Introduction
The health sector of the UAE initially used to be an eyesore. Most people relied on traditional medicine and conventional treatments. High class of society was able to go abroad for better treatment. After the discovery of oil sources UAE since then has had a drastic turn over. In 2009 MoH (UAE Ministry of Health) has launched a national project to focus on hospital information system in UAE, and this system is to be implemented over the span of three years. The main purpose of the project is to put more focus on the quality of health care by enhancing through a centralized new system for health care centers and public hospitals and providing direct access to important information for public health. So will this system will be as much beneficial as it seems to be before its implementation?
Experts
Khailfa bin zaid Al nahyan
Al Nahyan is the president of the UAE, he played a vital role for improvement of health care in UAE. It was his vision that MoH was given such budget and thought to move forward.
Dr Mohammad Al-Redha
He is an Acting Chief Operating Officer at Rashid Hospital and worked hard to implement the new advanced E-health care system in UAE.
Humaid Mohamed Al Qutami,
Qutami is minister of education in UAE and played great roll for technological advancement in UAE. He supported this project by contacting world best consultancy and technology companies to work for this advance healthcare system.
This project is a part of new strategy by MoH, it started in the beginning of year 2009 and includes multiple steps to make a financial and technical health care system, revolutionize administration, building a database for scientific evidence and health information, development of an E-health information system and linking all local and federal health divisions, and implementation of advanced medical data system in health care institutions. His Excellency Humaid Mohamed Al Qutami, during the signing of implementation contract said that this is pioneering project as it is the first national and centralized system in the Middle East and this project is fully equipped with the most advanced health care systems of the world. This project will set a new standards for our nation. MoH has named this project as Wareed, which is an electronic initiative designed for enhancement of external and internal care for public healthcare sector in Dubai and Northern Emirates. This project will integrate around 15 public hospitals and around 68 affiliate clinics in the country with a single and centralized platform that will use to manage patient information and it will deliver a full spectrum of healthcare services as per global best practices.
The project will be completed in 3 years with as first 2 hospitals were scheduled to live by mid-2009. After this on an average every three months two more hospitals with the affiliated care centers were attached to the system. 15 hospitals and 68 affiliated health care clinics were planned to utilize this system by the end of 2011. His Excellency explained about Project 'Wareed' that this project is based on an advanced technological platform which will virtually link public health care establishments in six emirates and automate all of the healthcare processes pathology, radiology, surgery, pharmacy, registration and emergency departments, supported through network infrastructure and high-end data centers.
The main objective of Wareed is to advance health care facilities and increase public's trust in health care organizations, and to provide modern health care services to public across UAE. UAE government supported this project as part of its policy to enhance the quality and improve interaction of health care that patients receive at hospitals. It is also considered as a step forward for a positive change which will dramatically increase access to accurate, vital and critical health care information of patients by medical personnel, physicians and health care administrators, this will in all minimize potential risks. Al Qutami said that Wareed is another testament of the commitment by UAE government to provide residents with best of public sector services which will improve and enhance their lifestyles. He also concluded that MoH are confident about this investment as it will quickly bring multiple tangible benefits to residents of UAE and will help in meeting end-users demand for more efficient health care sector, this will improve the UAE global image as a country which cares for its residents and citizens. As physicians will gain faster and unfettered access to patient’s medical records, Wareed will help in improving in-patient and out-patient care and acting as a barrier against risk of medication errors. It will improve confidence levels for overall efficiency and quality of public healthcare system. His Excellency put a light on the effective cooperation of MoH which helped in completing the initial study of the project, and efforts by Dubai Healthcare City for supporting studies and research of MoH database. This initiative, which is complemented by Abu Dhabi-government led an initiative which rolled out in August 2009, will eventually help in healthcare access throughout the UAE. MoH assigned this project to a Dubai-based solution providers and project management company HHS (Hybrid Health Solutions) for the management of this project. This project will be implemented by an internationally renowned technology providers for healthcare system and led by leading consultancy and systems integration Company iCapital.
Impacts of ‘Wareed’
Growth in population and changing lifestyle are creating many new challenges for UAE health care industry. In last couple of years an increasing health care concerns with great consequence to the government at federal and emirate level evolved, as well this situation requires more participation from private sector. This project initiates new opportunities for private sector and the government sector with the direct provision for health care services in rapidly increasing health care segment.
