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The Role of the Saudi Government in the National Health Information Infrastructure NHII

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... advances in basic computer science and informatics research ... At the same time, the development of new information systems is a costly and risky activity ... – PowerPoint PPT presentation

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Title: The Role of the Saudi Government in the National Health Information Infrastructure NHII


1
The Role of the Saudi Government in the National
Health Information Infrastructure (NHII)
  • Mohammed R. Alyemeni, DrPH
  • King Saud University
  • mohammed_at_alyemeni.com

2
What is the NHII?
  • Its an effort (initiative) to improve the
    effectiveness, efficiency and overall quality of
    health and healthcare in the country
  • A comprehensive knowledge-based network of
    interoperable systems of
  • Clinical
  • Public health
  • Personal health information
  • To improve decision-making by making health
    information available when and where it is needed

3
What is the NHII?
  • Technologies
  • Standards
  • Applications
  • Systems
  • Values
  • Laws
  • Support all facets of individual health,
    healthcare, and public health
  • Conceptually A collection of healthcare delivery
    providers that share patient-level information
    electronically

4
Why Do We Need NHII?
  • Breakthroughs in basic biomedical sciences,
    including
  • Human genomics
  • Stem cell biology
  • Biomedical engineering
  • Molecular biology
  • Immunology
  • Provided an unprecedented supply of information
    for improving human health

5
Why Do We Need NHII?
  • The explosion in biomedical knowledge is
    accelerating
  • At the current rate of publication, a person who
    finishes school knowing everything, and reads two
    articles every night, becomes 1,225 years behind
    at the end of the first year
  • Scientific approach to the effective use of
    information in biomedical and health disciplines

6
Why Do We Need NHII?
  • Decisions based on evidence from the literature
  • IT training and use are important for doctors and
    other healthcare professionals as, increasingly,
    evidence-based medicine is being practiced from
    information obtained from the Internet
  • NHII would allow all patients, healthcare
    providers, and those interested in population
    health to have access to comprehensive electronic
    health records

7
An Idea Whose Time Has Come
  • Significant improvements in the quality and
    efficiency of healthcare are achievable if
    physicians and other providers are supported with
    readily accessible information about their
    patients and the most current medical knowledge
    through the NHII

8
An Idea Whose Time Has Come
  • The availability of information alone is not
    sufficient it must be in a form that allows
    clinicians to interact with it easily and
    efficiently in their day-to-day practice

9
An Idea Whose Time Has Come
  • While the NHII concept is not novel, recent
    developments in IT and successful demonstrations
    of community-wide health information exchange
    clearly indicate that it is now both feasible and
    realistic
  • The continued improvement in the
    price/performance ratio of computer systems

10
An Idea Whose Time Has Come
  • The transition of the Internet from a largely
    academic communications network to a nearly
    ubiquitous utility used daily by millions
  • The growing sophistication of clinical
    information systems have all helped to transform
    NHII from an appealing but far-distant prospect
    to a near-term achievable goal

11
The Status Quo
  • Development of IT solutions involves a
    substantial investment of resources
  • Regrettably, the entire healthcare industry
    continues to invest significantly less in IT than
    any other information intensive industry
  • Healthcare agencies in Saudi Arabia are no
    exception

12
The Status Quo
  • Since progress in developing IT solutions is
    likely to improve system efficiency and patient
    outcomes
  • By reducing medical error rates
  • More rapidly displaying critical information
  • Offering clinicians evidence-based decision
    support
  • It is imperative to provide financial incentives
    to invest in such technology

13
The Status Quo
  • The potential application and benefits of a more
    connected global community via IT
  • WTO and SA how will healthcare be structured in
    5 to 10 years?
  • IT and communication via the Internet is a
    fundamental commodity inherent in the delivery of
    healthcare now and in the future

14
The Role of SA Government
  • The Saudi government should play a more active
    leadership role in educating the medical
    community and in coordinating and encouraging a
    more rapid and effective implementation of
    clinically relevant applications of wide-area
    networking

15
Critical Areas for SA Government to Play a Vital
Role
  • Developing standards
  • Providing funding for research and development
  • Ensuring the equitable distribution of resources,
    particularly to places and people considered by
    private sector to provide low opportunities for
    profit
  • Protecting rights of privacy, intellectual
    property, and security

16
Standards
  • Standards ensure consistency, integration, and
    accuracy, yet standards for data entry, database
    management, and other processes vary among care
    providers, health insurers, and other members of
    the health sector
  • Standardization in other industries has
    facilitated vast savings through process
    improvement, and IT has been an integral part of
    this transformation

17
Standards
  • This same revolution has yet to happen in
    healthcare, and the lack of strong interfaces and
    unified systems significantly complicates
    research and clinical decision support
  • information systems with very different user
    interfaces may exchange information with each
    other if they capture data with the same
    terminology i.e., standards are the middle ground

18
Standards
  • It is therefore, imperative to develop national
    Saudi standards, and it is the proposal of this
    researcher to develop a National Health
    Information Infrastructure to coordinate and
    integrate systems, technologies, and tools on a
    national level to support the best possible
    health decision making

19
Standards
  • Under the Saudi government leadership, this
    infrastructure would be supported by
    telecommunications technology that allows
    different information systems to interact via the
    Internet

