA) play key roles in formulating policies, providing financial support, and establishing frameworks to encourage the adoption of digital healthcare technologies in Korea.

In particular, the MOHW conducts an annual smart hospital support project to develop a model that can enhance patient safety and improve medical quality by utilizing information and communication technology in medical care.

For example, Kangwon National University Hospital created a system that detects falls in hospitalized patients to reduce the occurrence of pressure ulcers in high-risk groups using AI to analyze CCTV footage in real-time.

The National Cancer Center also established a smart special ward system that automates the patient's chemotherapy process so that medical personnel can respond immediately to varying levels of pain input by the hospitalized cancer patient.

The digital healthcare ecosystem in Korea also includes regulatory bodies like the Ministry of Food and Drug Safety (MFDS), industry associations, medical centers, large corporations, blockchain-based healthcare service providers, and start-ups.

Earlier this month, the Ministry of Food and Drug Safety (MFDS) announced the revision of regulations to recognize RWE data as clinical trial data to confirm safety and efficacy when approving medical devices with digital technologies, such as big data and AI, medical devices designated as rare or urgently needed for introduction, and medical devices made using 3D printers.

Also, digital healthcare solution companies such as VUNO, Lunit, and Coreline Soft are collaborating with hospitals to implement their AI-based technologies for analyzing medical images faster and predicting disease risks.

Still slow progress in telemedicine adoption

Despite this high level of digitalization of health information systems and the implementation of robotic surgeries, Korea is still dragging its feet on telehealth.

According to Newsweek’s ranking of the World’s Best Smart Hospitals, 13 Korean hospitals appear, tieing for seventh place with Japan. The list ranks 300 hospitals according to their use of AI, digital imaging, telemedicine, robotics, and electronic functionalities.

Among Korean hospitals, Samsung Medical Center ranked highest coming in at 30th place, standing out in the AI category, followed by Seoul National University Hospital and Asan Medical Center in 58 and 59th place respectively. Others who made the list also included Gangnam Severance Hospital, SNUBH, and more.

However, it can be argued that telemedicine is dragging Korean hospitals further down this list as telemedicine is still in the pilot project phase. This is also affecting the use of decentralized clinical trials (DCT) in the country, thus slowing the approval of some digital therapeutics (DTx) devices.