Doctors will definitely be capable to retrieve patients' medical reports with click of the mouse as a latest electronic storing system is spread across Dubai. Approximately eighty percent of United Arab Emirate's hospitals - both private and public - are on the way to shifting patients' paper records to the electronic files system, conferring to a latest survey conducted by the Dubai Health Authority (DHA). "For the physicians, it signifies cleaner data, quicker service, an enhanced secured information which improved health quality," stated by Dr Mohammad Al-Redha, the substitute director of Information Analysis and Health Data Department at Dubai Health Authority. "We have files within a single click of the fingers, as not in favor of sending anyone into the warehouse to retrieve them. Using paper files, there is a bigger risk too of being lost."
Given the advantages of using the electronic system, not a single hospital would be able to continue using manual road, added up the doctor. Parallel systems have also been adopted in the US and Europe and with changing in degrees for success. In order to shift from the paper-based storing system to the electronic system, hospitals must achieve eight-stage procedure as per Management Systems and Healthcare Information Electronic Record access Model. A sum of twenty three hospitals were inspected to observe how long they were under this procedure. Of those, forty percent were discovered to be on stage one, along with a further thirty percent had shifted on to second stage. Few less than ten percent were at the stage three and stage four - the best level achieved so far. To perform fourth stage, all doctors' orders and prescriptions must be entered electronically. The rests were still managing under the manual system, positioning them at initial stage. Although facilities of health care are illegally obliged to shift to the 'paper-free' workstation, the viewpoint is promising. Stated by Dr Al Redha "I am not saying I am fully satisfied, whereas I am pleased to have platform now. It is the primary Objective. It is just not to achieve the sixth level or seventh level straight away – in fact it is much more about having to know where we stay."
In January 2012, in favor of introduction of the electronic system, they declared that all insurance claims for health will then be treated online. John Hoyt, a HIMSS Analytics, stated, "Information systems installed within hospitals have tremendous ability to improve efficiency, safety and quality leading to the decrease in treatment errors, decrease in execution time, increase in satisfaction for nursing and improves in patient along with his family satisfaction."
A naturally- friendly step, while an exact quantity of paper and paper material that will ultimately be avoided cannot be calculated, it must be vast. Stated Dr Al Redha "It is directly related to number of patients all hospitals have, but I must say each patient file has minimum ten pages." While environmental concerns are important, Dr. Al Redha added a main emphasis is to formulate a more effective and well-organized service and finally link every medical center and hospital around emirate with the single network. The Dubai Health Authority hospitals group, at present share information rather when it approaches to other hospitals, like New Medical Centre and the American Hospital in Dubai, we don't allow - but it will. MoH is determined about electronic system within Dubai.
Some healthcare workers and doctors have questioned the worth of the system, and conveyed concerns about working hours consumed to feed data into the system. Dr. Biniam Tesfayohannes, an emergency medicine consultant and Mafraq Hospital's chairman, stated there was not any need of such a time-consuming and extensive system. "If the intention is injuries and accidents prevention, we just aware of a tip of the iceberg, and is mortality rate," stated Dr Tesfayohannes. "Prevention happens every time - we do not require collecting data to avoid prevention because we know before." He told once the system of healthcare matured, the further step should be much improved detail collection for further help in reducing burden. "The information can easily be retrieved." Dr. Tesfayohannes stated. "We understand the burden of work in Emirates. They are falls and road accidents.
"If we overcome this issue, then we are aligned at reducing burden by minimum to fifty percent. And then in the end this fine-tuned data collection can become certainly important." According to fatalities in workplace, every year after 2007, we recorded 93.6 occupational fatalities on average. Previous year, 71 deaths were recorded on worksites whereas12 were recorded as the result of road accidents, which is just single drop of around Twenty percent from the year 2010. What could be the major source of these recorded fatal injuries? We have come to know that over few years, about fifty percent are from falling objects and falls.
Organization
The MoH (Ministry at Health) is responsible for operating public health care facilities and regulating the health care sector. The majority of medical care centers in UAE are public institutions. The MoH consists of a significant portion of emirate’s health care system. However, like many forms of policy making in the UAE, health care policy is largely determined at local level, The MoH receives input from local government for health policies, many local MoH employees are hired from the emirate. The system at MoH is comprises of general hospitals, PHCs (primary health centers), specialty hospitals, pediatric, maternity and school health care centers and it also provide support to pharmacies. All hospitals and clinics operating in UAE are required to be certified by MoH, whether they are form private or public sector.
