March 06 2012
National Health Framework: The UAE Vision
Part I The Current Environment
The Ministry of Health (MoH) in the United Arab Emirates (UAE) sponsored an eHealth Strategy to enable them to achieve their mission of providing efficient, world class health care that is accessible to all people through a mixture of public and private delivery channels. The scope of this strategy encompasses all the elements of the Ministry's business processes in Defining Policy, Regulatory Affairs and Service Delivery. Achieving these goals requires that the MoH is able to interact with internal and external organisations, processes and technologies in an open and flexible manner. To gather information and deliver it to policy makers, care providers and the general population in a concise and timely manner, whilst being supported rather than constrained by technology. As Cerner's CRE on this programme, I was asked by the Undersecretary of Health to help define an Enterprise Architecture, the initial results of which were delivered in a paper presented at the Sheik Hamdan University eHealth Conference in January 2012.
I wanted to share some of what we did, though some of the technical activities, such as choice of Architecture, have been omitted for brevity, they are available in the paper. It has been split into three parts.
The health care sector in the UAE is a child of the history of the development of the UAE over the last 40 years from a union of seven separate Emirates to a federation which has a major role as a regional model for the development in the Middle East. The Federal Ministry of Health regulates health care providers and sets strategy and policy for the sector as a whole; The Health Authority of Abu Dhabi is the regulatory and policy body and SEHA is the principal provider of acute and primary care services to the population of Emirate of Abu Dhabi; Dubai Health Authority is the principal provider of acute and primary care services to the population of the Emirate of Dubai; The Ministry of Health is also the principal provider of acute and primary care services to the population of the Northern Emirates (Sharjah, Ajman, Fujeirah, Ras Al Khaimah, Umm Al Quwain), in addition to managing two hospitals and a number of primary health care centers in Dubai; Dubai Health care City (DHCC) the world's first health care free zone; The Army Directorate of Medical Service which provides health care services to the military personnel and their direct family members; and the Private Sector which provides acute and/or primary care services.
In their strategy, the Ministry defined eHealth as “the use of information and communication technology to share health information and enhance the delivery of health care services.” It includes a range of services, products and tools to support various groups, including patients, clinicians, researchers, managers, administrators and policy makers. This definition spans all aspects of the Ministry of Health's remit, and tools are used to varying degrees by the health care providers in the UAE, mainly for sharing information within their organizations. However there is currently little exploitation of technology to share information between organizations or provide information to patients and the general public.
Caption: Phases of eHealth adoption
The current infrastructure suffers from reliability issues and has very limited capacity to exchange some types of clinical information, such as diagnostic images. In addition clinical and support staff in the health care sector have highly variable IT literacy and competency. Consequently, clinical information is often not available to health care professionals at the point of care, there is limited information available to epidemiologists, researchers, managers and policy makers and opportunities to deliver health information and advice to patients and the public are being missed. The push within the MoH is for automation and aggregation to achieve the benefits that CPOE and data aggregation provide, a number of enablers support MoH's efforts to improve the eHealth environment in the UAE such as the Federal Government drive to e-enable services in the UAE; the launch of the national health strategy for 2011-2013.
Cerner Millennium is currently being used in the Northern Emirates and SEHA as the complete HIS system for Hospitals and Primary Health care, with this and other initiatives, the vision for eHealth promises to provide an environment where patients can quickly and easily access locally-tailored general health information and advice; Manage their care (e.g. book health care appointments and visits); and, view their own care record. Clinicians in any care setting within the UAE will be able to view summary clinical information; get the results of clinical investigations; order clinical investigations and prescriptions electronically; and quickly see more detailed clinical information for a patient in their care.
Jim has been involved at the forefront of the IT sector since graduating in Pure Physics in 1979, initially working in systems development where he has a number of worldwide patents to his name. Since 1985 he has delivered professional services in many locations around the world, specialising in consultancy and business development for healthcare, banking, government, and retail. He has worked in the Middle East and Africa since 2000 for IBM and its business partners before being appointed Client Results Executive at Cerner Middle East in 2011. Since then he has worked closely with the Ministry of Health in the UAE on the implementation of the Wareed project and the future direction for helping deliver the MoH's vision for health care in the UAE.