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by Akram Sami Dhaini | Ahmad Yahya
Published on November 23, 2017

Older health IT systems are synonymous with the "do more and charge more" model of reimbursement, especially since healthcare is a supply-driven market. 

Buying new technology isn't the solution if it's put into an old business model. Rather, new technologies need to go hand in hand with agile, new processes, policies, guiding principles and proven approaches.

HIMSS Middle East speaks to Akram Sami Dhaini, Senior Client Results Executive, Cerner Middle East and Ahmad Yahya, Chief Information Officer, UAE Medical Services Corps. Find out how the UAE Medical Services Corps and Cerner are transforming old business models and achieving the vision of One Patient, One Record together.

How do you see the role of IT in supporting the ever-changing landscape for new care and payment models?

Yahya: Health care in the Middle East has been undergoing massive changes with the goal of transforming delivery models. Hospitals started moving from traditional general, secondary and tertiary hospitals to facilities focused on centers of excellence, where specialized programs supplied exceptionally high concentrations of expertise and related resources centered on specific medical areas delivering care in a comprehensive and interdisciplinary fashion. The move to clinical service lines was also embraced where integrated specific bundles of services across multiple operating units of a health care system was developed.

Payment models have also been transforming to insurance-based. These new care and payment models required long planning and development and optimized cycles with cost and complexity. In addition, regulatory authorities have taken more responsibility in regulating the sector, which resulted in various public policy changes, technology advances and collaboration.

To meet these changes, organizations needed to be flexible and agile, which meant leadership and employees needed to think and act like owners and promote out-of-the box approaches and innovation to be competitive. IT has been at the heart of this transformation, growth and modernization of the health care sector. IT has been transformed from being a back-office function to a key driver and backbone in supporting business operations, health care workers and their patients.

In the context of care delivery models, technology has been key in improving patient safety, improving quality of care and improving efficiencies. Proper implementation of IT fundamentals with change management can transform the benefits provided by technology into tangible improvements to patient care and organizational efficiencies. Clinical decision support (CDS) has repeatedly demonstrated its worth.

What are the keys to success of an electronic health record deployment?

Yahya: Success and realized benefits of deploying an electronic health record (EHR) can be oversold if the approach, expectations and potential benefits are not made clear to the stakeholders. It’s critical to capture value metrics, before and after implementation, to support the benefits realization efforts. EHR implementations are complex, and success depends on having a proper EHR strategy, governance and implementation roadmap with solid cross functional teamwork.

The benefits of EHRs in the GCC can vary from private to government based facilities, where the private sector is more financially driven while government-sponsored hospitals tend to be quality-driven. Adoption of clinical workflows and CDS systems must be an integral part of the implementation, and the effectiveness of system usage depends on how quickly clinicians get to the information they need and make the right decisions for the patient.

Workflow optimization, CDS and training go well beyond the implementation phase and should become a steady state focus in the organization — especially with the turnover and transient nature of staff in the Middle East, coupled with the system developments that are likely to take place.

How can IT succeed in ensuring alignment with the continuous changes of policies, operating models and directions in the health care industry?

Yahya: Older health IT systems are synonymous of the “do more and charge more” model of reimbursement, particularly given that health care is a supply-driven market. Therefore, buying new technology isn’t the solution if it’s put into an old business model. Rather, new technologies need to go hand in hand with agile, new processes, policies, guiding principles and proven approaches.

Organizations who optimize their approaches for a more agile model will prevail and IT is at the heart — allowing organizations to accelerate, implement and drive change with new platforms, application programming interfaces, and interoperability. With these IT systems, organizations are moving to a data-driven health care ecosystem focusing on improvements and cost reductions, but success depends on top executive commitment and strong information governance.

The realization of the benefits of data goes with the science of informatics where integration of clinical sciences, computer and information science come into play to manage and communicate data, information and knowledge in clinical practices. Priorities of data analysis and business intelligence have been mainly for financial performance, patient safety, outcomes and health care policy changes.

How can technology be a key driver for growth and modernization of the health care sector?

Dhaini: The Gulf Cooperation Council (GCC) health care sector has grown tremendously in recent years, with huge investments in people, buildings, equipment and technology. Hundreds of hospitals have been built and transformed with the goal of providing better health care outcomes to its citizens. At Cerner, we believe that the usage of integrated systems, with structured workflows and CDS systems centered around the patient, is key to efficient operations and enhanced clinical outcomes. The GCC, especially Saudi Arabia, United Arab Emirates and Qatar, have embraced this notion and embarked on utilizing technology to achieve their critical and strategic goals in optimizing health care delivery.

An effective and rich hospital information system should be at the core of hospital operations for the successful delivery of patient care and enhanced health care outcomes. Clinicians who embrace and adopt these systems and information for health care delivery can prevent adverse drug interactions, allow for faster recovery and use data for epidemiological and research purposes. CDS systems are at the heart of improving patient care with a multidisciplinary approach and proactive leadership to drive positive change.

What is the 2021 Vision in the UAE, and how is Cerner working with leading health care organizations to achieve this vision?

Dhaini: The UAE leadership’s vision aims to achieve a world-class health care system that will provide the best health care services to its citizens and residents. To achieve this, the UAE believes in having complete medical histories extended across health care facilities no matter where the patients are, resulting in better outcomes. Cerner plays a vital role in leveraging IT to help facilitate coordinated care, reduce duplicative treatments and avoid costly mistakes.

As the UAE implements its Vision 2021, Cerner continues to work with our clients to deliver better and safer care by engaging patients with their health information, providing caregivers with CDS tools for effective treatment and eliminating unnecessary paperwork.

Having a nationwide near real-time patient-centric records solution will help streamline efforts and improve care. The National Unified Medical Record (NUMR) project was recently announced to achieve this. The NUMR project is bringing public and private sector stakeholders together to realize the ambitious goals of the Vision 2021. The Ministry of Health & Prevention of the UAE is leading Abu Dhabi Health Services Company, Dubai Health Authority, private health care organizations, telecommunication providers and health care information suppliers in an effort to establish a shared medical record platform across the UAE. This will achieve the centralization of essential data and analytics for all UAE consumers of health information.

Cerner has made its footprint in the GCC and UAE specifically with investments, people and support, making it among the leading enterprise vendors in the market. The majority of government-based hospitals in the UAE have adopted the Cerner Millennium® EHR with a vision of having a single patient record.

Achieving the UAE’s 2021 Vision will require reliable infrastructure, the foundation EHR, data and analytics and an exchange platform. These are all components that Cerner offers and has successfully implemented in other markets.