Private Sector
For much of UAE history, public health organizations were the only source for medical treatment. This is now changing, in the recent years as private medical centers began to enter into the UAE market and playing their role for the health care industry. The growing private medical care industry and MoH have shown collaboration in most part of health care facilities. While private health care is expanding in the UAE the public health care facilities are also on the rise to facilitate the process of new hospitals for public. In late 2009 the president of the UAE, AI Nahyan called for the establishment of FHA (Federal Health Authority). Sheilh Khalifa reversed this decision and bind it with a law in February 2012. The decision was taken as MoH board advised that administrative resources and funds would be directed towards facilitating supplying medicines, public hospital services and upgrading technical medical and staff qualifications rather than creating a new organizational network. Reports in early 2011 shows that the khalifa have relieved MoH for the responsibility for functioning of substantial hospitals public sector clinics all over the UAE.
Statistics and Data
There is the deficiency of quality of locally available data on poisonings and injuries in the UAE, stated Dr. Thomsen. Certain data on deadly injuries however there is a considerable data gap regarding non-fatal poisoning and injuries cases. This available data will make us enable to research and to evaluate more in detail limited epidemiology of wounds. According to the WHO (World Health Organization) the health care system in UAE is ranked as the 27th best health care system in the world. In early 2012, the MoH was managing around 15 public hospitals and 64 public health centers and employing over 1000 local nurses and over 400 doctors in addition to health care professionals from abroad, according to data released in February 2012, Health care spending in UAE is indicative of the increasing costs and demands placed on the system. Expenditures of MoH were estimated to $10.2bn in 2011 and were projected to reach $16.bn by 2015. Health care expenses were forecast to reach 2.9 percent of GDP in 2011. The GCC average for same year was 3.1 percent. Per head Health care spending in the UAE was $1451 in 2011 as compared to the GCC average of $709. According to data provided by a Hospital in Ras Al Kaimah in the UAE, the Intelligence Unit Average life expectancy was projected 76.5 years in 2011.
Conclusion
Health care is main priority for the government in UAE and a commitment to the sector is clearly stated in 2012 budget. The federal government have increased budget for the MoH by a third from $626.1m in 2011 to $816.6m in 2012, according to recent information published in Khaleej Times. The MoH and the MoPW (Ministry of Public Works) are working together to direct funding towards the improvement and maintenance of government hospitals across UAE, the planned upgrade of Saqr Hospital roughly 40 percent had been completed by start of 2012. This process includes scheduled maintenance such as updating ultrasound and x-ray machines, construction of parking area for patients and visitors is also completed to reduce congestion in the facilities.
The Poisoning and Injury Notification System, which is fully operating by this January, has plug the gap between statistics of injury-related fatalities, those are known to doctors, and such injuries, for which less information is available. The data will help in the development of precautionary measures by identifying when and where accidents happen, and most risky person. A report for last year using data from system showed that almost two-thirds of deaths in case of injuries in Abu Dhabi were due to road accidents. About 340 of 537 injury-related deaths occurred by crashes, while sixty-six deaths were due to falls or some falling objects. Last year Injuries were second leading cause of death in the UAE. The report also mention that around 130,000 people visited hospitals in emergency across the UAE last year, 12,000 of them were admitted to health care centers, 1 of 22 admissions in trauma hospital resulted in death. These figures clearly notify the need for more advance and risk free system.
References
Group, O. B. (2011). The Report: Abu Dhabi 2011. Oxford Business Group.
Group, O. B. (2012). The Report: Ras Al Kaimah 2012. Oxford Business Group.
Hassani, Z. A. (2012, Feb 14). electronic-hospital-records-system-rolled-out-across-dubai. Retrieved from http://www.thenational.ae: http://www.thenational.ae/news/uae-news/electronic-hospital-records-system-rolled-out-across-dubai
Hassani, Z. A. (2012, Octuber 24). new-system-to-track-injuries-and-deaths-in-abu-dhabi-hospitals. Retrieved from http://www.thenational.ae: http://www.thenational.ae/news/uae-news/health/new-system-to-track-injuries-and-deaths-in-abu-dhabi-hospitals
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