20
Standards
  • It is easier to grasp the scope of the NHII if it
    is seen in terms of building blocks layered over
    time
  • The early building blocks can leverage current
    technology and know-how later ones will require
    advances in basic computer science and
    informatics research

21
Standards
  • The pragmatic steps, which can be taken
    immediately to accelerate the building of the
    NHII, deal with policy and governance issues as
    well as standardization and data interchange
    approaches
  • Standards are an important building block for
    achieving the required comprehensive and
    integrated health information infrastructure

22
Standards
  • One of the priority areas for national action is
    accelerating standards development
  • For many years, in the experience of other
    countries, the absence of universal and efficient
    standards for managing and exchanging health
    information has been identified as a key barrier
    in developing the national health information
    infrastructure

23
Standards
  • This vision should facilitate the capture and
    exchange of standardized health data, as well as
    its translation into information, knowledge and
    wisdom

24
Standards
  • Incompatibilities amongst data, communications
    and technology structures abound
  • Data collected at different times, by different
    practitioners or organizations, are frequently
    difficult to interpret, compare and exchange

25
Standards
  • At the same time, the development of new
    information systems is a costly and risky
    activity
  • Although new technologies offer many promises,
    the rapid evolution of information technology
    increases the risks associated with their adoption

26
Standards
  • The application of information technology to
    healthcare is still in its youth
  • Although much has been learned over the years,
    there are still many lessons to be learned about
    how and when a computer-based intervention is
    most likely to be successful
  • The scope of harms and benefits to be anticipated
    when information technology is implemented has
    not been well catalogued

27
Standards
  • Many of these issues can be reduced or resolved
    through the implementation of consensus standards
  • As in other industries, health informatics
    standards have the potential to increase the
    quality and lower the costs and risks of
    developing, purchasing and managing health
    information and information technology

28
Standards
  • To date, standards development efforts have
    focused on messaging standards and terminologies
  • Messaging standards provide a standard format for
    exchange of a transaction, such as an order,
    among systems
  • Terminology standards provide a standard
    vocabulary for representing a concept, such as a
    specific orderable item, for use across systems

29
Standards
  • To meet the objectives of the proposed NHII,
    Saudi Arabia will need additional standards,
    including ones dealing with authentication and
    security, healthcare delivery processes,
    representations of medical knowledge that are
    interpretable by a computer, and interfaces to
    software components

30
Standards
  • Spreading a technology before the standards are
    established could lead to advances that do not
    achieve the full benefits for society that might
    otherwise be attained
  • Waiting is equally unacceptable

31
Standards
  • A transformation of healthcare can occur if the
    country establishes minimum standards for the
    generation, capture, manipulation, and exchange
    of health-related information and the governance
    and informatics tools to support their evolution

32
NHII Prospective
  • Properly executed, such a comprehensive,
    knowledge-based network could be the key to
    engaging patients in their care, providing care
    when and where needed, supporting processes that
    avoid error, and reducing administrative cost

33
NHII Prospective
  • A National Health Information Infrastructure, in
    practice, will serve more as an enabler that
    facilitates the convergence of information with
    security and privacy, rather than an information
    system in itself, or even a federation of
    information systems

34
Conclusion
  • Saudi Arabia is at a decisive point in its
    investment in healthcare delivery and the
    nation's health. The scientific revolutions in
    biology, chemistry, and physics during the past
    century, combined with the more recent
    substantial increase in national budget and the
    movement toward privatization, now combine to set
    the stage for a dramatic alleviation of human
    suffering from disease

35
Conclusion
  • The goal, an improved healthcare system resting
    on an information and communication
    infrastructure, is achievable
  • Saudi Arabia will not reach this goal by
    maintaining the status quo
  • Action is necessary at all levels, by MOH and all
    other agencies that fund healthcare delivery

36
Conclusion
  • The complexity of the task of implementing
    infrastructure increases as the scope changes
    from organization, to region, to country
  • Accordingly, approaches that work in one
    organization are unlikely to work for the country
    as a whole

37
Conclusion
  • The NHII (initiative) should focus on a few
    critical items, such as establishing key
    standards and healthcare policies, which must be
    done on a national scale to make it easier to
    exchange information among regions and
    organizations
  • In parallel, regional- and organization-based
    efforts to share information across the care
    continuum need to begin seriously

38
Conclusion
  • Best practices and successes need to be
    reproduced
  • If successful organizational and regional
    undertakings are aligned with national strategy,
    the collective efforts will incrementally build
    toward an effective healthcare information and
    communication infrastructure

39
Closing
  • The NHII has the potential to transform
    healthcare in Saudi Arabia improving healthcare
    quality, reducing healthcare costs, preventing
    medical errors, improving administrative
    efficiencies, reducing paperwork, and increasing
    access to affordable healthcare

40
Closing
  • The same infrastructure that facilitates
    improved patient care can also be used to provide
    the information needed for earlier detection of
    bioterrorism and other adverse health events
    e.g., SARS and Avian Influenza

41
Closing
  • The current practice of medicine . . .depends
    upon the decision-making capacity and reliability
    of autonomous individual practitioners, for
    classes of problems that routinely exceed the
    bounds of unaided human cognition.
  • -Daniel R. Masys
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